Children's Healthcare of Atlanta, Department of Neuropsychology and Emory University, Department of Rehabilitation Medicine, Atlanta, Georgia, USA.
Children's National Health System, Division of Neuropsychology and George Washington University School of Medicine, Departments of Psychiatry and Behavioural Sciences and Paediatrics, Washington, DC, USA.
Cardiol Young. 2020 Nov;30(11):1623-1636. doi: 10.1017/S1047951120003546. Epub 2020 Nov 4.
In 2012, the American Heart Association and the American Academy of Paediatrics released a scientific statement with guidelines for the evaluation and management of the neurodevelopmental needs of children with CHD. Decades of outcome research now highlight a range of cognitive, learning, motor, and psychosocial vulnerabilities affecting individuals with CHD across the lifespan. The number of institutions with Cardiac Neurodevelopmental Follow-Up Programmes and services for CHD is growing worldwide. This manuscript provides an expanded set of neurodevelopmental evaluation strategies and considerations for professionals working with school-age children with CHD. Recommendations begin with the referral process and access to the evaluation, the importance of considering medical risk factors (e.g., genetic disorders, neuroimaging), and the initial clinical interview with the family. The neurodevelopmental evaluation should take into account both family and patient factors, including the child/family's primary language, country of origin, and other cultural factors, as well as critical stages in development that place the child at higher risk. Domains of assessment are reviewed with emphasis on target areas in need of evaluation based on current outcome research with CHD. Finally, current recommendations are made for assessment batteries using a brief core battery and an extended comprehensive clinical battery. Consistent use of a recommended assessment battery will increase opportunities for research collaborations, and ultimately help improve the quality of care for families and children with CHD.
2012 年,美国心脏协会和美国儿科学会发布了一份科学声明,其中包含了针对先天性心脏病(CHD)儿童神经发育需求评估和管理的指南。几十年来的研究结果强调了一系列认知、学习、运动和社会心理方面的脆弱性,这些脆弱性会影响终生患有 CHD 的个体。全球范围内,设有心脏神经发育随访计划和服务的机构数量正在增加。本文为从事 CHD 学龄儿童工作的专业人员提供了一套扩展的神经发育评估策略和注意事项。建议从转诊流程和评估机会开始,考虑医疗风险因素(例如遗传疾病、神经影像学),以及与家庭的初步临床访谈的重要性。神经发育评估应考虑家庭和患者因素,包括儿童/家庭的主要语言、原籍国和其他文化因素,以及处于更高风险的发育关键阶段。本文回顾了评估领域,重点介绍了基于当前 CHD 研究结果需要评估的目标领域。最后,根据推荐的简短核心电池和扩展综合临床电池,提出了当前的评估建议。一致使用推荐的评估电池将增加研究合作的机会,并最终有助于提高 CHD 患儿及其家庭的护理质量。