Connection after correction: Parent-child relationships following early cardiac surgery

Early cardiac surgery for congenital heart disease (CHD) may have enduring effects on the parent-child emotional connection and a child's capacity for regulation. This study explored emotional availability in parent-child interaction following early cardiac surgery in relation to emotional and behavioral regulation in children and identified early predictors. Participants were 23 preschool-aged children with CHD and their parents from a longitudinal cohort assessed at infancy (post-surgery) and preschool age in Australia. Dyadic interaction was assessed using the Emotional Availability Scales (EA), and parents reported on child's emotional and behavioral regulation. Predictors included infant social-emotional functioning, parental attachment feelings and traumatic stress, hospitalization length, timing of diagnosis and duration of contact at birth. Over 50% of dyads demonstrated emotional availability, however 30% were classified as complicated and 12% detached. Greater parental sensitivity was associated with less externalizing behavior. Longer hospitalization was associated with lower child involvement and greater parental intrusiveness. Contact at birth was associated with greater emotional availability and more optimal parental structuring at preschool. Findings highlight the enduring impact of early medical adversity on emotional availability in CHD and illuminate effects on both child and parent. Future research should explore targeted interventions that buffer relational disruptions in medically vulnerable dyads.