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Enhancing School Readiness for Children with Critical Congenital Heart Disease: Insights and Strategies for Health Care Clinicians

Enhancing School Readiness for Children with Critical Congenital Heart Disease: Insights and Strategies for Health Care Clinicians 1024 664 Erin Gregory

A recent publication in Pediatric Cardiology explores the complexities of school readiness among children with critical congenital heart disease (CCHD) compared to their peers. The study hypothesizes that children with CCHD will face more significant difficulties in school readiness, linked to specific medical risk factors associated with their condition.

Identifying Barriers to Progress

The study, led by Hudson Taylor, PhD, principal investigator in the Center for Biobehavioral Health at Nationwide Children’s Hospital, and conducted in collaboration with Carl Backes, MD, PhD, a neonatologist and cardiologist at Nationwide Children’s Hospital and a principal investigator in the Center for Perinatal Research, highlights the challenges faced by children with more severe forms of congenital heart disease.

“Children with more severe forms of congenital heart disease are at risk for having developmental problems at school age,” says Dr. Taylor. “We wanted to identify specific medical risk factors that may contribute.”

Children with CCHD face significant challenges due to cognitive impairments, motor skills deficits, and higher rates of social and behavioral problems, which affect their academic performance and peer interactions. These difficulties are exacerbated by medical risk factors such as co-morbid genetic disorders, postnatal CCHD diagnosis, major perioperative complications, and prolonged hospital stays, highlighting the complex impact of CCHD on a child’s development.

Addressing the Challenges

The study included 60 children with CCHD and 60 community control (CC) children, aged 4 to 5 years, who were not yet attending kindergarten. “Assessments were conducted to describe their readiness skills, examine individual differences in school readiness, and identify medical factors related to readiness problems,” says Dr. Taylor.

The children in both groups were matched for age, sex, and race, ensuring comparability. The study employed a holistic approach to assess and address these challenges:

  • Comprehensive Assessments: The study used a range of measures to evaluate cognitive abilities, executive function, motor skills, and pre-academic skills in children. Caregivers also provided detailed behavior ratings.
  • Latent Class Analysis: This method was used to identify different readiness profiles among children with CCHD, highlighting the variability in their challenges and needs. Some children displayed significant deficits across multiple areas, while others showed more selective impairments.
  • Identification of Risk Factors: By examining medical histories, the study pinpointed specific risk factors contributing to school readiness difficulties, offering valuable insights into the underlying causes of these challenges.

Recommendations for Health Care Clinicians

To effectively support children with CCHD, Dr. Taylor says, “Clinicians should encourage caregivers to communicate with educators about observed readiness difficulties and seek educational supports, such as those available through schools or special education programs.” Based on the findings, the study provides several strategies for health care clinicians to better support the developmental and educational needs of children with CCHD:

  • Early screening and intervention: Essential for identifying at-risk children and providing timely support. Routine school readiness screening can help detect issues early, allowing for prompt intervention. Tailored educational interventions should address specific readiness profiles and focus on cognitive development, motor skills, and social communication.
  • Integrating developmental support into routine pediatric cardiology care: Pediatric cardiologists should incorporate developmental assessments into regular check-ups. Collaboration with educators is vital to ensure necessary support and accommodations in school settings, creating a seamless support system for these children. Supporting families by providing resources and guidance can help them address their child’s needs, fostering a supportive home environment.
  • Advocating for healthcare policies: Necessary to support comprehensive developmental and educational interventions, including securing funding for early intervention programs and special education services to ensure these children receive the support they need to thrive.

By implementing these strategies, health care clinicians can play a crucial role in enhancing school readiness for children with CCHD. Early identification of at-risk children, comprehensive developmental support, and strong collaboration with educators and families are essential steps in ensuring these children receive the support they need to thrive academically and socially.

 

Reference:

Taylor HG, Quach J, Bricker J, Riggs A, Friedman J, Kozak M, Vannatta K, Backes C. School Readiness in Preschool-Age Children with Critical Congenital Heart Disease. Pediatr Cardiol. 2024 Apr 1. doi: 10.1007/s00246-024-03460-6. Epub ahead of print. PMID: 38557774.

Image credit: Adobe Stock

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