Children with complex congenital heart defects often show delays and deficits in cognitive, language, motor, and social-emotional functioning. As such, the American Academy of Pediatrics and the American Heart Associated recommend ongoing monitoring and support of development. In conjunction with the formal therapeutic supports frequently recommended for young children with CHD, caregivers are instrumental in providing an enriching environment to enhance development in the hospital, at home, and in early childhood settings. In this article, we review the common developmental sequelae associated with CHD, underlying causes, and ways in which parents, family members, and professional caregivers can support development for children with CHD from birth to three years old.