{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:19:25Z","timestamp":1787501965964,"version":"build-2736575974"},"reference-count":165,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p xml:lang=\"en\">Due to improvements in recognition and management of their multisystem disease, the long\u2010term survival of infants, children, and adolescents with trisomy 21 and congenital heart disease now matches children with congenital heart disease and no genetic condition in many scenarios. Although this improved survival is a triumph, individuals with trisomy 21 and congenital heart disease have unique and complex care needs in the domains of physical, developmental, and psychosocial health, which affect functional status and quality of life. Pulmonary hypertension and single ventricle heart disease are 2 known cardiovascular conditions that reduce life expectancy in individuals with trisomy 21. Multisystem involvement with respiratory, endocrine, gastrointestinal, hematological, neurological, and sensory systems can interact with cardiovascular health concerns to amplify adverse effects. Neurodevelopmental, psychological, and functional challenges can also affect quality of life. A highly coordinated interdisciplinary care team model, or medical home, can help address these complex and interactive conditions from infancy through the transition to adult care settings. The purpose of this Scientific Statement is to identify ongoing cardiovascular and multisystem, developmental, and psychosocial health concerns for children with trisomy 21 and congenital heart disease from birth through adolescence and to provide a framework for monitoring and management to optimize quality of life and functional status.<\/jats:p>","DOI":"10.1161\/jaha.124.036214","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T05:42:47Z","timestamp":1726119767000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Trisomy 21 and Congenital Heart Disease: Impact on Health and Functional Outcomes From Birth Through Adolescence: A\u00a0Scientific Statement From the American Heart Association"],"prefix":"10.1161","volume":"13","author":[{"given":"Jennifer K.","family":"Peterson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanelle","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce D.","family":"Gelb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine A.","family":"Kasparian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanna","family":"Kazazian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karyn","family":"Pieciak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Pike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun P.","family":"Setty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa K.","family":"Uveges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Rudd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the American Heart Association Pediatric Cardiovascular Nursing Committee of the Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; and Council on Cardiovascular Radiology and Intervention","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000606"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-057010"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001211"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2020.12.058"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.113523"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.491"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025358"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.122.059706"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12823"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.10.014"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2015.11.047"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2013.02.017"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-0123"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1854"},{"key":"e_1_3_2_16_2","unstructured":"National Down Syndrome Society (NDSS) . About down syndrome. Accessed August 2 2023. https:\/\/ndss.org\/about"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2017.12.005"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24687"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-3245"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/2045894018782405"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951114000419"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.07.085"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135121991528"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2017.11.007"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivw413"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2020.06.037"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000764"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.01.026"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000004"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.06.014"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.5409\/wjcp.v10.i6.177"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