Abstract
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. 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. A strong association was found between the parent's ratings of cognitive problems and the children's 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. 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.
Highlights
A large number of studies show that children with congenital heart defects (CHD) have higher incidence of cognitive impairments and poor academic results compared to healthy controls [1, 2]
This study aimed to evaluate whether the PedsQL Cognitive Problems subscale from the cardiac module could be used as a screening tool for identifying children with CHD who need to undergo more extensive cognitive assessments
This evaluation was done by investigating the association between children with CHD self-reports of their cognitive problems as well as their parents’ reports of their children’s cognitive problems and their children’s actual full scale IQ (FSIQ)
Summary
A large number of studies show that children with congenital heart defects (CHD) have higher incidence of cognitive impairments and poor academic results compared to healthy controls [1, 2]. Because cognitive impairments are overrepresented in children and adolescents with CHD, it is important to have reliable screening tools to identify children and adolescents in need of more extensive evaluations [3]. One such possible measure is the Cognitive Problems Scale from the Pediatric Quality of Life Inventory Cardiac Module. Standardized measures of cognitive functioning, such as the Wechsler Scales of Intelligence, are time-consuming and require the person administrating the test and interpreting the test results to be a psychologist; access to a reliable and swift screening tool not requiring a psychologist would help identify the children who need to undergo standardized testing
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