Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-13T22:47:15.319Z Has data issue: false hasContentIssue false

A sibling-controlled, prospective study of outcomes at home and school in children with severe congenital heart disease

Published online by Cambridge University Press:  19 October 2012

Christopher G. McCusker*
Affiliation:
School of Psychology, The Queen's University of Belfast, Belfast, Northern Ireland, United Kingdom The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, United Kingdom
Mark P. Armstrong
Affiliation:
School of Psychology, The Queen's University of Belfast, Belfast, Northern Ireland, United Kingdom
Mairead Mullen
Affiliation:
The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, United Kingdom
Nicola N. Doherty
Affiliation:
The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, United Kingdom
Frank A. Casey
Affiliation:
The Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, United Kingdom
*
Correspondence to: Prof. C. McCusker Ph.D. C.Psychol, School of Psychology, The Queen's University of Belfast, 180 Falls Road, Belfast BT7 1NN, Northern Ireland, United Kingdom. Tel: +00442890 974353; Fax: +00442890 974222; E-mail: [email protected]

Abstract

Objectives

The objectives of this study were to compare behaviour problems and competencies, at home and school, in 7-year-old children with congenital heart disease with a sibling control group, to examine the prospective determinants of outcome from infancy, and to explore whether any gains were maintained in our sub-group of children who had participated in a previous trial of psychological interventions in infancy.

Methods

A total of 40 children who had undergone surgery to correct or palliate a significant congenital heart defect in infancy were compared (Child Behavior Checklist) with a nearest-age sibling control group (18 participants). Comparisons were made between sub-groups of children and families who had and had not participated in an early intervention trial.

Results

Problems with attention, thought and social problems, and limitations in activity and school competencies, were found in comparison with siblings. Teacher reports were consistent with parents, although problems were of a lower magnitude. Disease, surgical, and neurodevelopmental functioning in infancy were related to competence outcomes but not behaviour problems. The latter were mediated by family and maternal mental health profiles from infancy. Limited, but encouraging, gains were maintained in the sub-group that had participated in the early intervention programme.

Conclusions

The present study is strengthened by its longitudinal design, use of teacher informants, and sibling control group. The patterns of problems and limitations discerned, and differential determinants thereof, have clear implications for interventions. We consider these in the light of our previously reported intervention trial with this sample and current outcomes at the 7-year follow-up.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Bellinger, DC, Newburger, JW. Neuropsychological, psychosocial and quality of life outcomes in children and adolescents with congenital heart disease. Prog Pediatr Cardiol 2010; 29: 8792.CrossRefGoogle Scholar
2. Karsdorp, P, Everaerd, W, Kindt, M, Mulder, B. Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 2007; 32: 527541.Google Scholar
3. Spijkerboer, A, Utens, E, Bogers, A, Helbing, W, Verhulst, F. A historical comparison of long-term behavioral and emotional outcomes in children and adolescents after invasive treatment for congenital heart disease. J Pediatr Surg 2008; 43: 534539.CrossRefGoogle ScholarPubMed
4. McCusker, CG, Doherty, NN, Molloy, B, et al. Determinants of neuropsychological and behavioural outcomes in early childhood survivors of congenital heart disease. Arch Dis Child 2007; 92: 137141.Google Scholar
5. Casey, FA, Stewart, M, McCusker, CG, et al. Examination of the physical and psychosocial determinants of health behaviour in 4–5 year old children with congenital heart disease. Cardiol Young 2010; 20: 532537.Google Scholar
6. Bellinger, DC, Newburger, J, Wypij, D, Kuban, K, duPlessis, A, Rappaport, L. Behavior at eight years in children with surgically corrected transposition: The Boston Circulatory Arrest Trial. Cardiol Young 2009; 19: 8697.CrossRefGoogle ScholarPubMed
7. Goldberg, S, Janus, M, Washington, J, Simmons, R, MacLuskey, I, Fowler, R. Prediction of preschool behavioral problems in healthy and pediatric samples. J Dev Behav Pediatr 1997; 18: 304313.Google Scholar
8. Miatton, M, De Wolf, D, Francois, K, Thiery, E, Vingerhoets, G. Intellectual, neuropsychological and behavioral functioning in children with tetralogy of Fallot. J Thorac Cardiovasc Surg 2007; 133: 449455.Google Scholar
9. Shillingford, A, Glanzman, M, Ittenbach, R, Clancy, R, Gaynor, W, Wernovsky, G. Inattention, hyperactivity, and school performance in a population of school-age children with complex congenital heart disease. Pediatrics 2008; 121: 759767.Google Scholar
10. Sharpe, D, Rossiter, L. Siblings of children with a chronic illness: a meta-analysis. J Pediatr Psychol 2002; 27: 699710.Google Scholar
11. McCusker, CG, Doherty, NN, Molloy, B, et al. A controlled trial of early interventions to promote maternal adjustment and development in infants with severe congenital heart disease. Child Care Health Dev 2009; 36: 110117.Google Scholar
12. Harris, J. Brain disorders and their effect on psychopathology. In: Rutter M, Bishop D, Pine D, Scott S, Stevenson J, Taylor E, Thapar A (eds.). Rutter's Child and Adolescent Psychiatry. Blackwell, Oxford, 2008, pp 459473.Google Scholar
13. Achenbach, TM, Rescorla, LA. Manual for the ASEBA School-age Forms and Profiles. University of Vermont, Research Center for Children, Youth, and Families, Burlington, VT, 2001.Google Scholar
14. Perrin, E, Stein, R, Drotar, D. Cautions in using the Child Behaviour Checklist: observations based on research about children with a chronic disease. J Pediatr Psychol 1991; 16: 411421.Google Scholar
15. Bayley, N. Bayley Scales of Infant Development, 2nd edn. The Psychological Corporation, Harcourt Brace & Company, San Antonio, TX, USA, 1991.Google Scholar
16. Derogatis, IR. Brief Symptom Inventory: Administration, Scoring and Procedures Manual. National Computer Systems, Minneapolis, MN, USA, 1993.Google Scholar
17. De Maso, C, Campis, L, Wypij, D, Bertram, S, Lipshita, M, Freed, M. The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Pediatr Psychol 1991; 16: 137149.Google Scholar
18. De Vet, K, Ireys, H. Psychometric properties of the maternal worry scale for children with chronic illness. J Pediatr Psychol 1998; 23: 257266.CrossRefGoogle ScholarPubMed
19. Moos, RH, Moos, BS. Family Environment Scale. McGraw-Hill, New York, 1991.Google Scholar
20. Townsend, P, Phillimore, P, Beattie, A. Health and Deprivation: Inequality and the North. Croom Helm, London, 1988.Google Scholar
21. Cohen, J. Statistical Power Analysis for the Behavioral Sciences. Erlbaum, Hilldale, NJ, 1988.Google Scholar
22. Menard, S. Applied Logistic Regression Analysis. Thousand Oaks, CA, USA, 1995.Google Scholar