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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: c.mccusker@qub.ac.uk

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 

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