While motor and cognitive development in children with congenital heart defects has been well documented over recent decades, language development has received considerably less attention—particularly in French-speaking populations. This study aimed to characterize the language profiles of children with critical congenital heart disease using standardized speech and language assessments and to identify associated vulnerability factors.

We assessed 33 children aged 5 to 6.5 years, all of whom had undergone cardiac surgery or catheterization before 6 months of age and had no diagnosed neurodevelopmental disorders. Language skills were evaluated using seven standardized tests covering receptive and expressive language domains, including phonology, lexicon, morphosyntax, and articulation.

Language performance was below population averages across all subtests; however, only lexical comprehension scores were significantly lower than normative data. The proportion of children with a pathological language profile (defined as at least two subtests with a Z score ≤ −1.65) was four times higher than in the general population. Phonology, morphosyntax, and expressive lexicon were particularly impaired in children with severe profiles. Factors such as length of hospitalization, intubation duration, 1-min APGAR score, and parental education level were significantly associated with pathological language outcomes.

Our findings confirm that language development represents a significant area of vulnerability in children with critical congenital heart disease. Early identification and referral to speech and language therapy are crucial for optimizing outcomes.