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Published on: July 18, 2014
Peer relationships and social-affective functioning of children with critical congenital heart defects and comparison
Olivia G Ritchey1, Amber T Riggs1,2, Andrea Goard1
1Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States.
Insights
Children with critical congenital heart defects (cCHD) experience more peer relationship difficulties, linked to both social-affective and executive functioning (EF) deficits. Early intervention in social-emotional skills is recommended.
Area of Science:
- Pediatric Cardiology
- Developmental Psychology
- Neuroscience
Background:
- Critical congenital heart defects (cCHD) are associated with increased neurodevelopmental impairment risks.
- Deficits in executive functioning (EF) and social-affective abilities may co-occur in children with cCHD, impacting peer relationships.
- Social difficulties in children with cCHD require detailed description and linkage to specific cognitive or social-affective skills.
Purpose of the Study:
- To compare social-affective abilities, EF, and peer relationship difficulties in children with cCHD versus healthy classmates.
- To determine if social-affective deficits predict peer relationship difficulties independently of EF impairments.
Main Methods:
- A comparative study involving 134 children with cCHD and 92 healthy comparison classmates (CC).
- Utilized multiple assessment methods including child, caregiver, and peer reports.
- Evaluated social-affective abilities, EF, peer interactions, and social adjustment in school and home settings.
Main Results:
- Children with cCHD exhibited greater peer relationship difficulties and deficits in both social-affective skills and EF compared to CC.
- Social-affective skills partially explained peer relationship difficulties in children with cCHD.
- Group differences in social-affective skills remained significant even after accounting for EF.
Conclusions:
- Peer relationship difficulties in cCHD are likely multifactorial, stemming from social-affective and neurocognitive deficits.
- Clinical screening should extend beyond neurocognitive deficits to include social and emotional skills.
- Further longitudinal research is necessary to elucidate causal pathways and identify targets for intervention.
Objective:
Children with critical congenital heart defects (cCHD) have an increased risk of neurodevelopmental impairment. Deficits in executive functioning (EF) and social-affective abilities may co-occur, undermining peer relationships. Social difficulties faced by children with cCHD have not yet been described in detail nor linked to specific cognitive or social-affective skills. This study compares children with cCHD and healthy classmates on these outcomes and examines whether social-affective deficits predict peer relationship difficulties independently of impairment in EF.
Methods:
Children with cCHD (N = 134; Mage =10.2) were compared to healthy comparison classmates (CC; N = 92, Mage =10.0) recruited through schools. Social-affective abilities, EF, peer interactions, and social adjustment were measured using multiple methods, including child, caregiver, and peer reports in school and home settings.
Results:
Children with cCHD had more peer relationship difficulties and deficits in both social-affective skills and EF than CC. Social-affective skills accounted for some, but not all, peer relationship difficulties for children with cCHD. Group differences in social-affective skills, and indirect effects involving those skills, often remained significant when taking EF into account.
Conclusions:
Peer relationship difficulties associated with cCHD likely result from an array of social-affective deficits and neurocognitive deficits. Clinicians might consider screening beyond traditional neurocognitive deficits and refer for early intervention of social and emotional skills. Longitudinal research is needed to clarify causal pathways and identify protective factors that could be targeted by tailored interventions.
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