When a Neurodevelopmental Assessment Is Needed
Even children who are on track when they are young can show delays when they start school, or when they go through transition points, such as 3rd grade or starting middle school, where expectations are increased. The American Heart Association (AHA) and the American Academy of Pediatrics (AAP) recommend developmental or neuropsychological testing for all children who have high-risk congenital heart disease.
CHOC is the only hospital in Southern California that is a member of the Cardiac Neurodevelopmental Outcome Collaborative, whose members are committed to optimizing outcomes for individuals with pediatric and congenital heart disease through clinical, quality improvement and research initiatives.
Evaluation is recommended for children with:
- Open heart surgery as a newborn/infant
- A heart condition that causes decreased oxygen levels (cyanotic heart lesions)
Or, more than one of the following:
- Prematurity
- Developmental delay
- Genetic syndrome associated with developmental delays
- History of mechanical support (ECMO or VAD use)
- Heart transplant
- Cardiopulmonary resuscitation (CPR)
- A hospital stay longer than two weeks after cardiac surgery
- Perioperative seizures related to congenital heart disease surgery
- Abnormalities on neuroimaging
If your child does not qualify based on the high-risk criteria, but you are concerned about your child’s development, please discuss your concerns with your cardiologist. Concerns you may have noticed include:
In early development
- Delays in learning to crawl, walk or run
- Problems with hands, such as picking up small toys or hold a crayon to scribble
- Difficulties with eating enough to grow as expected
- Says or understands fewer words than other kids their age
During childhood and teenage years
- Learning at a slower rate than their peers
- Slower to learn academic skills in math, reading and writing
- Inattention
- Impulsivity
- Messy, disorganized or often loses things
- Less able to follow multi-step directions than other children their age
- Knows or understands fewer words than children the same age
- Messy handwriting or less-developed drawing skills
- Problems making or keeping friends
Once our neuropsychologists complete an evaluation, they meet with the child’s family to discuss the results, as well as provide a custom report that can be shared with the child’s pediatrician, referring physician and school. The report includes recommendations for treatment to help a child improve his or her overall cognitive function. We work closely with families to ensure that their child receives the recommended therapies.