2022.08.027"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.4250\/jcu.2015.23.2.72"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/HHF.0000000000000080"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000329"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135119893648"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.03.304"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1653-2"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030850"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024883"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7238.816"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13837"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-0625"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12617"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.11"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15153"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.23624"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2017.07.003"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1159\/000457952"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1159\/000362450"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1177\/2150135119857704"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2012.00667.x"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-004-2549-1"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.6065\/apem.2142236.118"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-020-01318-8"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.008124"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2022.2044780"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-0854-5"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-04-350017"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.2147\/EB.S319817"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.09.053"},{"key":"e_1_3_2_62_2","unstructured":"Immunization Schedules|Red Book Online|American Academy of Pediatrics . Accessed August 9 2023. https:\/\/publications.aap.org\/redbook\/pages\/Immunization\u2010Schedules"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.1064108"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2021.03.023"},{"key":"e_1_3_2_65_2","unstructured":"National Down Syndrome Society (NSDD) . Physical Therapy Occupational Therapy & Down Syndrome|National Down Syndrome Society (NDSS). Accessed September 17 2023. https:\/\/ndss.org\/resources\/pt\u2010ot\u2010down\u2010syndrome"},{"key":"e_1_3_2_66_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2016.29014.jat"},{"key":"e_1_3_2_67_2","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0000000000000582"},{"key":"e_1_3_2_68_2","unstructured":"Guy J Neve A. Music therapy & down syndrome fact sheet. Accessed October 6 2023. https:\/\/www.themusictherapycenter.com\/wp\u2010content\/uploads\/2016\/11\/mtcca_downsyndrome.pdf"},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1161\/HCQ.0000000000000110"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12780"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1754470X22000587"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1037\/cps0000077"},{"key":"e_1_3_2_73_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2013.08.030"},{"key":"e_1_3_2_74_2","doi-asserted-by":"publisher","DOI":"10.1352\/1944-7558-126.2.114"},{"key":"e_1_3_2_75_2","unstructured":"Eunice Kennedy Scriver National Institute of Child Health and Development . What are common treatments for Down syndrome? 2023. Accessed January 7 2024. https:\/\/www.nichd.nih.gov\/health\/topics\/down\/conditioninfo\/treatments"},{"key":"e_1_3_2_76_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2021-001669"},{"key":"e_1_3_2_77_2","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12977"},{"key":"e_1_3_2_78_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060995"},{"key":"e_1_3_2_79_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951123000525"},{"key":"e_1_3_2_80_2","unstructured":"Down Syndrome Education International . Education21\u2014#6. Inclusive education can provide better language and academic outcomes. 2023. Accessed August 10 2023. https:\/\/www.down\u2010syndrome.org\/en\u2010us\/research\/education\u201021\/6\/"},{"key":"e_1_3_2_81_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-008-2188-7"},{"key":"e_1_3_2_82_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v5.i7.264"},{"key":"e_1_3_2_83_2","doi-asserted-by":"publisher","DOI":"10.3390\/dj10110205"},{"key":"e_1_3_2_84_2","first-page":"38","article-title":"Caring for children with trisomy 21 in the dental setting","volume":"5","author":"Wang K","year":"2019","unstructured":"Wang K. Caring for children with trisomy 21 in the dental setting. Decisions Dent. 2019;5:38\u201341. Accessed August 9, 2023. https:\/\/decisionsindentistry.com\/article\/caring\u2010children\u2010trisomy\u201021\/","journal-title":"Decisions