Abstract 4370811: Domains of School Readiness in Children Ages 3 to 5 Years Born With and Without Heart Disease: A Study From the 2022-2023 National Survey of Children’s Health

Background: Children born with heart disease (HD) face academic challenges due to associated physical, neurodevelopmental, cognitive, psychosocial delays that begin in early infancy and span their lifetime. Early delays impact readiness to start school, which includes early learning, social-emotional, self-regulation, motor, and health domains. Research questions: Examine differences in school readiness profiles between children ages 3 to 5 years who were and were not born with HD, and to identify risk factors for lack of school readiness in children ages 3 to 5 years born with HD. Methods: Data from the 2022-2023 National Survey of Children’s Health, an annual cross-sectional survey of parents and caregivers, was analyzed. Chi-square tests were used to compare sociodemographic, health-related, and school readiness data between children ages 3 to 5 years who were or were not born with HD. Multivariate logistic regression identified predictors of school readiness not “on track” among children born with HD. Results: Children born with HD (n =558) were less likely than children not born with HD (n =22567) to be “on track” for school readiness (52.2% vs 64.85%, p <0.001), and were less likely to be “on track” in early learning (62% vs 70.3%), social-emotional (70.2% vs 84.3%), motor (57.3% vs 68.1%), and health (71% vs 89.4%) domains, with no differences in self-regulation domain. There were no differences between groups in sex, family income, highest adult education, household language, or difficulty meeting basic needs. Children born with HD were more likely to be White (61.5% vs 47.9%), and to have speech, vision, or hearing deficits. Children born with HD were more likely to have been born prematurely (26.6% vs 11.9%), and to be born at low or very low birth weight. After controlling for sociodemographic and health variables, risk factors for school readiness not “on track” included male sex (aOR 2.30, p =0.016), difficulty meeting basic needs (aOR 2.80, p =0.043), current developmental delay (aOR 3.19, p =0.037), and speech delay (aOR 3.38, p =0.015). Conclusions: Children born with HD face school readiness challenges across 4 of 5 domains, compared to peers not born with HD. Risk factors for lack of school readiness include developmental and speech delays as well as social determinants of health. These findings highlight the importance of early intervention for children born with HD with developmental delays to improve their trajectory for school readiness.