Abstract
COVID-19 has markedly impacted the provision of neurodevelopmental care. In response, the Cardiac Neurodevelopmental Outcome Collaborative established a Task Force to assess the telehealth practices of cardiac neurodevelopmental programmes during COVID-19, including adaptation of services, test protocols and interventions, and perceived obstacles, disparities, successes, and training needs. A 47-item online survey was sent to 42 Cardiac Neurodevelopmental Outcome Collaborative member sites across North America within a 3-week timeframe (22 July to 11 August 2020) to collect cross-sectional data on practices. Of the 30 participating sites (71.4% response rate), all were providing at least some clinical services at the time of the survey and 24 sites (80%) reported using telehealth. All but one of these sites were offering new telehealth services in response to COVID-19, with the most striking change being the capacity to offer new intervention services for children and their caregivers. Only a third of sites were able to carry out standardised, performance-based, neurodevelopmental testing with children and adolescents using telehealth, and none had completed comparable testing with infants and toddlers. Barriers associated with language, child ability, and access to technology were identified as contributing to disparities in telehealth access. Telehealth has enabled continuation of at least some cardiac neurodevelopmental services during COVID-19, despite the challenges experienced by providers, children, families, and health systems. The Cardiac Neurodevelopmental Outcome Collaborative provides a unique platform for sharing challenges and successes across sites, as we continue to shape an evidence-based, efficient, and consistent approach to the care of individuals with CHD.
Highlights
S of clinical test protocols for neurodevelopmental evaluation in an effort to improve quality of care and research collaborations across member sites and internationally.[3]
Prior to the COVID-19 pandemic, the 30 participating sites provided a range of in-person clinical services, including neurodevelopmental assessment for infants (90%), pre-school (93%), and school-aged children (90%) with congenital heart disease (CHD), and interventions for infants or children (50%), caregivers (43%), or caregiver-child dyads (33%; e.g., Parent-Child Interaction Therapy)
Change in the use of telehealth for neurodevelopmental care had been initiated in direct response to COVID-19 in all but one of these 24 sites
Summary
Participants for this cross-sectional survey were recruited via 42 Cardiac Neurodevelopmental Outcome Collaborative member sites across North America within a 3-week timeframe, from 22 July to 11 August 2020. During this period, many states across the United States, as well as many other countries, were experiencing increasing COVID-19 cases and implementing closures and restrictions on in-person clinical services. Many hospitals had implemented policies limiting in-person patient care.
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