Dent"},{"key":"e_1_3_2_85_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11113217"},{"key":"e_1_3_2_86_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40949-021-00061-3"},{"key":"e_1_3_2_87_2","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14138"},{"key":"e_1_3_2_88_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-053418"},{"key":"e_1_3_2_89_2","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000382"},{"key":"e_1_3_2_90_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2009.80"},{"key":"e_1_3_2_91_2","doi-asserted-by":"publisher","DOI":"10.3233\/TRD-200090"},{"key":"e_1_3_2_92_2","unstructured":"Down Syndrome Education International . Education21\u2014#4. Learning to talk is a particular challenge. Accessed August 10 2023. https:\/\/www.down\u2010syndrome.org\/en\u2010us\/research\/education\u201021\/4\/"},{"key":"e_1_3_2_93_2","doi-asserted-by":"publisher","DOI":"10.1097\/DBP.0b013e3181d5aa6d"},{"key":"e_1_3_2_94_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.13217"},{"key":"e_1_3_2_95_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-023-03146-5"},{"key":"e_1_3_2_96_2","doi-asserted-by":"publisher","DOI":"10.1002\/aur.1371"},{"key":"e_1_3_2_97_2","unstructured":"National Down Syndrome Society (NSDD) . Mental Health & Down Syndrome|National Down Syndrome Society (NDSS). Accessed September 17 2023. https:\/\/ndss.org\/resources\/mental\u2010health\u2010down\u2010syndrome"},{"key":"e_1_3_2_98_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239040"},{"key":"e_1_3_2_99_2","doi-asserted-by":"publisher","DOI":"10.1161\/HCQ.0000000000000114"},{"key":"e_1_3_2_100_2","unstructured":"American College of Physicians . Pediatric to Adult Care Transitions Initiative|ACP. Pediatric to Adult Care Transitions Initiative. Accessed February 27 2024. https:\/\/www.acponline.org\/clinical\u2010information\/high\u2010value\u2010care\/resources\u2010for\u2010clinicians\/pediatric\u2010to\u2010adult\u2010care\u2010transitions\u2010initiative"},{"key":"e_1_3_2_101_2","unstructured":"Toronto Congenital Cardiac Centre for Adults . I <3 Change. I Heart Change. Accessed February 27 2024. https:\/\/iheartchange.org\/"},{"key":"e_1_3_2_102_2","unstructured":"The National Alliance to Advance Adolescent Health . Got Transition\u00ae. Accessed February 27 2024. GotTransition.org. https:\/\/www.gottransition.org\/"},{"key":"e_1_3_2_103_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-3447"},{"key":"e_1_3_2_104_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6904a1"},{"key":"e_1_3_2_105_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.aac9396"},{"key":"e_1_3_2_106_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cels.2021.07.009"},{"key":"e_1_3_2_107_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951123000598"},{"key":"e_1_3_2_108_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1813"},{"key":"e_1_3_2_109_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396941520962406"},{"key":"e_1_3_2_110_2","doi-asserted-by":"publisher","DOI":"10.1186\/1866-1955-7-5"},{"key":"e_1_3_2_111_2","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12344"},{"key":"e_1_3_2_112_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19106043"},{"key":"e_1_3_2_113_2","doi-asserted-by":"publisher","DOI":"10.1111\/cch.13174"},{"key":"e_1_3_2_114_2","doi-asserted-by":"publisher","DOI":"10.1177\/0883073811405201"},{"key":"e_1_3_2_115_2","doi-asserted-by":"publisher","DOI":"10.17294\/2330-0698.1875"},{"key":"e_1_3_2_116_2","unstructured":"National Down Syndrome Society (NSDD) . ADHD & Down Syndrome|National Down Syndrome Society (NDSS). Accessed September 17 2023. https:\/\/ndss.org\/resources\/adhd\u2010down\u2010syndrome"},{"key":"e_1_3_2_117_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-1693"},{"key":"e_1_3_2_118_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcell.2022.877711"},{"key":"e_1_3_2_119_2","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2013.24"},{"key":"e_1_3_2_120_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.36861"},{"key":"e_1_3_2_121_2","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12322"},{"key":"e_1_3_2_122_2","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12376"},{"key":"e_1_3_2_123_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10309-022-00506-8"},{"key":"e_1_3_2_124_2","doi-asserted-by":"publisher","DOI":"10.1186\/s11689-019-9306-9"},{"key":"e_1_3_2_125_2","doi-asserted-by":"publisher","DOI":"10.5014\/ajot.2014.009274"},{"key":"e_1_3_2_126_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.38721"},{"key":"e_1_3_2_127_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2016.08.018"},{"key":"e_1_3_2_128_2","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci11081012"},{"key":"e_1_3_2_129_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.33553"},{"key":"e_1_3_2_130_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-013-0820-3"},{"key":"e_1_3_2_131_2","volume-title":"Children, Families, and Health Care Decision\u2010Making","author":"Ross LF","year":"2004","unstructured":"Ross LF. Children, Families, and Health Care Decision\u2010Making. Oxford University Press; 2004."