Attention and executive functioning in pediatric congenital heart disease: a construct-based approach

Area of Science:

• Neuroscience
• Developmental Psychology
• Pediatric Cardiology

Background:

• Congenital heart disease (CHD) affects neurodevelopment.
• Attention and executive functioning (EF) are crucial for school-age children.
• A construct-based approach can refine understanding of attention/EF in CHD.

Purpose of the Study:

• To characterize the attention and executive functioning (EF) profile in school-age children with CHD.
• To investigate if attention/EF difficulties vary by CHD complexity and neurodevelopmental diagnosis.

Main Methods:

• Retrospective analysis of neuropsychological data from 154 children (aged 6-16) with CHD.
• Exploratory factor analysis to identify attention/EF constructs.
• Comparison of construct scores to normative data and analysis of impairment frequency.

Main Results:

• All attention/EF construct scores were significantly lower than normative means.
• One-third of participants showed exceptionally low performance in processing speed, attention, and impulse control.
• Children with simple CHD exhibited worse impulse control and attention issues compared to those with complex CHD.

Conclusions:

• Children with CHD demonstrate attention/EF deficits across multiple skill areas.
• Findings suggest a neurobehavioral profile in CHD that may not fit traditional diagnostic categories.
• Neurodevelopmental monitoring is crucial for all CHD types, and dimensional diagnostic approaches are warranted.