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Developmental and Psychological Concerns in Children With Complex Congenital Heart Disease: The Need for a Screening
Ashani Mahawattege1, Karina Laohachai1
1Women's and Children's Hospital, Adelaide, Australia.
Insights
Children with complex congenital heart disease (CHD) show higher rates of developmental and psychological concerns than the general population. Routine screening is crucial as many affected children lack necessary healthcare engagement.
Area of Science:
- Pediatric Cardiology
- Developmental Pediatrics
- Child Psychology
Background:
- Complex congenital heart disease (CHD) is linked to adverse neurodevelopmental and psychological outcomes.
- Limited Australian data exist on these outcomes and follow-up care for children with complex CHD.
Purpose of the Study:
- To determine the prevalence of developmental and psychological concerns in South Australian children with complex CHD.
- To assess concurrent healthcare utilization for these concerns.
Main Methods:
- Cross-sectional study involving 55 children (3-7 years 11 months) with complex CHD.
- Utilized validated screening tools: Parents' Evaluation of Developmental Status (PEDS), PEDS-Developmental Milestones (PEDS:DM), and Strengths and Difficulties Questionnaire (SDQ).
- Collected demographic, cardiac, comorbidity, and healthcare data via questionnaires and medical records.
Main Results:
- High prevalence of developmental concerns: 57% (PEDS) and 70% (PEDS:DM), significantly exceeding Australian population rates (22%).
- Psychological concerns were prevalent at 28%, higher than Australian population data (10%).
- Nearly half of children with concerns lacked current engagement with relevant healthcare professionals.
Conclusions:
- Screening reveals significantly higher rates of developmental and psychological concerns in children with complex CHD compared to the general Australian population.
- A substantial proportion of children with identified concerns were not actively followed up, highlighting the need for routine screening programs.
Aim:
Complex congenital heart disease (CHD) is associated with adverse neurodevelopmental and psychological outcomes. Limited Australian data exist regarding these outcomes or follow-up. This cross-sectional study aims to determine the prevalence of developmental and psychological concerns in South Australian children with complex CHD and concurrent developmental or psychological healthcare utilisation.
Methods:
Families of children with complex CHD aged between 3 years and 7 years 11 months undertook a series of validated screening questionnaires for development (Parents' Evaluation of Developmental Status [PEDS], Parents' Evaluation of Developmental Status-Developmental Milestones [PEDS:DM]) and mental health (Strengths and Difficulties Questionnaire [SDQ]). Demographic data, cardiac history, comorbidities, and current healthcare engagement was determined through standardised patient information questionnaires and medical records. Rates of developmental and psychological concern were determined and compared to Australian general population data.
Results:
Fifty-five participants enrolled in the study. The most common cardiac diagnoses were Transposition of the Great Arteries (n = 13) and Tetralogy of Fallot (n = 11). Predictive developmental domain/s of concern were highly prevalent utilising both PEDS (57%) and PEDS:DM (70%) screening tools, exceeding Australian population rates (22%). Psychological concern (28%) also exceeded Australian population data (10%). Nearly half of participants identified to have developmental or psychological concern/s had no current general paediatric, allied health or mental health professional engagement.
Conclusions:
Developmental and psychological concerns detected on screening in children with complex CHD significantly exceed Australian general population prevalence rates. Without an established screening program, a large proportion of participants did not have active follow-up, indicating the importance of routine screening.
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