Behavioral adjustment of children with surgically palliated complex congenital heart disease.

Examined the behavioral adjustment at school age of 26 children with surgically treated complex congenital heart disease compared to that of 26 children who had been diagnosed as having an innocent murmur. The children with complex heart disease were rated by their parents as more withdrawn, having more social problems, and engaging in fewer activities, and by their teachers as more withdrawn. The families of the children with complex heart disease reported experiencing more stress. Two variables, family strain and exercise tolerance, were strong predictors of teacher-rated school adjustment in the children with complex heart disease, with family strain accounting for 33% of the variance, and exercise tolerance 24%. The impact of the child's chronic condition on the family thus seems to be a critical factor in the school adjustment of these children, more so even than the physical limitations imposed on the child by the chronic condition.