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- Buratti, Sandra, 1983, et al.
(författare)
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Do Self- and Proxy Reports of Cognitive Problems Reflect Intellectual Functioning in Children and Adolescents with Congenital Heart Defects?
- 2016
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Ingår i: Frontiers in Pediatrics. - : Frontiers Media SA. - 2296-2360. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Children with congenital heart defects (CHD) who suffer from cognitive impairments and school difficulties need to be identified as early as possible in order to set appropriate interventions in place that may enhance the school situation and quality of life for these children. Identifying children and adolescents at risk for cognitive difficulties requires specific screening tools. This study assessed such a tool - Pediatric Quality of Life Inventory Cardiac Module subscale: Cognitive Problems - to investigate whether proxy reported and self-reported cognitive problems were associated with measured intellectual functioning in children and adolescents with CHD treated with surgery or by catheter interventions. Method: The sample consisted of 184 children/adolescents aged 3, 5, 9, and 15 years. The severity of the CHD diagnoses was categorized into three groups (mild, moderate, or severe) for all age groups. For all the age groups, we collected proxy ratings of cognitive problems, and for the 5-, 9-, and 15-year-olds, we also collected self-reported cognitive problems. Intellectual functioning was measured with the Wechsler intelligence scales. The control variables were socioeconomic status and severity of diagnosis. Results: A strong association was found between the parents ratings of cognitive problems and the childrens and adolescents results on the Wechsler scales. This association was present for all ages, including the 3-year-olds. As for the self-reports, an association was only found between the 15-year-olds self-report of cognitive problems and their results on the Wechsler scales. Conclusion: To identify children with cognitive problems as early as at the age of 3 years, parent-rated Pediatrics Quality of Life subscale: Cognitive Problems can be used as a screening tool. For 15-year-olds, the self-report ratings can be used as a screening tool. We also suggest a cutoff score of 80 for both the 15-year olds as well as the proxy reports. If the score falls below 80 the child should be formally evaluated using standardized cognitive test.
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- Ryberg, Carmen
(författare)
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Children with Congenital Heart Defects. Intellectual Functioning and Family Impact
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of the present doctoral thesis was to investigate intellectual functioning and the influence of the children with congenital heart defects in their families. We analyzed how the severity of the heart defect, the child's age, and the socio-economic status of the child's family were related to the intellectual functioning of the children and to the impact on the family. A scale from a screening tool, the PedsQL 3.0 Cardiac module, was also tested to identify children and adolescents at risk of intellectual problems. A psychological model for understanding the development of children was used in discussing how physical and psychosocial factors affect each other and how parents, healthcare professionals, and the child's environment influence children's development. This thesis is based in three empirical studies. Studies I and II deal with intellectual functioning in children with CHD in Sweden, and suggest a screening instrument to detect early intellectual difficulties in children. Children with a broad spectrum of congenital heart defects, different ages, different intellectually functioning and from families with different socio-economic backgrounds were investigated. Study I found out that children with CHD treated with surgery or by catheter interventions as a group performed within the normal range on overall intellectual functioning and identified severity of the heart diagnosis and SES as important factors related to increased risk for lower FSIQ. Study II found that the use of the Self-report and the Proxy-reports of PedsQL Subscale Cognitive Problems was valid as a screening tool for identifying children who need to undergo further cognitive evaluation. Study III investigate the influence of a child with CHD in the family and showed that in families of children with CHD mothers reported higher levels of negative im-pact than fathers, that severity of the CHD was significantly related to parental stress for both fathers and mothers, that mothers with low and medium SES reported higher stress than mothers in the high SES groups and that the strongest predictor for negative impact for both mothers and fathers was the presence of multiple risk factors. Our results show that children and parents of children with CHD are a heterogenous group and that we need longitudinal studies to help us understand how children with congenital heart defects develop over time and how their families experience the impact of having a child with CHD.
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- Ryberg, Carmen, et al.
(författare)
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Intellectual Functioning in Children with Congenital Heart Defects Treated with Surgery or by Catheter Interventions.
- 2016
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Ingår i: Frontiers in pediatrics. - : Frontiers Media SA. - 2296-2360. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Studies suggest that children with congenital heart defects (CHD) are at risk for adverse intellectual functioning. However, factors related to lower intellectual functioning in this group are largely unknown. This study describes intellectual functioning in children with CHD in relation to severity of the heart defect, the child's age, and the socioeconomic status of the family (SES).Two hundred twenty-eight children treated with surgery or by catheter technique were tested using the Wechsler intelligence scales to determine full scale IQ (FSIQ). FSIQ was then analyzed in relation to age (3-, 5-, 9-, and 15-year olds), severity of the diagnosis (mild, moderate, and severe), and SES (low, medium, and high). The median age was 70months (5.8years) with a range of 162months [30months (2.5years) to 192months (16.0years)].The total mean score on FSIQ was 100.8 (SD=14.5). Children with severe CHD had significantly lower FSIQ than children with mild and moderate CHD, and 9- and 15-year olds had significantly lower FSIQ compared to the 3-year olds. Children from families with low SES had significantly lower FSIQ than children from medium SES and high SES families. No interaction between severity of diagnosis, age, and SES was found for FSIQ.Eighty-three percent of the children with CHD performed at or above average with respect to FSIQ. SES and severity of diagnosis had significant main effects on FSIQ. These factors should be considered when planning interventions and follow-up programs for children with CHD.
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