Saini, Maneet Kaur;
(2023)
Cognitive, language, and psychosocial outcomes in children with complex congenital heart disease: A longitudinal cohort study from infancy to early school years.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Congenital heart disease (CHD) and its surgical treatment can expose neonates to episodes of hypoxia-ischaemia. Brain structures that have high oxygen requirements are susceptible to neurotoxic reactions potentially leading to hypoxic-ischaemic brain injury. Children with CHD may be at risk of adverse neurodevelopmental outcomes which can consequently impact their psychosocial functioning and quality of life. The aim of this research was to examine the emergence and longitudinal trajectories of cognition, language and motor function in the first three years of life, in a paediatric cohort with hypoplastic left heart syndrome (HLHS) (n=11), or d-transposition of the great arteries (TGA) (n=21), compared to a group of healthy controls (n=28). Speech, language, and pre-reading skills were then investigated at 4-5 years, coupled with an auditory event-related potential (ERP) study to explore neural correlates of speech sound processing. Parent-rated social-emotional, behavioural, and psychosocial functioning were also examined, including their role in overall quality of life. A pattern was observed in children with TGA having scores similar to those of healthy controls in many domains, longitudinally. Children with HLHS showed impaired gross motor skills between 5-15 months, but by 3-4 years they scored within the normal range. At 4-5 years, the CHD groups displayed no impairments in expressive or receptive language, but some patients showed impaired phonological processing (31-60%), narrative skills (23-54%), and pragmatics (15-40%). ERP findings showed that children with CHD did not process phonemes differently to healthy controls and no significant associations were found between ERPs and behavioural measures of speech and language. Children with HLHS had poorer social-emotional, behavioural, executive functioning, and psychosocial status and 71% had impaired quality of life, compared to other groups. A number of these outcomes were significantly associated with parental/maternal mental health and family functioning. Overall, despite group scores in the normative range, a high proportion of children with complex CHD had impaired scores in one or more domains. This highlights the need for an individualised approach and regular neurodevelopmental surveillance, currently not routinely available in the UK.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Cognitive, language, and psychosocial outcomes in children with complex congenital heart disease: A longitudinal cohort study from infancy to early school years |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10183975 |
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