{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:27:21Z","timestamp":1762658841226,"version":"3.40.5"},"reference-count":63,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,3,1]]},"abstract":"<jats:p>Objective. Research into cognitive development and behavior in children undergoing heart or heart-lung transplantation has focused mainly on older children, with investigation of children undergoing transplantation as infants or toddlers being largely retrospective. This study was conducted, therefore, to obtain pretransplant baseline measures of development and behavior for preschool-aged children.<\/jats:p><jats:p>Methods. Children &amp;lt;3.5 years old were assessed before transplantation (n = 35) and compared with a group of children awaiting conventional cardiac surgery, a group undergoing bone marrow transplantation, and a group of healthy children. Development was measured by using the Ruth Griffiths Mental Development Scales, and behavior was measured with the Achenbach Child Behavior Checklist.<\/jats:p><jats:p>Results. Within the transplant group, 17 had congenital heart disease (CHD), and 18 had cardiomyopathy (CM). Although the overall mean developmental scores were within the normal range for the transplant, conventional cardiac surgery, and bone marrow transplantation groups, scores were significantly lower than those of the healthy group. Within the transplant group, those with CHD had a significantly lower mean developmental quotient than those with CM. Furthermore, the CHD patients obtained significantly lower scores than those with CM on areas of development covering locomotor abilities, speech and hearing, eye-hand coordination, and performance.<\/jats:p><jats:p>Conclusions. In common with other groups of ill children, patients awaiting heart or heart-lung transplantation are at risk for developmental delay. Diagnosis is a salient factor in determining outcome in most areas of development. Psychosocial interventions need to be targeted to maximize developmental potential before transplantation.<\/jats:p>","DOI":"10.1542\/peds.113.3.488","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:53:04Z","timestamp":1092444784000},"page":"488-495","source":"Crossref","is-referenced-by-count":22,"title":["Developmental and Behavioral Status of Infants and Young Children Awaiting Heart or Heart-Lung Transplantation"],"prefix":"10.1542","volume":"113","author":[{"given":"Jo","family":"Wray","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Royal Brompton and Harefield National Health Service Trust, Harefield Hospital, Middlesex, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary","family":"Radley-Smith","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Royal Brompton and Harefield National Health Service Trust, Harefield Hospital, Middlesex, United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2004,3,1]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"Eiser C. Psychological sequelae of brain tumours in childhood: a retrospective study. Br J Clin Psychol.1981;20:35\u201338","key":"2021121006113472500_R1","DOI":"10.1111\/j.2044-8260.1981.tb00493.x"},{"doi-asserted-by":"crossref","unstructured":"So SKS, Chang PN, Najarian JS, Mauer SM, Simmons RL, Nevins TE. Growth and development in infants after renal transplantation. J Pediatr.1987;110:343\u2013350","key":"2021121006113472500_R2","DOI":"10.1016\/S0022-3476(87)80491-2"},{"doi-asserted-by":"crossref","unstructured":"Stewart SM, Uauy R, Waller DA, Kennard BD, Andrews WS. Mental and motor development correlates in patients with end-stage biliary atresia awaiting liver transplantation. Pediatrics.1987;79:882\u2013888","key":"2021121006113472500_R3","DOI":"10.1542\/peds.79.6.882"},{"doi-asserted-by":"crossref","unstructured":"Davis ID, Chang P, Nevins TE. Successful renal transplantation accelerates development in young uremic children. Pediatrics.1990;86:594\u2013600","key":"2021121006113472500_R4","DOI":"10.1542\/peds.86.4.594"},{"doi-asserted-by":"crossref","unstructured":"Wayman KI, Cox KL, Esquivel CO. Neurodevelopmental outcome of young children with extrahepatic biliary atresia 1 year after liver transplantation. J