Executive functioning and academic performance in preadolescent children with congenital heart disease

Abstract

Objectives: 1) To assess the level of executive and academic functioning of preadolescent children with moderate to severe congenital heart diseases (CHD); 2) To evaluate the structure of executive functioning (EF) core components in children with diverse types of moderate and severe CHD; 3) To examine the relationship between EF and academic achievement in preadolescent children with CHD.

Study design: Seventy-one children aged 8 to 11 years old with CHD underwent a neuropsychological evaluation to measure EF and academic achievements. To compare the level of EF and academic achievement in children with CHD with age-matched normative data, one sample t-tests were performed. Then, to identify the structure of EF core components in children with CHD, an exploratory factor analysis was conducted. Lastly, multiple hierarchical linear regression analyses were computed to examine the relationship between EF and academic achievement.

Results: Inhibition, reading accuracy, reading speed and spelling results were significantly lower for children with CHD, while cognitive flexibility/shifting and working memory scores were comparable to normative data. The underlying structure of EF in school-aged children with CHD was best understood by a two-factor model where inhibition and working memory represented one construct and cognitive flexibility/shifting represented another distinct construct. EF played a significant part in explaining the variance observed in academic performances.

Conclusion: These findings could serve as a steppingstone for the development of EF interventions in children with CHD that could have direct impact on their academic performances and ultimately, long-term impact on their overall adaptation.

Keywords: Cardiology; Neurodevelopment; Neuropsychology; Preadolescence; School.