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Visuospatial processing in adolescents with critical congenital heart disease: Organization, integration, and implications for academic achievement.

Authors
  • Bean Jaworski, Jessica L1
  • White, Matthew T1
  • DeMaso, David R1
  • Newburger, Jane W1
  • Bellinger, David C1
  • Cassidy, Adam R1
  • 1 a Department of Psychiatry , Boston Children's Hospital , Boston , MA , USA.
Type
Published Article
Journal
Child Neuropsychology
Publisher
Informa UK (Taylor & Francis)
Publication Date
May 01, 2018
Volume
24
Issue
4
Pages
451–468
Identifiers
DOI: 10.1080/09297049.2017.1283396
PMID: 28277152
Source
Medline
Keywords
License
Unknown

Abstract

Among the most significant factors affecting quality of life in individuals with critical congenital heart disease (CCHD) are neurodevelopmental challenges, including deficits in visuospatial processing and academic achievement. Few studies have compared outcomes across CCHD subgroups, despite their significant differences in anatomy/physiology and medical/surgical courses. This study compared visuospatial processing abilities using the Developmental Scoring System for the Rey-Osterrieth Complex Figure (DSS-ROCF) across groups of adolescents with CCHD (d-transposition of the great arteries [TGA, n = 139], Tetralogy of Fallot [TOF, n = 68], single-ventricle cardiac anatomy requiring the Fontan operation [SVF, n = 145]) and a group of healthy controls (CTR, n = 111), and examined the validity of visuospatial processing in predicting concurrent academic outcomes. The CCHD subgroups were found to differ in Organization, ps < .001, Structural Accuracy, ps < .001, and Incidental Elements Accuracy scores, ps ≤ .008; the post hoc analyses show that the SVF group tended to underperform compared to the other CCHD groups. With respect to academic skills, all CCHD groups scored lower than the CTR group, ps ≤ .007; however, the CCHD groups were not different from each other, ps > .23. The regression results showed that the DSS-ROCF Style rating (reflecting integration) accounted for a small yet statistically significant portion of unique variance in "assembled" academic outcomes, over and above the variance already accounted for by DSS-ROCF Organization, p < .01. These findings support the need for comprehensive neuropsychological assessment and monitoring of children and adolescents with CCHD, as well as targeted intervention for organization and integration deficits that may increase their risk for academic underachievement.

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