This article reviews behavioral, neuropsychological, and academic outcomes of individuals with cleft across three age levels: 1) infancy/early development, 2) school age, and 3) adolescence/young adulthood. The review points out that attachment, neurocognitive functioning, academic performance/learning, and adjustment outcomes are the result of a complex interaction between biological and environmental factors and vary with developmental level, sex, and craniofacial anomaly diagnosis. The degree to which associated genetic or neurodevelopmental conditions may explain inconsistent findings is unknown and suggests the need for caution in generalizing from group data on cleft.

Objective Evaluate speech, hearing, and neuropsychological correlates to reading among children, adolescents and young adults with non-syndromic cleft of the lip and/or palate (NSCL/P). Method All testing was completed in one visit at a Midwestern university hospital. Subjects in both the NSCL/P (n = 80) and control group (n = 62) ranged in age from 7 to 26 years (average age = 17.60 and 17.66, respectively). Subjects completed a battery of standardized tests evaluating intelligence, neuropsychological skills, and word reading. Subjects with NSCL/P also underwent speech assessment and past audiology records were evaluated. Results After controlling for age and SES, subjects with cleft performed significantly worse on a test of word reading. For subjects with cleft, word reading deficits were not associated with measures of speech or hearing, but were correlated with impairments in auditory memory. Conclusions These findings show poorer reading among subjects with NCL/P compared to those without. Further work needs to focus on correlates of reading among subjects with cleft to allow early identification and appropriate intervention/accommodation for those at risk.

Objective-Preterm infants are frequently transfused with red blood cells based on standardized guidelines or clinical concern that anemia taxes infants' physiological compensatory mechanisms and thereby threatens their health and well-being. The impact of various transfusion guidelines on long-term neurocognitive outcome is not known. The purpose of this study is to evaluate longterm neurocognitive outcome on children born prematurely and treated at birth with different transfusion guidelines.Methods-Neurocognitive outcomes were examined at school age for 56 preterm infants randomly assigned to a liberal (n = 33) or restrictive (n = 23) transfusion strategy. Tests of intelligence, achievement, language, visual-spatial/motor, and memory skills were administered. Between-group differences were assessed.Results-Those in the liberal transfusion group performed more poorly than those in the restrictive group on measures of associative verbal fluency, visual memory, and reading.Conclusions-Findings highlight possible long-term neurodevelopmental consequences of maintaining higher hematocrit levels. KeywordsPreterm; Neuropsychology; Red Blood Cell Transfusion; Hematocrit; LongitudinalThe high incidence of anemia in preterm, very low birth weight (VLBW; <1500 grams) infants mandates frequent red blood cell (RBC) transfusions during the first few weeks after birth. Though all infants experience decreased hemoglobin (i.e., physiologic anemia) during the first months after birth, anemia of prematurity is common in infants weighing less than 1 kg (< 32 weeks gestation), and is essentially low endogenous erythropoietin (EPO; a hormone that stimulates RBC production in response to low oxygen saturation) production and exaggeration of physiologic anemia in which hemoglobin levels fall 7-10 g/dl more than in term infants and remain lower for longer periods of time (Bain & Blackburn, 2004). Concern regarding the preterm infant's capacity to tolerate anemia as well as the potential consequences (e.g., increased risk of death), have resulted in routine RBC transfusions among preterm infants (Hebert et al., 1999; Straus, 1995). Views on the risks of anemia and the effectiveness of RBC transfusion in addressing these risks, however, are varied, while the clinical signs of anemia are nonspecific and require significant physician interpretation (Maier et al., 2000;Strauss, 1995). Information has begun to emerge about the impact of transfusion strategy on the outcome of anemic preterm infants, but the outcomes analyzed to date have been limited to the neonatal period and later infancy (i.e., up to 18 to 21 months of (Whyte et al., 2009). Evaluating long-term neurodevelopmental outcomes associated with different transfusion thresholds is critical for assessing the safety of current transfusion practice especially in terms of potential cognitive and behavioral morbidity. The Impact of Preterm Birth on Neurocognitive OutcomesThe survival rate of preterm infants has improved in recent decades as a result of advances in neonatal in...

Objective Examine the relationship between brain structure and cognition in preterm children randomly assigned to a liberal red blood cell (RBC) transfusion strategy as neonates. Methods Intelligence, achievement, and neuropsychological measures were assessed and structural imaging was obtained (n = 26; 38% male). Results Global brain volumes were related to cognitive outcome. Additionally, Females performed lower on verbal fluency; lower performance was related to temporal white matter volume. Conclusions Findings provide possible evidence of adverse effect of liberal RBC transfusion strategy in which females had decreased temporal lobe white matter directly related to poor verbal fluency.

This study explored the relationship among Asian values, depressive symptoms, perceived peer substance use, coping strategies, and substance use among 167 Asian American college women. More than 66% of the women in our sample scored higher than the clinical cutoff score on the Center of Epidemiological Depression Scale. Three path analyses examining illicit drugs, alcohol use, and binge drinking indicated that perceived peer use was the most robust predictor of substance use. Depressive symptoms were positively associated with illicit drug use and alcohol consumption but were not related to binge drinking. Asian values and coping strategies were not predictive of substance use. Additional analysis revealed that avoidant coping was a strong predictor of depressive symptoms.