Care & Support for Your Child After Cardiac Arrest

Key Takeaways

    • Individualized Care is Essential: Each child’s post-cardiac arrest care plan should be tailored to their developmental stage and specific needs, involving a range of specialists including physical therapists, occupational therapists, neuropsychologists, and/or psychologists.
    • Early Intervention Matters: Early and appropriate interventions, such as physical therapy for infants or speech therapy for young children, can help address developmental delays and support overall growth and recovery.
    • Supports Can Come from Your School or Community: In addition to medical interventions, your child may benefit from neuropsychological or developmental evaluations and academic services and supports to address cognitive and learning changes and needs.  
    • Emotional and Psychological Support is Crucial: Regardless of age, children who experience cardiac arrest may face psychological challenges. Support from child psychologists, therapists, and support groups is important for managing trauma and emotional development.
    • Transition to Independence: As children grow, especially into adolescence, transitioning to managing their health and developing independence in self-care becomes a critical part of their post-cardiac arrest care.
How does developmental age influence care?

While cardiac arrest can affect anyone at any age, the timing and specific circumstances surrounding each event shape the unique needs of each child. Bodies and minds can be impacted differently due to variations in developmental stages between infants, children, and adolescents (teens). These challenges can also be long-lasting. Due to this, care after cardiac arrest varies and must be tailored to address these age-related differences. This article is designed to help you, your child’s parent/caregiver, understand the different stages of childhood and approaches to care immediately after cardiac arrest and also long-term.

First, what’s the same across ages of development?

This is hard. No matter the age of your child, your baby is your baby, and you’ve all just been through something traumatic. As a parent of a child who has had a cardiac event, you will have to learn about cardiac arrest, make decisions about future care, advocate for your child, and, if appropriate, empower your child to be involved in their care process. Do not be afraid to ask questions, ask for a second opinion, or speak up for yourself and your child. You play a critical role in their care, but you will get through this with the support of a collaborative healthcare team that can include nurses, pediatricians, cardiologists, neurologists, therapists, educators, social workers, neuropsychologists, and/or psychologists. 

Cardiac arrest can have significant impacts on a child’s development at any age, affecting their ability to move, speak, understand, think, learn, and remember. It could also impact their social-emotional health both immediately and over the long term. Your child will need an individualized care plan that considers age-appropriate treatments and desired outcomes in the hospital, school, community, and home environments. The majority of treatments and supports for each stage remain relevant as your child gets older, but with updates that will address their unique stage of development.

Cardiac arrest during infancy

For infants (ages 0-2 years), cardiac arrest may cause neurological damage and muscle weakness, leading to developmental delays such as speech and motor skills. At this stage, services that may be appropriate for your child include:

    • Developmental Psychological Evaluation: An evaluation with a developmental psychologist can assess whether your child may have any developmental delays and which therapies and community supports may be helpful.
      • Rehabilitative Therapies: In coordination with your child’s medical team, your child may benefit from speech-language therapy to support speech and language development, physical therapy to improve strength and gross motor skills, and occupational therapy to help with fine-motor development and adaptive skills.
      • Early Intervention Services: In the United States, free services are available in every state and territory for children ages 0-3 years that may not be meeting developmental milestones, including speech-language, physical, and occupational therapies.
    Cardiac arrest during middle childhood

    When cardiac arrest occurs during middle childhood (ages 6-12 years), it can result in neuromuscular challenges and psychological struggles, including feelings of loneliness and anxiety. Cognitive and learning challenges can also be common as this stage is during a critical time of a child’s educational journey. Cognitive or neuropsychological evaluations can continue to help identify areas of weakness and recommended treatments, while rehabilitative therapies and IEP services may continue to be helpful. Additional services that may be appropriate for your child include:

      • Section 504 Plans: Students who do not qualify for an IEP may qualify for a Section 504 Plan, which provides accommodations in the classroom such as extended time on tests and assignments to support students with disabilities so they can learn alongside their peers in a regular classroom. Named after Section 504 of the Rehabilitation Act, this plan ensures that students with disabilities can access a free and suitable education without discrimination in any federally funded school. A school evaluation is required to determine eligibility for a Section 504 Plan. 
      • Psychologists and Therapists: Child psychologists and therapists can help with understanding and addressing emotional and behavioral challenges. They can also help with addressing the trauma of the cardiac event, self-esteem issues, resilience, any lingering feelings of fear, or coping with developmental and physical challenges. Cognitive behavioral therapy (CBT) is a specific evidence-based talk therapy that may be helpful, as it involves working with the therapist to recognize and change negative thought patterns related to the cardiac arrest event and resulting symptoms of trauma, depression, or anxiety.
    Cardiac arrest during adolescence

    All of the above challenges often persist into adolescence (ages 13-18 years), during which additional support is needed to foster independence and self-care skills. Adolescents may continue to experience muscle weakness, neurological effects, and psychological difficulties but must also learn to manage their health independently. This includes taking responsibility for medications and scheduling healthcare appointments, which can empower them as they transition to adulthood. At this stage, neuropsychological evaluations, rehabilitative therapies, IEP/504 services, and mental health treatment may all continue to be relevant. Additional services that may be appropriate for your child include:

      • Transition Plan: For adolescents, an IEP includes a Transition Plan that helps students prepare for life after high school, including setting goals and identifying the support needed to achieve them. The plan includes transition services in the areas of education, employment, and independent living.
      • Support Groups: Support groups for the child can foster friendships and provide emotional support to combat feelings of otherness, loneliness, or anxiety. Parent support groups can do the same, also providing care and learning from other families.
    Conclusion

    The challenges of childhood still exist for children affected by a cardiac event. Young children need our help and support all the time, and older children want more independence, which is not always possible after a cardiac arrest. Speak with your child’s healthcare team if you think any of the above services or supports could help your child. 

    But do not forget – you and your child went through something extraordinary and are coping with things that most other children do not have to face. Try to prevent comparisons to other kids, take care of yourself during this challenging time, and ask for help. Develop an external support community of family, friends, your healthcare team, and peer support networks locally or digitally online. With additional care, your child can thrive and reach their full potential.

    Sources

    Autism Speaks. (2024). Applied Behavior Analysis (ABA). Retrieved August 5, 2024, from https://www.autismspeaks.org/applied-behavior-analysis

    Cleveland Clinic. (2023, May 3). Speech therapy. Retrieved August 5, 2024, from https://my.clevelandclinic.org/health/treatments/22366-speech-therapy

    Mayo Clinic. (2019, March 16). Cognitive behavioral therapy (CBT). Retrieved December 9, 2024, from https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610

    Nemours KidsHealth. (2023, March). 504 education plans. Retrieved  August 5, 2024, from https://kidshealth.org/en/parents/504-plans.html

    PCIT International. (2023). Parent-Child Interaction Therapy (PCIT). Retrieved  August 5, 2024 from https://www.pcit.org/

    UNC Department of Physical Medicine & Rehabilitation. (2024). Neuropsychology services. Retrieved  August 5, 2024, from https://www.med.unc.edu/phyrehab/patient-services/services-and-specialties/rehabilitation-psychological-and-neuropsychological-services-2/

    University of Massachusetts Global. (n.d.). What is a behavior analyst and how do you become one. Retrieved  August 5, 2024, from https://www.umassglobal.edu/news-and-events/blog/what-does-a-behavior-analyst-do

    Thank you to our contributors

    Alessandra Dinin & Alexander Tan

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