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Specific patterns of executive functioning weaknesses among children after heart transplant
Author(s) -
Jassal Yasmine R.,
Christofferson Elizabeth S.,
Everitt Melanie D.,
Wolfe Kelly R.
Publication year - 2021
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.14033
Subject(s) - cognitive flexibility , anxiety , neuropsychology , executive functions , medicine , cognitive skill , population , cognition , clinical psychology , psychological intervention , executive dysfunction , depression (economics) , flexibility (engineering) , neuropsychological assessment , psychiatry , psychology , statistics , mathematics , environmental health , economics , macroeconomics
Background Children with a history of heart transplant (HT) are at risk of executive functioning weaknesses secondary to heart disease and associated morbidity. However, specific executive functioning weaknesses have not been identified. Method The present study, anchored in Anderson's (2002) Developmental Model of Executive Functioning, provides a detailed, retrospective analysis of executive functioning in the areas of goal setting, cognitive flexibility, attentional control, and information processing for a clinically referred sample of 53 pediatric HT recipients who underwent neuropsychological evaluations as part of typical clinical care. Results Broadly, the sample demonstrated mild‐to‐moderate deficits across cognitive, adaptive behavior, executive functioning, and academic domains, as well as elevated parent‐reported concerns for depression and anxiety. Executive functioning weaknesses, while global, persisted after controlling for the effects of depression and anxiety and were most prominent in cognitive flexibility. In addition, poor cognitive flexibility predicted lower adaptive behavior, IQ, and academic outcomes among this population, placing them at considerable risk of extensive impairment in several domains of their lives. Conclusions Taken together, children with a history of HT demonstrated broad difficulties across several areas of functioning, with particular concerns for working memory. As such, interventions and accommodations specifically targeting working memory may help provide the most optimal outcomes for this population.