Early academic achievement in children with isolated clefts: a population-based study in England

Fitzsimmons, Kate Jane; Copley, Lynn P.; Setakis, Efrosini; Charman, Susan C.; Deacon, Scott; Dearden, Lorraine; Meulen, Jan van der

doi:10.1136/archdischild-2017-313777

Cited by 31 publications

(80 citation statements)

References 22 publications

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“…In our work, the percentage of children with NS OFCs receiving special education services ranged from 35% in third grade to 29% in fifth grade. These estimates are consistent with previous work in both the United States and Internationally which reported 20–29% of children with NS OFCs across multiple ages and grade levels were enrolled in special education services (Fitzsimons et al, ; Wehby et al, ; Yazdy et al, ).…”

Section: Discussionsupporting

confidence: 91%

“…Among children with NS OFCs who were receiving services, 44–55% of children with NS OFCs across third, fourth, and fifth grade were placed for special education services under the speech and language eligibility category with 16–22% of children being placed under the specific learning disability category. This estimate is marginally lower than other studies which reported 74–86% of children with NS OFCs were placed for services under the speech and language impairment exceptionality (Fitzsimons et al, ; Yazdy et al, ). In Yazdy's work, the mean age of entry into special education among children with NS OFCs was 6 years of age.…”

Section: Discussioncontrasting

confidence: 58%

“…Several population‐based studies examined academic performance among children with NS OFCs. Children with NS OFCs are at risk for academic underperformance in reading and math from elementary school through adolescence when compared to children without a birth defect (Fitzsimons et al, ; Watkins et al, ; Wehby et al, ; Wehby, Collett, Barron, Romitti, & Ansley, ). Children with cleft lip and palate were 74% more likely to underperform in reading and math in third grade compared to their unaffected peers (Watkins et al, ).…”

Section: Introductionmentioning

confidence: 99%

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Special education use in elementary school by children with nonsyndromic orofacial clefts

Watkins

Allori

Meyer

et al. 2018

Birth Defects Research

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Background Children with nonsyndromic orofacial clefts (NS OFCs) may require exceptional children's (EC) services for academic delays. We examined EC service use of children with and without NS OFCs in NC in elementary school. Methods We included 559 children with NS OFCs and 6,822 children without birth defects who had NC educational records. We estimated prevalence ratios, trends in enrollment, and characteristics of eligibility classification using descriptive statistics and logistic regression by cleft subtype and race/ethnicity. We estimated the odds of third grade retention by EC enrollment using logistic regression with inverse probability of treatment weights. Results Children with NS OFCs were 3.02 (95% CI: 2.50, 3.64) times as likely to receive third grade special education (SE) services compared to unaffected peers. The prevalence odds was highest among children with CL+P (OR: 4.61, 95% CI: 3.49, 6.09) declining by 54% by fifth grade. The prevalence odds of SE for white children was approximately 1.50 times that for African American children in fourth and fifth grades. Approximately 33% of children with NS OFCs within each racial/ethnic group received SE in third grade. African American children were twice as likely to receive services under specific learning disability. Children with NS OFCs receiving EC services were 44% (OR: 0.56; 95% CI: 0.13, 2.38) less likely to be retained in third grade compared to children with NS OFCs who were not receiving services. Conclusions Children with NS OFCs are more likely to receive SE services in elementary school compared to their unaffected peers. The eligibility category differed by racial/ethnic group.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

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Special education use in elementary school by children with nonsyndromic orofacial clefts

Watkins

Allori

Meyer

et al. 2018

Birth Defects Research

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“…Specifically, children with CPO are at higher risk of underperforming in several areas of academic learning, compared to both their unaffected peers, and also children born with CLO or CLP 52 . On the contrary, children born with CLO have been found to have academic achievement higher than children born with CLP or CPO 15 and sometimes 53 (though not always 13,15 ) in-line with children born without a cleft.…”

Section: Strengths and Limitationsmentioning

confidence: 92%

“…Interestingly however, achievement scores were similar between affected children and their unaffected siblings 14 . In the most recent population-based study, 2,802 five-year-old children born with a non-syndromic cleft in England had lower average academic achievement across all learning domains compared to national averages 15 .…”

Section: Introductionmentioning

confidence: 94%

Cleft lip/palate and educational attainment: cause, consequence, or correlation? A Mendelian randomization study

