title: Influence of CHDs on psycho-social and neurodevelopmental outcomes in children with Down syndrome.
abstract: OBJECTIVE
  To evaluate the family psycho-social outcomes of children with Down syndrome and atrioventricular septal defect, and examine the impact of these variables on the child's neurodevelopmental outcome.
  
  
  METHODS
  This was a cross-sectional study that consisted of 57 children with Down syndrome - 20 cases and 37 controls - of ~12-14 months of age. In both groups, we assessed the development of the child, the quality of the child's home environment, and parenting stress.
  
  
  RESULTS
  Compared with the Down syndrome without CHD group, the atrioventricular septal defect group revealed lower scores in all developmental domains, less optimal home environments, and higher parental stress. Significant differences in development were seen in the areas of cognition (p=0.04), expressive language (p=0.05), and gross motor (p<0.01). The Home Observation for Measurement of the Environment revealed significant differences in emotional and verbal responsiveness of the mother between the two groups. The Parenting Stress Index revealed that the Down syndrome with atrioventricular septal defect group had a significantly higher child demandingness subdomain scores compared with the Down syndrome without CHD group.
  
  
  CONCLUSIONS
  The diagnosis of a CHD in addition to the diagnosis of Down syndrome may provide additional stress to the child and parents, elevating parental concern and disrupting family dynamics, resulting in further neurodevelopmental deficits. Finding that parental stress and home environment may play a role in the neurodevelopmental outcomes may prompt new family-directed interventions and anticipatory guidance for the families of children with Down syndrome who have a CHD.
authors: 1Department of Human Genetics,Emory University,Atlanta,Georgia,United States of America.
authors: Jeannie
authors: J
authors: Visootsak
authors: 1Department of Human Genetics,Emory University,Atlanta,Georgia,United States of America.
authors: Lillie
authors: L
authors: Huddleston
authors: 2Department of Pediatrics,Emory University,Atlanta,Georgia,United States of America.
authors: Allison
authors: A
authors: Buterbaugh
authors: 1Department of Human Genetics,Emory University,Atlanta,Georgia,United States of America.
authors: Adrienne
authors: A
authors: Perkins
authors: 1Department of Human Genetics,Emory University,Atlanta,Georgia,United States of America.
authors: Stephanie
authors: S
authors: Sherman
authors: 1Department of Human Genetics,Emory University,Atlanta,Georgia,United States of America.
authors: Jessica
authors: J
authors: Hunter
mesh_terms: D002657:Child Development; D003430:Cross-Sectional Studies; D004314:Down Syndrome / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006330:Heart Defects, Congenital / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology
keywords: CHDs; Down syndrome; neurodevelopmental outcomes; psychosocial