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Are children with congenital cardiac malformations at increased risk of deficits in social cognition?

Published online by Cambridge University Press:  20 December 2007

David C. Bellinger
David C. Bellinger*
Affiliation:
Children’s Hospital Boston, Harvard Medical School, Harvard School of Public Health, Boston, Massachusetts, United States of America
*
Correspondence to: David C. Bellinger, PhD, MSc, Children’s Hospital Boston, Farley Basement Box 127, 300 Longwood Avenue, Boston MA02115, USA. Tel: +617 355-6565; Fax: +617 730-0618; E-mail: david.bellinger@childrens.harvard.edu
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Abstract

In this review, I summarize observations suggesting that social cognition deficits are an important element of the neurodevelopmental morbidities of children with congenital cardiac malformations. Referred to as “theory of mind” deficits, they pertain to the ability to “read” other people, that is, to infer their internal states and thus to interpret their actions appropriately. I also hypothesize that children with such congenital cardiac malformations have difficulty identifying and describing their own internal states, which is referred to as alexithymia. These hypotheses are based on data collected as part of a prospective study of the neurologic outcomes of children with concordant atrioventricular and discordant ventriculo-arterial connections, or transposition. On a variety of tasks that assess pragmatic language and discourse skills, such as elicited personal narratives, free play with a parent, and written narratives, the children consistently performed below age-expected levels and in ways that suggested the presence of “theory of mind” deficits. Their narratives lacked coherence, failed to include critical information required by a listener, and made infrequent reference to internal states. In ongoing evaluations of the children as adolescents, we are testing these hypotheses more systematically by administering several instruments specifically developed to assess “theory of mind” and alexithymia.

Keywords

Alexithymiatranspositionpragmatic language
Type
Review Article
Information
Cardiology in the Young , Volume 18 , Issue 1 , February 2008 , pp. 3 - 9
Copyright
Copyright © Cambridge University Press 2008

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