TY - JOUR
T1 - Executive function in preschool children with congenital heart disease and controls: the role of a cognitively stimulating home environment.
AU - Chew, Andrew
AU - Bonthrone, Alexandra
AU - Alford, Arezoo
AU - Kelly, Christopher
AU - Pushparajah, Kuberan
AU - Egloff, Alexia
AU - Hajnal, Jo
AU - Simpson, John
AU - Rutherford, Mary
AU - Edwards, David
AU - Nosarti, Chiara
AU - Counsell, Serena
N1 - Funding Information:
This work received funding from the Medical Research Council UK (MR/V002465/1; MR/L011530/1), Action Medical Research (GN2630), the British Heart Foundation (FS/15/55/31649), and the European Research Council under the European Union's Seventh Framework Programme (FP7/20072013/ECR grant agreement no [319456] Developing Human Connectome Project project). This work was supported by core funding from the Wellcome/EPSRC Centre for Medical Engineering [WT203148/Z/16/Z]. The study sponsors had no role in study design; collection, analysis and interpretation of data; writing the report; or decision to submit the paper for publication. The authors declare no conflicts of interest.
Publisher Copyright:
© 2023 The Author(s)
PY - 2024/4
Y1 - 2024/4
N2 - Objective: To assess the relationships between (1) environmental and demographic factors and executive function (EF) in preschool children with congenital heart disease (CHD) and controls and (2) clinical and surgical risk factors and EF in preschool children with CHD. Study design: At 4-6 years of age, parents of children with CHD (n = 51) and controls (n = 124) completed the Behavior Rating Inventory of Executive Function, Preschool Version questionnaire and the Cognitively Stimulating Parenting Scale (CSPS). Multivariable general linear modeling assessed the relationship between Behavior Rating Inventory of Executive Function, Preschool Version composite scores (Inhibitory Self-Control Index [ISCI], Flexibility Index [FI], and Emergent Metacognition Index [EMI]) and group (CHD/control), sex, age at assessment, gestational age, Index of Multiple Deprivation, and CSPS scores. The relationships between CHD type, surgical factors, and brain magnetic resonance imaging injury rating and ISCI, FI, and EMI scores were assessed. Results: The presence of CHD, age at assessment, sex, and Index of Multiple Deprivation were not associated with EF scores. Lower gestational age was associated with greater ISCI and FI scores, and age at assessment was associated with lower FI scores. Group significantly moderated the relationship between CSPS and EF, such that CSPS significantly predicted EF in children with CHD (ISCI: P = .0004; FI: P = .0015; EMI: P = .0004) but not controls (ISCI: P = .2727; FI: P = .6185; EMI: P = .3332). There were no significant relationships between EF scores and surgical factors, CHD type, or brain magnetic resonance imaging injury rating. Conclusions: Supporting parents to provide a cognitively stimulating home environment may improve EF in children with CHD. The home and parenting environment should be considered when designing intervention studies aimed at improving EF in this patient group.
AB - Objective: To assess the relationships between (1) environmental and demographic factors and executive function (EF) in preschool children with congenital heart disease (CHD) and controls and (2) clinical and surgical risk factors and EF in preschool children with CHD. Study design: At 4-6 years of age, parents of children with CHD (n = 51) and controls (n = 124) completed the Behavior Rating Inventory of Executive Function, Preschool Version questionnaire and the Cognitively Stimulating Parenting Scale (CSPS). Multivariable general linear modeling assessed the relationship between Behavior Rating Inventory of Executive Function, Preschool Version composite scores (Inhibitory Self-Control Index [ISCI], Flexibility Index [FI], and Emergent Metacognition Index [EMI]) and group (CHD/control), sex, age at assessment, gestational age, Index of Multiple Deprivation, and CSPS scores. The relationships between CHD type, surgical factors, and brain magnetic resonance imaging injury rating and ISCI, FI, and EMI scores were assessed. Results: The presence of CHD, age at assessment, sex, and Index of Multiple Deprivation were not associated with EF scores. Lower gestational age was associated with greater ISCI and FI scores, and age at assessment was associated with lower FI scores. Group significantly moderated the relationship between CSPS and EF, such that CSPS significantly predicted EF in children with CHD (ISCI: P = .0004; FI: P = .0015; EMI: P = .0004) but not controls (ISCI: P = .2727; FI: P = .6185; EMI: P = .3332). There were no significant relationships between EF scores and surgical factors, CHD type, or brain magnetic resonance imaging injury rating. Conclusions: Supporting parents to provide a cognitively stimulating home environment may improve EF in children with CHD. The home and parenting environment should be considered when designing intervention studies aimed at improving EF in this patient group.
UR - http://www.scopus.com/inward/record.url?scp=85183527200&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2023.113897
DO - 10.1016/j.jpeds.2023.113897
M3 - Article
SN - 0022-3476
VL - 267
JO - Journal of Pediatrics
JF - Journal of Pediatrics
M1 - 113897
ER -