DISCUSSION
Our research identified a high prevalence
of DD in this cohort of children
with CHD whose developmental progress
was evaluated multiple times over
the first 3 years of life. Serial assessment
allowed us to model the longitudinal
developmental trajectory in
cognitive, language, and motor skills.
Scores were considered at risk or
delayed in $1 area in 75% of the group.
However, many of the delays were
subtle and may not have been detected
without formal evaluation. Also of note,
there were delays that emerged over
time, emphasizing the importance of
longitudinal evaluation and revealing
that development is not static in children
with CHD. This is in contrast to
healthy children, who typically have
stable development over time and of
whom only 16% would be expected to
have any DD. Health care providers
caring for children with CHD should
anticipate these problems and encourage
developmental follow-up.