O1028: Educational Achievement Partnership Program: Tools to Prepare Preschool Children with Heart Disease for Academic Success

Background: Children with heart disease experience increased risk for neurodevelopmental deficits and may require learning support via individualized school plans that incorporate consideration of health, learning, and medical issues. However, a recent study shows only ~1/3 of school staff recognize heart-brain-body connections. This knowledge and information gap may lead schools to inadvertently not qualify the child for access to support services. Educational practitioners’ misunderstanding about heart-brain-body connections presents an existential threat to adequate school supports for this vulnerable population, a public health hazard that is escalating as more children with heart disease survive and attend school.

Methods: This project developed and evaluated a new intervention toolkit and protocol designed to improve early childhood development, school health, and learning outcomes in children with heart disease and related neurodevelopmental deficits. The Educational Achievement Partnership Program (EAPP) is a hospital-based service that collaborates with multidisciplinary community, medical, and educational teams to implement medically-informed interventions in school settings. In this study, the standard EAPP toolkit for children aged 3-24 was re-evaluated and optimized to target appropriate early childhood development milestones for children aged 3-5 years across 4 key school assessment areas: medical limitations, developmental progress, classroom performance, and academic skills. This project further investigated communication modalities to increase minority family engagement with EAPP services. This IRB approved study enrolled 80 consenting participants from January 2020 to December 2021.

Results: As hypothesized, minimal toolkit content modifications for preschoolers were required for medical limitations, developmental progress, and classroom performance sections (5-10%). The modifications required for the academic skills section were less than expected (36%).

To increase minority family utilization, the EAPP secured access to office space in the cardiology clinic with “walk-in” services for school support. The walk-in office along with other protocol modifications to increase opportunities for face-to-face interactions with families significantly increased minority family utilization from a baseline of 17% in 2018-19 (with a cohort of 59 patients aged 3-17 years) to 43% in 2020-21 (with a cohort of 80 patients aged 2.0-5.8 years). For reference, this center’s pediatric cardiology population is comprised of 33% minority patients (based on 2019 data). Study participants averaged 4.3 years, 56% were male, and the cohort had the following cardiac characteristics: 19% single ventricle anatomy, 65% double ventricle anatomy, 16% other.

Conclusion: The ultimate goal of this research study was to identify early childhood development, school health, and learning challenges at the beginning of a child’s academic career to increase access to early school intervention services, narrow performance gaps, and improve long-term developmental, medical, and educational outcomes. Further research is needed to identify strategies increase minority family utilization beyond enrollment and across all phases of program services.