3:00 PM - 3:30 PM
[II-IL-05] Evaluating and Interpreting Neurodevelopmental Outcomes in Children with Congenital Heart Disease
The neurodevelopmental outcome rates of children born with congenital heart disease are of interest to parents, health care providers, decision makers and society. Outcomes have been assessed at different ages, using different definitions on children with different types of congenital heart disease. Choosing and interpreting results can therefore be difficult. Neuroimaging, mean IQ, proportion with low IQ scores and quality of life outcomes in isolation may lead to different conclusions about neurodevelopmental prognosis. When counselling parents and for decision making, methodologically sound studies that measure outcomes important to parents on populations generalizable to their child should be used. The youngest age that major disabilities can be detected is 18 – 24 months. The Bayley Scales of Infant and Toddler Development, or previous editions, are frequently used standardized tests with limitations in the predictive ability and important differences between the 2nd and 3rd editions. Motor, cognitive, language, behavior, functional outcomes and quality of life can be better evaluated at school age. The American Academy of Pediatrics recommends developmental surveillance for all children with congenital heart disease and screening for high risk subgroups to facilitate early intervention. A follow-up program can provide integrated clinical care, audit, research and teaching. All children, including those born with congenital heart disease, have abilities along a spectrum which vary by age. Outcomes should not be considered as dichotomous normal and abnormal categories.