Specific Developmental Disorders of Scholastic Skills Can Successfully Be Treated with Individualized Cognitive and Metacognitive Strategies in Children with Complex Congenital Heart Disease

Background: Neurodevelopment in pediatric patients with complex congenital heart disease (CHD) can be complicated by specific disorders of scholastic skills (DOSS) concerning reading (RD), spelling (SD), and arithmetical skills (AD). Often brain matter morphological abnormalities are present. In this study, we tested the following hypotheses: (1) is collaboration of an expert psychologist, certified learning therapists, school teachers, doctors, patients, and parents feasible? (2) Are patients with complex CHD at higher risk for DOSS? (3) Is individualized learning therapy less effective in children with compared with children without CHD?

Method: Patients with complex (cyanotic defects, bad clinical condition before therapy, and ≥3 operations [CCHD]), and ordinary defects (OCHD) operated on within the first 6 months from 2007 to 2010 were contacted. Telephone interview by an expert psychologist was followed by written questionnaire, testing of IQ (CFT-1R/20-R) and DOSS (DEMAT 2+, DERET1–2+, and ZLT-II). The discrepancy criterium was set to 1 SD. Treatment was offered (A) as an expert designed individual learning therapy once a week tailored to their needs for 1 year (group KI), (B) as treatment recommendations for potential homebound learning therapy (group KV), and (C) comparable to (A) for school children with DOSS without CHD. Retesting of DOSS after therapy in all children using equivalent parallel test (EPT), as well as next year test (NYT). Standard descriptive statistics and paired t-test were calculated using SPSS software.

Results: A total of 275 out of 311 parents of patients born and operated on within the first 6 months from 2007 to 2010 responded, 141 (85 CCHD and 56 OCHD) approved an expert psychologist telephone interview, 65 of them had additional written questionnaire interrogation. Thirty-eight children were tested, 21 (18 CCHD) with positive results. In the retests, all groups increased their test result significantly (p < 0.05). Group A (n = 10) increased from T 31.9 to 52.2 (+20.3, EPT)/47.8 (+15.9, NYT), group B (n = 10) from T 33.3 to 43.3 (+10, EPT)/37.5 (+4.2, NYT), group C (n = 10) from T 30.8 to 46.5 (+15.7, EPT)/38.5 (+7.7 NYT).

Conclusion: (1) Interdisciplinary collaboration can be successful, and recruitment is predominantly hampered by lack of parental interest. (2) The institutional incidence of DOSS (14.89%) is higher in CCHD (21.2%) than in OCHD (5.4%). And (3) individualized learning therapy is highly effective for DOSS in patients with CCHD.

Publication History

Article published online:
12 February 2022