Cognitive Mechanisms That Predict Lower Math in Children With Congenital Heart Disease

Abstract

Objective: Broad cognitive deficits have been reported in children with congenital heart disease (CHD), which is associated with abnormal neurological development. As cardiac neurodevelopmental follow-up programs grow to meet patient demands, research is needed to guide clinical care. Of interest to the current study are deficits in fine motor and visuospatial skills, processing speed, and working memory in CHD, which are known contributors to math. Method: Retrospective chart review was completed from an outpatient clinic to collect data from neuropsychology and medical records. Evaluations were completed upon physician referral and represent a high-risk clinical sample. Participants included 105 children (M _age = 10 years) with various types of CHD requiring surgery during infancy. Measures included standardized testing and caregiver ratings. Results: Using hierarchical linear regression, perceptual reasoning, processing speed, and working memory explained significant variance in math. Demographic variables (e.g., maternal education, ethnicity), prematurity, and CHD severity were not related to math. Caregiver report of executive function was also unrelated to math. Conclusions: Psychologists completing an evaluation of the clinically referred child with CHD should assess visuospatial skills, working memory, and processing speed when math is a concern. Identifying weaknesses in these areas can inform math instruction and accommodations.

Implications for Impact Statement

This study of clinically referred children with CHD shows lower performance in math. Cognitive areas related to lower math included visuospatial skills, working memory, and processing speed. Findings support assessment of these areas in cardiac neurodevelopmental follow-up programs to help facilitate intervention.