Pediatr.1997;131:894\u2013898","key":"2021121006113472500_R5","DOI":"10.1016\/S0022-3476(97)70039-8"},{"doi-asserted-by":"crossref","unstructured":"Polinsky MS, Kaiser BA, Stover JB, Frankenfield M, Baluarte HJ. Neurologic development of children with severe chronic renal failure from infancy. Pediatr Nephrol.1987;1:157\u2013165","key":"2021121006113472500_R6","DOI":"10.1007\/BF00849288"},{"unstructured":"Gonzalez-Pardo L, Miles M, Taylor M, Mattioli L. Congenital heart disease: developmental and neurological evaluation in preschool children. J Kans Med Soc.1981;82:115\u2013118","key":"2021121006113472500_R7"},{"doi-asserted-by":"crossref","unstructured":"O\u2019Dougherty M, Wright FS, Garmezy N, Loewenson RB, Torres F. Later competence and adaptation in infants who survive severe heart defects. Child Dev.1983;54:1129\u20131142","key":"2021121006113472500_R8","DOI":"10.2307\/1129669"},{"doi-asserted-by":"crossref","unstructured":"Newburger JW, Silbert AR, Buckley LP, Fyler DC. Cognitive function and age at repair of transposition of the great arteries in children. N Engl J Med.1984;310:1495\u20131499","key":"2021121006113472500_R9","DOI":"10.1056\/NEJM198406073102303"},{"doi-asserted-by":"crossref","unstructured":"Aram DM, Ekelman BL, Ben-Shachar G, Levinsohn MW. Intelligence and hypoxemia in children with congenital heart disease: fact or artifact?J Am Coll Cardiol.1985;6:889\u2013893","key":"2021121006113472500_R10","DOI":"10.1016\/S0735-1097(85)80501-5"},{"doi-asserted-by":"crossref","unstructured":"DeMaso DR, Beardslee WR, Silbert AR, Fyler DC. Psychological functioning in children with cyanotic heart defects. J Dev Behav Pediatr.1990;11:289\u2013294","key":"2021121006113472500_R11","DOI":"10.1097\/00004703-199012000-00002"},{"doi-asserted-by":"crossref","unstructured":"Stieh J, Kramer HH, Harding P, Fischer G. Gross and fine motor development is impaired in children with cyanotic congenital heart disease. Neuropediatrics.1999;30:77\u201382","key":"2021121006113472500_R12","DOI":"10.1055\/s-2007-973464"},{"doi-asserted-by":"crossref","unstructured":"Samango-Sprouse C, Suddaby EC. Developmental concerns in children with congenital heart disease. Curr Opin Cardiol.1997;12:91\u201398","key":"2021121006113472500_R13","DOI":"10.1097\/00001573-199701000-00014"},{"doi-asserted-by":"crossref","unstructured":"Aisenberg RB, Rosenthal A, Nadas AS, Wolff PH. Developmental delay in infants with congenital heart disease-correlation with hypoxemia and congestive heart failure. Pediatr Cardiol.1982;3:133\u2013137","key":"2021121006113472500_R14","DOI":"10.1007\/BF02312960"},{"doi-asserted-by":"crossref","unstructured":"Limperopoulos C, Majnemer A, Shevell MI, Rosenblatt B, Roblicek C, Tchervenkov C. Neurodevelopmental status of newborns and infants with congenital heart defects before and after open heart surgery. J Pediatr.2000;137:638\u2013645","key":"2021121006113472500_R15","DOI":"10.1067\/mpd.2000.109152"},{"doi-asserted-by":"crossref","unstructured":"Dees E, Lin H, Cotton RB, Graham TP, Dodd DA. Outcome of preterm infants with congenital heart disease. J Pediatr.2000;137:653\u2013659","key":"2021121006113472500_R16","DOI":"10.1067\/mpd.2000.108568"},{"unstructured":"Baum M, Chinnock R, Ashwal S, Peverini R, Trimm F, Bailey L. Growth and neurodevelopmental outcome of infants undergoing heart transplantation. J Heart Lung Transplant.1993;12:S211\u2013S217","key":"2021121006113472500_R17"},{"doi-asserted-by":"crossref","unstructured":"Baum M, Freier C, Freeman KR, Chinnock RE. Developmental outcomes and cognitive functioning in infant and child heart transplant recipients. Prog Pediatr Cardiol.2000;11:159\u2013163","key":"2021121006113472500_R18","DOI":"10.1016\/S1058-9813(00)00046-1"},{"doi-asserted-by":"crossref","unstructured":"Fleisher BE, Baum D, Brudos G, et al. Infant heart transplantation at Stanford: growth and neurodevelopmental outcome. Pediatrics.2002;109:1\u20137","key":"2021121006113472500_R19","DOI":"10.1542\/peds.109.1.1"},{"doi-asserted-by":"crossref","unstructured":"Wray J, Sensky T. Controlled study of preschool development after surgery for congenital heart disease. Arch Dis