Academic Outcomes Among Children With Congenital Heart Disease: A Paired Sibling Study Open Access

Strid, Penelope (Spring 2018)

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Objective. A better understanding of long-term development among children with congenital heart disease (CHD) is needed as survival rates have improved.

Population. A cohort of 208 adolescents born between 1998 - 2003, and surgically treated at Children’s Healthcare of Atlanta for CHD and their similarly-aged siblings were recruited to assess long-term outcomes in children with CHD. Parents completed questionnaires about academic and social function of both children. Siblings with birth defects were excluded from the study and if more than one sibling was eligible, the one closest in age to the proband was selected. 

Methods. The association between CHD and academic outcomes was assessed. Three characteristics of poor academic success were studied: ever having an individualized education plan (IEP), current eligibility for an accommodation, and ever repeating a grade since starting kindergarten. Using conditional logistic regression, models were adjusted for sex and current grade. To understand the observed associations better, the combined contribution of CHD, type of school attended and comorbidities were considered on the association with adverse educational outcomes.

Results. Among children with CHD, 71 (34.1%) experienced at least one of three adverse academic outcomes. In contrast, only 33 (15.9%) of the siblings had experienced an academic outcome of interest. From paired crude analysis, the odds of a child with CHD having one of the outcomes was approximately three times greater than the odds among siblings. When controlling for sex and current graded level, children with CHD were more likely to ever have an IEP than were their siblings (OR: 5.79, 95% confidence interval (CI): 2.06, 16.28). The odds of currently receiving an academic accommodation were 5.78 (95% CI: 2.15, 15.54) times the odds for siblings when controlling for current grade. The percentage of children with CHD who had repeated a grade was more than twice that of siblings. When controlling for grade level, the odds of repeating a grade were 4.20 (95% CI: 1.50, 11.70) times greater for children with CHD compared to their siblings.

Conclusions. Among adolescents, individuals with CHD were more likely to experience adverse academic outcomes and require academic assistance compared to their similarly-aged siblings.

Table of Contents

ABBREVIATIONS                                                                               1

BACKGROUND                                                                                  2

METHODS                                                                                           7

                Study Population                                                              7

                Data Collection & Variable Selection                        7

                Data Analysis                                                                     9

RESULTS                                                                                               11

DISCUSSION                                                                                       14

                Strengths and Weaknesses                                          17

FUTURE DIRECTIONS                                                                      19

REFERENCES                                                                                       21

TABLES AND FIGURES                                                                     30

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