Research gaps in the neurodevelopmental assessment of children with complex congenital heart defects: A Scoping Review Provisionally Accepted

Johannes Hofer^{1, 2*} Marina Blum¹ Regina Wiltsche¹ Nikoletta Deluggi¹ Daniel Holzinger^{1, 2, 3} Johannes Fellinger^{1, 2, 4} Gerald Tulzer⁵ Gina Blum¹ Raphael Oberhuber^{1, 5, 6}

• ¹Research Institute for Developmental Medicine, Johannes Kepler University of Linz, Austria
• ²Institut für Sinnes und Sprachneurologie, Krankenhaus Barmherzige Brüder Linz, Austria
• ³Other, Austria
• ⁴Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna,, Austria
• ⁵Children's Heart Center Linz, Department of Pediatric Cardiology, Kepler University Hospital, Austria
• ⁶Department of Inclusive Education, University of Education Upper Austria, Austria

Background: Children with congenital heart defects (CHD) are at risk for a range of developmental disabilities that challenge cognition, executive functioning, self-regulation, communication, social-emotional functioning, and motor skills. Ongoing developmental surveillance is therefore key to maximizing neurodevelopmental outcome opportunities. It is crucial that the measures used cover the spectrum of neurodevelopmental domains relevant to capturing possible predictors and malleable factors of child development.Objectives: This work aimed to synthesize the literature on neurodevelopmental measures and the corresponding developmental domains assessed in children aged 1-8 years with complex CHD. Methods: PubMed was searched for terms relating to psycho-social, cognitive and linguisticcommunicative outcomes in children with CHD. 1,380 papers with a focus on complex CHD that reported neurodevelopmental assessments were identified; ultimately, data from 78 articles that used standardized neurodevelopmental assessment tools were extracted. Results: Thirty-nine (50%) of these excluded children with syndromes, and 9 (12%) excluded children with disorders of intellectual development. 10% of the studies were longitudinal. The neurodevelopmental domains addressed by the methods used were: 53% cognition, 16% psychosocial functioning, 18% language/communication/speech production, and 13% motor development-associated constructs. Conclusions: Data on social communication, expressive and receptive language, speech motor, and motor function are underrepresented. There is a lack of research into everyday use of language and into measures assessing language and communication early in life. Overall, longitudinal studies are required that include communication measures and their interrelations with other developmental domains.