Child.1999;80:511\u2013516","key":"2021121006113472500_R20","DOI":"10.1136\/adc.80.6.511"},{"unstructured":"Pot-Mees C. The Psychosocial Effects of Bone Marrow Transplantation in Children. Delft, The Netherlands: Eburon Delft; 1989","key":"2021121006113472500_R21"},{"unstructured":"Griffiths R. The Abilities of Babies: A Study in Mental Measurement. Thetford, United Kingdom: Lowe & Brydone Ltd; 1954","key":"2021121006113472500_R22"},{"unstructured":"Griffiths R. The Abilities of Young Children: A Comprehensive System of Mental Measurement for the First Eight Years of Life. London, United Kingdom: Child Development Research Centre; 1970","key":"2021121006113472500_R23"},{"doi-asserted-by":"crossref","unstructured":"Rasof B, Linde LM, Dunn OJ. Intellectual development in children with congenital heart disease. Child Dev.1967;38:1043\u20131053","key":"2021121006113472500_R24","DOI":"10.2307\/1127102"},{"doi-asserted-by":"crossref","unstructured":"Aldridge Smith J, Bidder RT, Gardner SM, Gray OP. Griffiths Scales of Mental Development and different users. Child Care Health Dev.1980;6:11\u201316","key":"2021121006113472500_R25","DOI":"10.1111\/j.1365-2214.1980.tb00792.x"},{"doi-asserted-by":"crossref","unstructured":"Hanson R, Aldridge-Smith J, Hume W. Achievements of infants on items of the Griffiths Scales: 1980 compared with 1950. Child Care Health Dev.1985;11:91\u2013104","key":"2021121006113472500_R26","DOI":"10.1111\/j.1365-2214.1985.tb00454.x"},{"unstructured":"Tyler B, Miller K. The use of tests by psychologists: report on a survey of BPS members. Bull Br Psychol Soc.1986;39:405\u2013410","key":"2021121006113472500_R27"},{"doi-asserted-by":"crossref","unstructured":"Bidder RT, Bryant G, Gray OP. Benefits to Down\u2019s syndrome children through training their mothers. Arch Dis Child.1975;50:383\u2013386","key":"2021121006113472500_R28","DOI":"10.1136\/adc.50.5.383"},{"doi-asserted-by":"crossref","unstructured":"Balestrini MR, Zanette M, Micheli R, Fornari M, Solero CL, Broggi G. Hemispheric cerebral tumors in children. Long-term prognosis concerning survival rate and quality of life\u2013considerations on a series of 64 cases operated upon. Childs Nerv Syst.1990;6:143\u2013147","key":"2021121006113472500_R29","DOI":"10.1007\/BF00308491"},{"doi-asserted-by":"crossref","unstructured":"Ludman L, Spitz L, Lansdown R. Intellectual development at 3 years of age of children who underwent major neonatal surgery. J Pediatr Surg.1993;28:130\u2013134","key":"2021121006113472500_R30","DOI":"10.1016\/S0022-3468(05)80257-X"},{"doi-asserted-by":"crossref","unstructured":"Van Mourik ID, Beath SV, Brook GA, Cash AJ, Mayer AD, Buckels JA, Kelly DA. Long-term nutritional and neurodevelopmental outcome of liver transplantation in infants aged less than 12 months. J Pediatr Gastroenterol Nutr.200;30:269\u2013275","key":"2021121006113472500_R31","DOI":"10.1097\/00005176-200003000-00011"},{"doi-asserted-by":"crossref","unstructured":"Achenbach TM, Edelbrock C, Howell CT. Empirically based assessment of the behavioral\/emotional problems of 2- and 3- year-old children. J Abnorm Child Psychol.1987;15:629\u2013650","key":"2021121006113472500_R32","DOI":"10.1007\/BF00917246"},{"doi-asserted-by":"crossref","unstructured":"Utens EMWJ, Versluis-Den Bieman HJ, Witsenburg M, Bogers AJJC, Verhulst FC, Hess J. Cognitive and behavioural and emotional functioning of young children awaiting elective cardiac surgery or catheter intervention. Cardiol Young.2001;11:153\u2013160","key":"2021121006113472500_R33","DOI":"10.1017\/S104795110100004X"},{"doi-asserted-by":"crossref","unstructured":"Bellinger DC, Wypij D, du Plessis AJ, et al. Developmental and neurologic effects of alpha-stat versus Ph-stat strategies for deep hypothermic cardiopulmonary bypass in infants. J Thorac Cardiovasc Surg.2001;121:374\u2013383","key":"2021121006113472500_R34","DOI":"10.1067\/mtc.2001.111206"},{"doi-asserted-by":"crossref","unstructured":"Bellinger DC, Wernovsky G, Rappaport LA, et al. Cognitive development of children following early repair of transposition of the great arteries using deep hypothermic circulatory