Cardiac Neurodevelopment Program  (CNP)

Neurodevelopment is the word used to describe how the brain makes connections that help us learn, focus, develop social skills, etc. Your brain makes these connections all the way until early adulthood, and heart defects can affect with the way the connections are made.

The American Heart Association (AHA) and the American Academy of Pediatrics (AAP) recommend developmental or neuropsychological testing for all children with high-risk congenital heart disease. Even if your child is meeting all of their milestones when they are young, they may have difficulties with learning, thinking, or behavior as they age.

Evaluation is recommended for children who:

• Had open heart surgery as a newborn or infant
• Have a heart condition that causes decreased oxygen levels (cyanotic heart lesions) – even if this is repaired and your child now has normal oxygen levels. 

OR if your child has CHD and any of the following:

• Prematurity (<37 weeks)
• Developmental Delay
• Genetic Syndrome associated with Developmental Delays
• History of mechanical support (ECMO or VAD use)
• Heart Transplant
• Cardiopulmonary Resuscitation (CPR/Code)
• A hospital stay longer than two (2) weeks after cardiac surgery
• Perioperative seizures related to cardiac surgery
• Abnormalities on neuroimaging

If your child does not meet the high-risk criteria, but you have concerns about their development, please discuss your concerns with your cardiologist.

Not every child who has CHD will have neurodevelopmental problems.

Some children may have delays that are noticed early on. In infants through pre-k, this may look like this:

• Gross Motor Delays (crawling/walking)
• Difficulty with Fine Motor Skills (drawing/writing)
• Language Delays
• Poor attention
• Difficulty managing emotions and behavior
• Less socially and emotionally mature than other children their age
• Feeding
• Sleeping

They may need physical, speech, occupational, or feeding therapy to help with this.

Some children may only have delays showing up once they start school. Some children may have difficulties learning more complex information, where their brain has to work quickly to process it. This may look like difficulty with:

• Attention
• Memory
• Organization and planning
• Reading and math
• Visual-spatial skills
• Social skills

Learn more about supporting development in children with congenital heart disease.