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Predictors of behavioural and emotional outcomes in toddlers with congenital heart disease

Published online by Cambridge University Press:  22 September 2021

Elizabeth Jilek ,
Ashley Shields ,
Liyun Zhang ,
Pippa Simpson ,
Laurel Bear ,
Sydney Allen Martins ,
Kathleen A. Mussatto  and
Cheryl L. Brosig Open the ORCID record for Cheryl L. Brosig [Opens in a new window]
Elizabeth Jilek
Affiliation:
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
Ashley Shields
Affiliation:
UVA Children’s, Charlottesville, VA, USA
Liyun Zhang
Affiliation:
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
Pippa Simpson
Affiliation:
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
Laurel Bear
Affiliation:
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI, USA
Sydney Allen Martins
Affiliation:
Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI, USA
Kathleen A. Mussatto
Affiliation:
Department of Nursing, Milwaukee School of Engineering, Milwaukee, WI, USA
Cheryl L. Brosig*
Affiliation:
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA Herma Heart Institute, Children’s Wisconsin, Milwaukee, WI, USA
*
Author for correspondence: C. Brosig, PhD, Children’s Wisconsin, 9000 W. Wisconsin Avenue, P.O. Box 1997, MS 713, Milwaukee, WI53201-1997, USA. Tel: 414-266-2948; Fax: 414-266-3261. E-mail: cbrosig@chw.org
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Abstract

Objectives:

Children with congenital heart disease (CHD) are at risk for psychological challenges, including internalising (e.g., depression, anxiety) and externalising (e.g., aggression, inattention) problems. The present study aimed to investigate the development of psychological concerns in early childhood by identifying predictors of behavioural and emotional problems in toddlers with CHD.

Methods:

Children with CHD who were seen for neurodevelopmental (ND) evaluation at 12 ± 3 months of age, who completed the Bayley Scales of Infant Development–III (BSID-III) and whose parents completed the Child Behavior Checklist (CBCL), a standardised measure of emotional/behavioural problems at age 24–36 months, were included in the study (n = 144). CBCL scores were compared to test norms and classified as normal or abnormal. A classification tree was used to assess the association between CBCL scores and demographic and clinical variables.

Results:

Multi-variable tree analyses revealed lower BSID-III language composite scores at age 9–15 months predicted clinical CBCL internalising (p < 0.001), externalising (p = 0.004) and total scores (p < 0.001) at age 24–36 months. Lower maternal education levels also predicted clinical CBCL internalising (p < 0.0001), externalising (p < 0.001) and total scores (p < 0.0001).

Conclusions:

Lower language abilities and lower maternal education predict increased behavioural and emotional problems in toddlers with CHD. These risk factors should be considered during routine ND evaluations to allow for earlier identification of children with CHD and their families who may benefit from psychological support.

Keywords

Congenital heart disease/defectsdevelopmental outcomeschild development
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 8 , August 2022 , pp. 1216 - 1221
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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