arrest. Pediatrics.1991;87:701\u2013701","key":"2021121006113472500_R35","DOI":"10.1542\/peds.87.5.701"},{"doi-asserted-by":"crossref","unstructured":"O\u2019Dougherty M, Wright FS, Loewenson RB, Torres F. Cerebral dysfunction after chronic hypoxia in children. Neurology.1985;35:42\u201346","key":"2021121006113472500_R36","DOI":"10.1212\/WNL.35.1.42"},{"doi-asserted-by":"crossref","unstructured":"Smedler A-C, Bolme P. Neuropsychological deficits in very young bone marrow transplant recipients. Acta Paediatr.1995;84:429\u2013433","key":"2021121006113472500_R37","DOI":"10.1111\/j.1651-2227.1995.tb13665.x"},{"unstructured":"Stein REK, Jessop DJ. A noncategorical approach to chronic childhood illness. Public Health Rep.1982;97:354\u2013362","key":"2021121006113472500_R38"},{"doi-asserted-by":"crossref","unstructured":"Vernon DTA, Schulman JL, Foley JM. Changes in children\u2019s behavior after hospitalization. Some dimensions of response and their correlates. Am J Dis Child.1966;111:581\u2013593","key":"2021121006113472500_R39","DOI":"10.1001\/archpedi.1966.02090090053003"},{"doi-asserted-by":"crossref","unstructured":"Goslin ER. Hospitalization as a life crisis for the preschool child: a critical review. J Community Health.1978;3:321\u2013346","key":"2021121006113472500_R40","DOI":"10.1007\/BF01498508"},{"unstructured":"Stein A, Barnes J. Feeding and sleeping disorder. In: Rutter M, Taylor E, eds. Child and Adolescent Psychiatry: Modern Approaches. Fourth ed. Oxford, United Kingdom: Blackwell Scientific Publications; 2002","key":"2021121006113472500_R41"},{"doi-asserted-by":"crossref","unstructured":"Jenkins S, Owen C, Bax M, Hart H. Continuities of common behavior problems in preschool children. J Child Psychol Psychiatry.1984;25:75\u201389","key":"2021121006113472500_R42","DOI":"10.1111\/j.1469-7610.1984.tb01720.x"},{"doi-asserted-by":"crossref","unstructured":"Clemente C, Barnes J, Shinebourne E, Stein A. Are infant behavioural feeding difficulties associated with congenital heart disease?Child Care Health Dev.2001;27:47\u201359","key":"2021121006113472500_R43","DOI":"10.1046\/j.1365-2214.2001.00199.x"},{"unstructured":"Gudermuth S. Mothers\u2019 reports of early experiences of infants with congenital heart disease. Matern Child Nurs J.1975;4:155\u2013164","key":"2021121006113472500_R44"},{"unstructured":"D\u2019Antonio IJ. Mothers\u2019 responses to the functioning and behavior of cardiac children in child-rearing situations. Matern Child Nurs J.1976;5:206\u2013259","key":"2021121006113472500_R45"},{"doi-asserted-by":"crossref","unstructured":"Wray J, Sensky T. How does the intervention of cardiac surgery affect the self-perception of children with congenital heart disease?Child Care Health Dev.1998;24:57\u201372","key":"2021121006113472500_R46","DOI":"10.1046\/j.1365-2214.1998.00058.x"},{"doi-asserted-by":"crossref","unstructured":"Cohn JK. An empirical study of parents\u2019 reaction to the diagnosis of congenital heart disease in infants. Soc Work Health Care.1996;23:67\u201379","key":"2021121006113472500_R47","DOI":"10.1300\/J010v23n02_04"},{"doi-asserted-by":"crossref","unstructured":"Menahem S. Counselling strategies for parents of infants with congenital heart disease. Cardiol Young.1998;8:400\u2013407","key":"2021121006113472500_R48","DOI":"10.1017\/S104795110000696X"},{"doi-asserted-by":"crossref","unstructured":"Linde LM, Rasof B, Dunn OJ, Rabb E. Attitudinal factors in congenital heart disease. Pediatrics.1966;38:92\u2013101","key":"2021121006113472500_R49","DOI":"10.2307\/1127102"},{"doi-asserted-by":"crossref","unstructured":"Offord DR, Cross LA, Andrews EJ, Aponte JF. Perceived and actual severity of congenital heart disease and effect on family life. Psychosomatics.1972;13:390\u2013396","key":"2021121006113472500_R50","DOI":"10.1016\/S0033-3182(72)71390-0"},{"unstructured":"Lobo ML. Parent-infant interaction during feeding when the infant has congenital heart disease. J Pediatr Nurs.1992;7:97\u2013105","key":"2021121006113472500_R51"},{"doi-asserted-by":"crossref","unstructured":"Hovels-Gurich HH, Seghaye M-C, Dabritz S, Messmer BJ, von Bernuth G. Cognitive and motor development in preschool and school-aged children