INS NYC 2024 Program

Poster	Poster Session 10 Program Schedule 02/17/2024 09:00 am - 10:15 am Room: Majestic Complex (Posters 61-120) Poster Session 10: Neurodevelopmental \| Congenital Conditions Final Abstract #96 Executive Function Predicts Adaptive Functioning in Children with Congenital Heart Disease Without Intellectual Disability Samantha van Terheyden, Children's National Hospital, Washington, United States Rachel Richie, Children's National Hospital, Washington, United States Brenda Mitchell, The Chicago School of Professional Psychology, Washington, United States Mary Donofrio, Children's National Hospital, Washington, United States Jacqueline Sanz, Children's National Hospital, Washington, United States Category: Medical/Neurological Disorders/Other (Child) Keyword 1: adaptive functioning Keyword 2: executive functions Keyword 3: pediatric neuropsychology Objective: Children with Congenital Heart Disease (CHD) are at an increased risk of neurodevelopmental challenges including deficits in Executive Functioning (EF), Adaptive Functioning (AF), and quality of life (Marino et al., 2012; Cassidy et al., 2018). While AF is associated with FSIQ in CHD (Tan et al., 2022), the relationship between AF and EF in children with CHD is less clear. Prior research in populations of children with Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) found that deficits in EF significantly contributed to AF (Gardiner & Iarocci 2017; Tsermentseli et al., 2018). The present study seeks to examine how EF contributes to AF in children with CHD. We hypothesize these constructs will correlate with one another, and that beyond IQ, EF contributes substantially to variance in AF. Participants and Methods: 102 children (M age= 10.4±3.48, 53.9% male, 54.98% white) with CHD were administered the Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF-2) to measure EF and the Adaptive Behavior Assessment System, 3rd Edition (ABAS-3) to measure AF as part of their routine assessment through the Cardiac Neurodevelopmental Outcome (CANDO) program. Pearson’s correlations examined the relationship between Global EF and General AF. From this group, 88 children (M age= 10.3±3.56, 58.4% male, 52.8% white) were also administered the Wechsler Intelligence Scale, 5^thEdition (WISC-5). Multiple regression analyses examined the relationship between AF and age, Full Scale IQ (FSIQ), and EF. Results: There were statistically significant correlations between Composite scores from the ABAS-3 and Global Executive Functioning T-scores from the BRIEF-2 (p<.001). Correlations were also found between core areas of EF (inhibition, flexibility, and working memory) and AF Composites (all p<.01). A multiple regression was run to predict General Adaptive Functioning from age, FSIQ, and Global Executive Functioning. These variables significantly predicted General AF (3, 84)=16.81, p<.001, accounting for 37.5% of the variance in General AF with an adjusted R²= 35.3%, a medium size effect according to Cohen (1988). Both FSIQ (p<.001) and Global EF (p<.001) were significant contributors in this model. To examine this relationship in a subgroup of individuals without Intellectual Disability, we ran the regression in a subset of patients with FSIQ above 75. The model significantly predicted General AF (3, 67)=8.39, p<.001, accounting for 27.3% of the variance with an adjusted R²=24.0%, a medium size effect size. However, only Global EF (p<.001) significantly predicted General AF when we controlled for Intellectual Disability in this way. Conclusions: In a clinically referred sample of children with CHD, IQ and EF contributed to AF. However, in a subsample of patients without IQ in the range of Intellectual Disability, only EF contributed to the model predicting AF. These results further suggest that EF is an important target for intervention in CHD, as it relates to broader outcomes such as quality of life (Sanz et al., 2018), Academic Skills (Gerstle et al., 2016), and Adaptive Function. This is true regardless of FSIQ. Future research with larger samples should examine how components of EF may relate to specific adaptive skills outcomes to better target intervention strategies.

Poster

02/17/2024
09:00 am - 10:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 10: Neurodevelopmental | Congenital Conditions

Final Abstract #96

Executive Function Predicts Adaptive Functioning in Children with Congenital Heart Disease Without Intellectual Disability

Samantha van Terheyden, Children's National Hospital, Washington, United States
Rachel Richie, Children's National Hospital, Washington, United States
Brenda Mitchell, The Chicago School of Professional Psychology, Washington, United States
Mary Donofrio, Children's National Hospital, Washington, United States
Jacqueline Sanz, Children's National Hospital, Washington, United States

Category: Medical/Neurological Disorders/Other (Child)

Keyword 1: adaptive functioning
Keyword 2: executive functions
Keyword 3: pediatric neuropsychology

Objective:

Children with Congenital Heart Disease (CHD) are at an increased risk of neurodevelopmental challenges including deficits in Executive Functioning (EF), Adaptive Functioning (AF), and quality of life (Marino et al., 2012; Cassidy et al., 2018). While AF is associated with FSIQ in CHD (Tan et al., 2022), the relationship between AF and EF in children with CHD is less clear. Prior research in populations of children with Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) found that deficits in EF significantly contributed to AF (Gardiner & Iarocci 2017; Tsermentseli et al., 2018). The present study seeks to examine how EF contributes to AF in children with CHD. We hypothesize these constructs will correlate with one another, and that beyond IQ, EF contributes substantially to variance in AF.

Participants and Methods:

102 children (M age= 10.4±3.48, 53.9% male, 54.98% white) with CHD were administered the Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF-2) to measure EF and the Adaptive Behavior Assessment System, 3rd Edition (ABAS-3) to measure AF as part of their routine assessment through the Cardiac Neurodevelopmental Outcome (CANDO) program. Pearson’s correlations examined the relationship between Global EF and General AF. From this group, 88 children (M age= 10.3±3.56, 58.4% male, 52.8% white) were also administered the Wechsler Intelligence Scale, 5^thEdition (WISC-5). Multiple regression analyses examined the relationship between AF and age, Full Scale IQ (FSIQ), and EF.

Results:

There were statistically significant correlations between Composite scores from the ABAS-3 and Global Executive Functioning T-scores from the BRIEF-2 (p<.001). Correlations were also found between core areas of EF (inhibition, flexibility, and working memory) and AF Composites (all p<.01). A multiple regression was run to predict General Adaptive Functioning from age, FSIQ, and Global Executive Functioning. These variables significantly predicted General AF (3, 84)=16.81, p<.001, accounting for 37.5% of the variance in General AF with an adjusted R²= 35.3%, a medium size effect according to Cohen (1988). Both FSIQ (p<.001) and Global EF (p<.001) were significant contributors in this model. To examine this relationship in a subgroup of individuals without Intellectual Disability, we ran the regression in a subset of patients with FSIQ above 75. The model significantly predicted General AF (3, 67)=8.39, p<.001, accounting for 27.3% of the variance with an adjusted R²=24.0%, a medium size effect size. However, only Global EF (p<.001) significantly predicted General AF when we controlled for Intellectual Disability in this way.

Conclusions:

In a clinically referred sample of children with CHD, IQ and EF contributed to AF. However, in a subsample of patients without IQ in the range of Intellectual Disability, only EF contributed to the model predicting AF. These results further suggest that EF is an important target for intervention in CHD, as it relates to broader outcomes such as quality of life (Sanz et al., 2018), Academic Skills (Gerstle et al., 2016), and Adaptive Function. This is true regardless of FSIQ. Future research with larger samples should examine how components of EF may relate to specific adaptive skills outcomes to better target intervention strategies.