As practitioners dedicated to improving the lives of children, we must continuously integrate new research findings into our clinical practice. A recent review article titled ‘Big issues’ in neurodevelopment for children and adults with congenital heart disease provides critical insights into the neurodevelopmental challenges faced by individuals with congenital heart disease (CHD) and highlights areas requiring further research. This blog aims to summarize the key findings and suggest actionable steps for practitioners to enhance neurodevelopmental outcomes in children with CHD.
Key Findings from the Research
The review identifies several significant issues related to neurodevelopmental disability (NDD) in children with CHD:
- Up to 50% of children requiring cardiac intervention exhibit NDD, including cognitive impairments, attention difficulties, motor deficits, and delayed executive function.
- NDD impacts educational achievement, employability, independence, and overall quality of life (QOL).
- The trajectory of NDD into adolescence and adulthood remains unclear, necessitating long-term studies.
- Fetal neuroimaging shows abnormalities from early gestation, indicating that neurodevelopmental issues may originate before birth.
Actionable Steps for Practitioners
To improve neurodevelopmental outcomes, practitioners can implement the following strategies:
- Early Identification and Intervention: Utilize standardized assessments such as the Bayley Scales of Infant and Toddler Development (BSITD) and the Wechsler Scales of Intelligence to identify developmental delays early. Early intervention is crucial for leveraging neuroplasticity and improving outcomes.
- Multidisciplinary Approach: Collaborate with a team of specialists, including developmental pediatricians, neurologists, psychologists, and speech and language pathologists, to provide comprehensive care tailored to each child's needs.
- Parental Involvement: Educate and involve parents in the intervention process. Parental support and a nurturing home environment are critical for maximizing neurodevelopmental potential.
- Long-Term Surveillance: Follow guidelines for universal screening and long-term surveillance of NDD in children with CHD, as recommended by the American Heart Association. Continuous monitoring helps in timely intervention and support.
- Research Participation: Encourage participation in longitudinal studies to contribute to the growing body of knowledge on NDD in CHD. Such research is essential for developing evidence-based interventions.
Encouraging Further Research
While current research provides valuable insights, there are still many gaps in our understanding of NDD in CHD. Practitioners are encouraged to stay updated with the latest research and consider contributing to studies aimed at:
- Exploring the genetic and environmental factors contributing to NDD in CHD.
- Developing and testing new intervention strategies to minimize the neurodevelopmental burden.
- Assessing the long-term efficacy and cost-effectiveness of intervention programs.
To read the original research paper, please follow this link: ‘Big issues’ in neurodevelopment for children and adults with congenital heart disease.
