We appreciate the comments of Drs Gnanavel and Robert regarding our recent article in CHEST.1 This study represents the largest sample to date on the psychosocial aspects of pediatric pulmonary hypertension (PH). In our article, we acknowledged limitations of the study, including small sample size and single-center design. We agree that a disease-specific instrument to assess quality of life in patients with PH could be useful; no such instrument has been validated for the pediatric age group. Optimally, this should use both self report and parental report. We agree that assessment of psychiatric morbidity in children with PH may be informative and could be addressed in additional studies. Finally, as we stated in our article, future multisite studies will be essential to further delineate the important psychosocial consequences of PH in pediatric patients.