Objective: Standardized developmental screening tools are important for the evaluation and management of developmental disorders in children with congenital heart disease (CHD). However, psychometric properties and clinical utility of screening tools, such as the Ages and Stages Questionnaires, Third Edition (ASQ-3), have not been examined for the CHD population. We hypothesized the ASQ-3 would be clinically useful for this population. Study Design: ASQ-3 developmental classifications for 163 children with CHD at 6, 12, 24 and/or 36 months of age were compared to those obtained from concurrent developmental testing with the Bayley Scales of Infant and Toddler Development, Third Edition. Results: When ASQ-3 screening failure was defined as ≥ 1 standard deviations below the normative mean, specificity (≥81.9%) and negative predictive value (≥ 81.0%) were high across ASQ-3 areas. Sensitivity was high for gross motor (79.6%), increased with age for communication (35.7%−100%), and generally decreased with age for problem solving (73.1%−50.0%). When ASQ-3 screening failure was defined as ≥ 2 standard deviations below the normative mean, specificity (≥93.6%) and positive predictive value (≥74.5%) were generally high across ASQ-3 areas, but sensitivity was low (31.1%) to fair (62.8%). The ASQ-3 improved accuracy in predicting delays over clinical risk factors alone. Conclusions: The ASQ-3 appears to be a clinically useful tool for screening development in children with CHD, although utility varied based on developmental area and time point. Clinicians are encouraged to refer children scoring ≥ 1 standard deviation below the normative mean on any ASQ-3 area for formal developmental evaluation.

To longitudinally explore children's developing beliefs towards mathematics, we asked 207 children to define "math" and "reading" at grades 2 and 3 and coded for spontaneous references to likability or difficulty of math (or reading) in their definitions. We found that children attributed more difficulty to math than to reading despite their relatively neutral comments on the likability of either subject. Children described math and reading with comparable degrees of specificity, but girls' definitions were more specific than boys' . Relative to their peers, children with mathematics learning disability (MLD) provided less specific definitions overall, were more likely to describe math as more difficult than reading, and were more likely to show a decrease in likability ratings of math (but not reading) from grades 2 to 3. Grade 2 ratings predicted math ability at grade 3, more so than predictors from grade 3. These findings, although based on informal analyses not intended to substitute for validated assessments of disposition, support the notions that distinct aspects of dispositions towards math emerge in early childhood, are revealed through casual discourse, and are predictive of later math achievement outcomes. This further supports current interests in developing formal measures of academic disposition in early childhood.

Objective: To examine the relations of individual and cumulative social risk factors to hospitalization outcomes and adherence to outpatient cardiology appointments within the first two years of life for congenital heart disease (CHD) survivors.Study design: Data were extracted for 219 patients who underwent infant cardiac surgery with cardiopulmonary bypass. Cumulative social risk was dichotomized into high social risk (≥2 risk factors; N=103) versus low social risk (≤1 risk factor; N=116). Risk of morbidity by procedure was assigned from 1-5 (STS-EACTS Morbidity Scores and Categories). Two-way ANOVAs examined effects of social risk and morbidity risk on length of first surgical hospitalization, number of readmissions and readmission days, subsequent cardiac surgical interventions, and adherence to outpatient cardiology appointments.Results: An interaction between social risk and morbidity risk was identified for number of readmission days (F(4,209)=3.07, P = .02, η 2 =.06). Pairwise comparisons demonstrated that among those patients with the lowest risk of morbidity by procedure (morbidity scores of 1 and 2), patients at high social risk had more readmission days than patients at low social risk

Medical cannabis is now legal in over half of the United States. As more patients adopt this unconventional therapy, it is inevitable that potential transplant recipients will disclose their cannabis use during transplant evaluation. Transplant teams are tasked with the decision to utilize a pressure resource, often with little guidance from international and national professional organizations. Many healthcare providers remain uniformed or misinformed about the risks of cannabis use and organ transplantation. In order to illustrate the multifaceted and complex evaluation of transplant patients using medical cannabis, this article presents the case of a 20-year-old woman recommended for renal transplant who was originally denied active listing due to her medical cannabis use. A review of the literature explores the perceived and actual risks of cannabis use in the immunocompromised patient. Furthermore, a discussion of the ethics of medical cannabis use and organ transplantation is included with recommendations for multidisciplinary transplant teams.