Neuropsychological, psychosocial, and quality-of-life outcomes in children and adolescents with congenital heart disease

This review addresses selected aspects of the functional morbidities observed at school-age and older in children with congenital heart disease. Although intelligence is not severely impaired, these patients are at increased risk of impairments in speech and language (including pragmatic skills), visual–spatial skills, executive functions, attention, and motor skills. Most patients achieve good psychosocial outcomes, although, by parent and teacher ratings, a substantial percentage is at increased risk. There might be sex differences and age-related changes in risk. Patients tend to rate their own behavior as similar to that of controls. Some data suggest that these patients have deficits in social cognition, specifically “theory of mind” skills. In terms of adaptive functioning, some children with congenital heart disease experience difficulties in activities of daily living, including maintaining adequate academic progress. Parents and others tend to rate the patients' quality-of-life less favorably than that of control populations, although the patients themselves often do not. A relatively neglected topic is the impact of a child with congenital heart disease on the well-being of parents and the family.