Congenital Heart Defects and Receipt of Special Education Services.
BACKGROUND
We investigated the prevalence of receipt of special education services among children with congenital heart defects (CHDs) compared with children without birth defects.


METHODS
Children born from 1982 to 2004 in metropolitan Atlanta with CHDs (n = 3744) were identified from a population-based birth defect surveillance program; children without birth defects (n = 860 715) were identified from birth certificates. Cohorts were linked to special education files for the 1992-2012 school years to identify special education services. Children with noncardiac defects or genetic syndromes were excluded; children with CHDs were classified by presence or absence of critical CHDs (ie, CHDs requiring intervention by age one year). We evaluated the prevalence of receipt of special education services and prevalence rate ratios using children without birth defects as a reference.


RESULTS
Compared with children without birth defects, children with CHDs were 50% more likely to receive special education services overall (adjusted prevalence rate ratio [aPRR] = 1.5; 95% confidence interval [CI]: 1.4-1.7). Specifically, they had higher prevalence of several special education categories including: intellectual disability (aPRR = 3.8; 95% CI: 2.8-5.1), sensory impairment (aPRR = 3.0; 95% CI: 1.8-5.0), other health impairment (aPRR = 2.8; 95% CI: 2.2-3.5), significant developmental delay (aPRR = 1.9; 95% CI: 1.3-2.8), and specific learning disability (aPRR = 1.4; 95% CI: 1.1-1.7). For most special education services, the excess prevalence did not vary by presence of critical CHDs.


CONCLUSIONS
Children with CHDs received special education services more often than children without birth defects. These findings highlight the need for special education services and the importance of developmental screening for all children with CHDs.
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; tja4@cdc.gov.
Tiffany
T
Riehle-Colarusso
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;
Andrew
A
Autry
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;
Hilda
H
Razzaghi
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;
Coleen A
CA
Boyle
Sibley Heart Center, Children's Health Care of Atlanta, Emory University School of Medicine, Atlanta, Georgia;
William T
WT
Mahle
Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;
Kim
K
Van Naarden Braun
Departments of Medicine and Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi.
Adolfo
A
Correa
D002648:Child; D002675:Child, Preschool; D004519:Education, Special; D005260:Female; D005845:Georgia; D006311:Hearing Disorders / Q000150:complications; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008607:Intellectual Disability / Q000150:complications; D007859:Learning Disabilities / Q000150:complications; D008297:Male; D008423:Maternal Age; D014786:Vision Disorders / Q000150:complications