Dardani

Howe

Stergiakouli

et al. 2018

Preprint

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AbstractImportancePrevious studies have found that children born with a non-syndromic form of cleft lip and/or palate have lower-than-average educational attainment. These differences could be due to a genetic predisposition to low intelligence and academic performance, factors arising due to the cleft phenotype (such as school absence, social stigmatization and impaired speech and language development), or confounding by the prenatal environment. A clearer understanding of this mechanism will inform development of interventions to improve educational attainment in individuals born with a cleft, which could have wide-ranging knock-on effects on their quality of life.ObjectiveTo assess evidence for the hypothesis that common variant genetic liability to non-syndromic cleft lip with or without cleft palate (nsCL/P) influences educational attainment.DesignUsing summary data from genome-wide association studies (GWAS), we performed Linkage Disequilibrium (LD)-score regression and two-sample Mendelian randomization to evaluate the relationship between genetic liability to nsCL/P (GWAS n=3,987) and educational attainment (GWAS n=766,345), and intelligence (GWAS n=257,828).ResultsThere was little evidence for shared genetic aetiology between nsCL/P and educational attainment (rg −0.03, 95% CI −0.14 to 0.08, P 0.58; βMR 0.002, 95% CI −0.001 to 0.005, P 0.417) or intelligence (rg −0.01, 95% CI −0.12 to 0.10, P 0.85; βMR 0.002, 95% CI −0.010 to 0.014, P 0.669).Conclusions and relevanceCommon genetic variants are unlikely to predispose individuals born with nsCL/P to low educational attainment or intelligence. This information will help tailor clinical-, school-, social- and family-level interventions to improve educational attainment in this group.Key PointsQuestionDo children born with a non-syndromic cleft lip with or without palate (nsCL/P) have lower-than average academic achievement because of an underlying genetic predisposition to educational attainment and/or intelligence?FindingsThere was little evidence for shared common variant genetic correlation between nsCL/P, educational attainment and intelligence.MeaningCommon genetic variants are unlikely to predispose individuals born with nsCL/P to low educational attainment or intelligence. This information will help tailor clinical-, school-, social- and family-level interventions to improve educational attainment in this group.

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Academic achievement and needs of school‐aged children born with selected congenital anomalies: A systematic review and meta‐analysis

Glinianaia

McLean

Moffat

et al. 2021

Birth Defects Research

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Children with congenital anomalies have poorer intellectual and cognitive development compared to their peers, but evidence for academic achievement using objective measures is lacking. We aimed to summarize and synthesize evidence on academic outcomes and special education needs (SEN) of school-aged children born with selected major structural congenital anomalies. Electronic databases (MEDLINE, EMBASE, Scopus, PsycINFO, CINAHL, ProQuest Natural Science and Education Collections), reference lists and citations for 1990-2020 were systematically searched. We included original-research articles on academic achievement in children with non-syndromic congenital anomalies that involved school test results, standardized tests and/or SEN data. Randomeffects meta-analyses were performed to estimate pooled mean test scores in mathematics and/or reading where possible and pooled odds ratios (ORs) for SEN in children with severe congenital heart defects (CHDs) and children with orofacial clefts (OFCs). Thirty-nine eligible studies (n = 21,066 children) were synthesized narratively. Sixteen studies were included in meta-analyses. Children with non-syndromic congenital anomalies were at a higher risk of academic underachievement than controls across school levels. Children with severe CHD (pooled OR = 2.32, 95% CI: 1.90, 2.82), and children with OFC (OR = 1.38 (95% CI: 1.20, 1.57), OR = 3.07 (95% CI: 2.65, 3.56), and OR = 3.96 (95% CI: 3.31, 4.72) for children with cleft lip, cleft palate and cleft lip/palate, respectively) had significantly higher ORs for SEN than controls. Children with non-syndromic congenital anomalies underperform academically and have higher SEN rates compared to their peers. Early monitoring and development of differential SEN are important to promote academic progress in these children.

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Early academic achievement in children with isolated clefts: a population-based study in England

Cited by 31 publications

References 22 publications

Special education use in elementary school by children with nonsyndromic orofacial clefts

Special education use in elementary school by children with nonsyndromic orofacial clefts

Cleft lip/palate and educational attainment: cause, consequence, or correlation? A Mendelian randomization study

Academic achievement and needs of school‐aged children born with selected congenital anomalies: A systematic review and meta‐analysis

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