after neonatal arterial switch operation. J Thorac Cardiovasc Surg.1997;114:578\u2013585","key":"2021121006113472500_R52","DOI":"10.1016\/S0022-5223(97)70047-3"},{"doi-asserted-by":"crossref","unstructured":"Bellinger DC, Jonas RA, Rappaport LA, et al. Developmental and neurological status of children after heart surgery with hypothermic circulatory arrest or low-flow cardiopulmonary bypass. New Engl J Med.1995;332:549\u2013555","key":"2021121006113472500_R53","DOI":"10.1056\/NEJM199503023320901"},{"doi-asserted-by":"crossref","unstructured":"Gomelsky A, Holden EW, Ellerbeck KA, Brenner JI. Predictors of developmental outcomes in children with complete transposition. Cardiol Young.1998;8:352\u2013357","key":"2021121006113472500_R54","DOI":"10.1017\/S1047951100006867"},{"doi-asserted-by":"crossref","unstructured":"Oates RK, Turnbull JAB, Simpson JM, Cartmill TB. Parent and teacher perceptions of child behaviour following cardiac surgery. Acta Paediatr.1994;83:1303\u20131307","key":"2021121006113472500_R55","DOI":"10.1111\/j.1651-2227.1994.tb13021.x"},{"doi-asserted-by":"crossref","unstructured":"Utens EMWJ, Verhulst FC, Meijboom FJ, et al. Behavioural and emotional problems in children and adolescents with congenital heart disease. Psychol Med.1993;23:415\u2013424","key":"2021121006113472500_R56","DOI":"10.1017\/S0033291700028518"},{"unstructured":"Graham P. Child Psychiatry: A Developmental Approach. Oxford, United Kingdom: Oxford University Press; 1986","key":"2021121006113472500_R57"},{"doi-asserted-by":"crossref","unstructured":"Angold A, Weissman MM, John K, et al. Parent and child reports of depressive symptoms in children at low and high risk of depression. J Child Psychol Psychiatry.1987;28:901\u2013915","key":"2021121006113472500_R58","DOI":"10.1111\/j.1469-7610.1987.tb00678.x"},{"doi-asserted-by":"crossref","unstructured":"Mulhern RK, Fairclough DL, Smith B, Douglas SM. Maternal depression, assessment methods and physical symptoms affect estimates of depressive symptomatology among children with cancer. J Pediatr Psychol.1992;17:313\u2013326","key":"2021121006113472500_R59","DOI":"10.1093\/jpepsy\/17.3.313"},{"doi-asserted-by":"crossref","unstructured":"Webster-Stratton C. Stress: a potential description of parent perceptions and family interactions. J Clin Child Psychol.1990;19:302\u2013312","key":"2021121006113472500_R60","DOI":"10.1207\/s15374424jccp1904_2"},{"doi-asserted-by":"crossref","unstructured":"DeMaso DR, Campis LK, Wypij D, Bertram S, Lipshitz M, Freed M. The impact of maternal perceptions and medical severity on the adjustment of children with congenital heart disease. J Pediatr Psychol.1991;16:137\u2013149","key":"2021121006113472500_R61","DOI":"10.1093\/jpepsy\/16.2.137"},{"doi-asserted-by":"crossref","unstructured":"Wray J, Pot-Mees C, Zeitlin H, Radley-Smith R, Yacoub M. Cognitive function and behavioural status in paediatric heart and heart-lung transplant recipients: the Harefield experience. BMJ.1994;309:837\u2013841","key":"2021121006113472500_R62","DOI":"10.1136\/bmj.309.6958.837"},{"doi-asserted-by":"crossref","unstructured":"Suddaby EC, Samango-Sprouse C, Vaught DR, Custer DA. Neurodevelopmental outcome of infant cardiac recipients. J Transplant Coordination.1996;6:9\u201313","key":"2021121006113472500_R63","DOI":"10.7182\/prtr.1.6.1.y447584r15628742"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/113\/3\/488\/1014748\/zpe00304000488.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/113\/3\/488\/1014748\/zpe00304000488.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T05:43:31Z","timestamp":1682747011000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/113\/3\/488\/63880\/Developmental-and-Behavioral-Status-of-Infants-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,3,1]]},"references-count":63,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2004,3,1]]},"published-print":{"date-parts":[[2004,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.113.3.488","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"type":"print","value":"0031-4005"},{"type":"electronic","value":"1098-4275"}],"subject":[],"published":{"date-parts":[[2004,3,1]]}}}