HOMESTUDY: Neurodevelopmental Consideration in Congenital Cardiac Conditions - Alexander Tan, Ph.D., ABPP/CN 2 CEs

Level of Activity: Intermediate Congenital heart disease (CHD) is the most common type of birth defect and leading cause of infant deaths in the United States (with disproportionate impact for racial and ethnic minority populations), with over 25% of cases representing a critical form of CHD requiring surgical intervention within the first year of life. While more than 90% of children with CHD are living into adulthood due to advances in medical care, brain development can be negatively impacted by genetic, preoperative, perioperative, and postoperative factors. As a result, increasing attention has been focused on the cumulative neuropsychological burden of CHD across the lifespan, including neurocognitive, academic, psychosocial, and adaptive sequelae. Research has also focused on the relationship between neuropsychological outcomes and associated medical and sociodemographic risk factors. In 2012, the American Heart Association and American Academy of Pediatrics developed guidelines for optimizing neuropsychological outcomes in the pediatric CHD population, resulting in a national increase in cardiac neurodevelopmental follow-up programs for systematic surveillance, screening, and evaluation. Since then, multicenter and multidisciplinary organizations such as the Cardiac Neurodevelopmental Outcome Collaborative have focused on collaborative clinical and research initiatives and identifying future directions for optimizing neuropsychological outcomes in this population. Additionally, given the growing diversification of the United States population, there is a significant need for culturally and linguistically responsive cardiac neurodevelopmental evaluations to improve outcomes for diverse children. Objectives Identify common congenital heart defects and influences on brain development. Describe the neuropsychological consequences of CHD and associated risk factors. Review current guidelines and future directions for neuropsychological management of CHD.