Abstract
This brief case report outlines a novel approach to supporting the development of a pediatric complex cardiac care patient. Patient X is a 19-month old patient who spent 5.5 months in hospital and underwent multiple surgeries including heart transplantation. This case report explores the impacts of his condition and care on his development and family functioning within the framework of an integrated care model. This case report is uniquely complimented by outpatient neurodevelopmental follow up, dyadic trauma-informed intervention and use of telemedicine allowing for a deeper understanding of the family adaptation that provide novel insight into long-term trajectory beyond discharge. Throughout care Patient X met criteria for both a traumatic stress disorder and global developmental delay. This case study highlights the threat complex care poses to neurodevelopment, pediatric mental health and family dynamics as well as opportunities for intervention.
Highlights
Hospitalization in childhood disrupts normative developmental processes and induces significant stressors on both children and their parents
The following case report exemplifies the implications of inpatient stress on long-term outpatient child development
This case is uniquely complimenting by long-term outpatient neurodevelopmental and mental health follow-up and interventions allowing for perspectives in post-discharge functioning
Summary
Hospitalization in childhood disrupts normative developmental processes and induces significant stressors on both children and their parents. Posttransplant imaging displayed global cerebral volume loss with confluent hypodensity of the periventricular white matter He required prolonged post-transplant hospitalization given his Abbreviations: EA, esophageal atresia; TEF, tracheoesophageal fistula; VSD, ventricular septal defect; NICU, neonatal intensive care unit; RVOT, right ventricular outflow tract; ECMO, extracorporeal membrane oxygenator; LVAD, left ventricular assist device; PTSD, posttraumatic stress disorder. A childhood mental health clinician was consulted due to poor parental coping, post-transplant concerns of developmental regression and an abnormal stress response. At this time the family reported that they had been unable to fulfill the referral for supportive services in their area that had been recommended at 4-months. Further goals are centered around decreasing parental distress and enhancing the family’s ability to engage in synchronous dyadic interactions
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