},{"key":"e_1_3_2_132_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0280014"},{"key":"e_1_3_2_133_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951115000062"},{"key":"e_1_3_2_134_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2020.1745907"},{"key":"e_1_3_2_135_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2019.104837"},{"key":"e_1_3_2_136_2","doi-asserted-by":"publisher","DOI":"10.1080\/17437199.2021.1927136"},{"key":"e_1_3_2_137_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004862"},{"key":"e_1_3_2_138_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-016-2902-6"},{"key":"e_1_3_2_139_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.028489"},{"key":"e_1_3_2_140_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-019-02774-9"},{"key":"e_1_3_2_141_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-2254"},{"key":"e_1_3_2_142_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.S4.1485"},{"key":"e_1_3_2_143_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.01.072"},{"key":"e_1_3_2_144_2","unstructured":"National Down Syndrome Society (NSDD) . National Down Syndrome Society (NDSS). National Downs Syndrome Society Resources & Support. Accessed February 26 2024. https:\/\/ndss.org\/"},{"key":"e_1_3_2_145_2","unstructured":"National Association for Down Syndrome . National Association for Down Syndrome|Serving the Down Syndrome community since 1960. National Association for Down Syndrome. Accessed February 26 2024. https:\/\/www.nads.org\/"},{"key":"e_1_3_2_146_2","unstructured":"National Academy for State Health Policy . National care coordination standards for children and youth with special healthcare needs. Accessed August 11 2023. https:\/\/eadn\u2010wc03\u20108290287.nxedge.io\/wp\u2010content\/uploads\/2022\/12\/care\u2010coordination\u2010report\u2010v5.pdf"},{"key":"e_1_3_2_147_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.121.008531"},{"key":"e_1_3_2_148_2","unstructured":"The Americans with disabilities act. ADA.gov. Accessed August 11 2023. https:\/\/www.ada.gov\/"},{"key":"e_1_3_2_149_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0034369"},{"key":"e_1_3_2_150_2","unstructured":"Special Olympics International launches \u201cThe Revolution is Inclusion\u201d Campaign. Accessed August 11 2023. SpecialOlympics.org. https:\/\/www.specialolympics.org\/about\/press\u2010releases\/special\u2010olympics\u2010international\u2010launches\u2010the\u2010revolution\u2010is\u2010inclusion\u2010campaign"},{"key":"e_1_3_2_151_2","volume-title":"NIH Designates People with Disabilities as a Population with Health Disparities","author":"National Institutes of Health","year":"2023","unstructured":"National Institutes of Health . NIH Designates People with Disabilities as a Population with Health Disparities. 2023. National Institutes of Health (NIH); Accessed September 27, 2023. https:\/\/www.nih.gov\/news\u2010events\/news\u2010releases\/nih\u2010designates\u2010people\u2010disabilities\u2010population\u2010health\u2010disparities"},{"key":"e_1_3_2_152_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.190690"},{"key":"e_1_3_2_153_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3182107c56"},{"key":"e_1_3_2_154_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3050"},{"key":"e_1_3_2_155_2","unstructured":"Down Syndrome International . Legal capacity and supported decision making. Down Syndrome International. Accessed January 5 2024. https:\/\/www.ds\u2010int.org\/pages\/category\/legal\u2010capacity\u2010and\u2010supported\u2010decision\u2010making"},{"key":"e_1_3_2_156_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.025278"},{"key":"e_1_3_2_157_2","doi-asserted-by":"publisher","DOI":"10.1111\/jar.13015"},{"key":"e_1_3_2_158_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.62403"},{"key":"e_1_3_2_159_2","doi-asserted-by":"publisher","DOI":"10.1111\/petr.14383"},{"key":"e_1_3_2_160_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0137093"},{"key":"e_1_3_2_161_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2022.05.006"},{"key":"e_1_3_2_162_2","doi-asserted-by":"publisher","DOI":"10.17294\/2330-0698.1824"},{"key":"e_1_3_2_163_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2020.06.190425"},{"key":"e_1_3_2_164_2","doi-asserted-by":"publisher","DOI":"10.1177\/10748407231163236"},{"key":"e_1_3_2_165_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-019-01457-2"},{"key":"e_1_3_2_166_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.104.2.337"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.036214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T05:44:25Z","timestamp":1728452665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.036214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":165,"journal-issue":{"issue":"19","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1161\/JAHA.124.036214"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.036214","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]},"assertion":[{"value":"2024-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e036214"}}