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Implications of attention and executive functioning weaknesses in youth with Fontan circulation

Yasmine R Jassal1,2, Sarah Kelly1,2, Michael DiMaria1,2

  • 1Department of Pediatrics, Children's Hospital Colorado, Aurora, CO, USA.

Child Neuropsychology : a Journal on Normal and Abnormal Development in Childhood and Adolescence
|September 9, 2022
PubMed

Insights

Youth with Fontan circulation face attention and executive functioning (EF) challenges. Early neuropsychological evaluation is vital for improving neurobehavioral and functional outcomes throughout life.

Area of Science:

  • Neuroscience
  • Pediatric Cardiology
  • Developmental Psychology

Background:

  • Youth with Fontan circulation are susceptible to neurodevelopmental challenges.
  • Risk factors include genetic, prenatal, surgical, and medical complexities.
  • Attention and executive functioning (EF) are commonly affected domains.

Purpose of the Study:

  • To characterize attention and EF in youth with Fontan circulation.
  • To investigate the relationship between attention/EF deficits and other neurobehavioral outcomes.
  • To examine impacts on adaptive behavior and academic achievement.

Main Methods:

  • Utilized standardized performance-based tests and caregiver rating scales.
  • Evaluated 93 youth with Fontan circulation undergoing neuropsychological assessments.
  • Analyzed relationships between attention/EF, adaptive behavior, academic achievement, and mental health.

Main Results:

  • The cohort demonstrated significant deficits (0.18-0.99 SD below norms) in attention, EF, academic achievement, and intellectual ability.
  • Caregiver reports indicated elevated concerns (0.35-0.85 SD above norms) for attention, EF, anxiety, and depression.
  • Adaptive behavior was significantly impaired (0.93-1.24 SD below norms).
  • Demographic and attention/EF variables influenced academic outcomes.
  • Depression and caregiver-reported EF predicted adaptive behavior.

Conclusions:

  • Routine neuropsychological evaluation is crucial for comprehensive Fontan care.
  • Early identification and intervention can enhance neurobehavioral and functional outcomes.
  • Multidisciplinary care is essential for optimizing lifelong well-being in this population.

Keywords:
Congenital heart diseaseFontanexecutive functioningpediatric neuropsychologysingle ventricle

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