Neuropsychological, Behavioral, and Academic Sequelae of Cleft: Early Developmental, School Age, and Adolescent/Young Adult Outcomes

Richman, Lynn C.; McCoy, Thomasin E.; Conrad, Amy L.; Nopoulos, Peg

doi:10.1597/10-237

Cited by 107 publications

(107 citation statements)

References 76 publications

(131 reference statements)

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“…The classmate sample is more than double that of affected children because we compared affected children to all of their matched controls on all grades with available ITP data (before and after switching school districts). This approach preserved the classmate sample composition when comparing academic achievement over multiple grades (2)(3)(4)(5)(6)(7)(8)(9)(10)(11) or school levels instead of including classmate data only for overlapping grades with the affected child (which would include different classmates at different grades for children who switched school districts). Also, this comparison reduces potential biases from selective switching on the basis of the child' s academic performance and characteristics of the new school district.…”

Section: Study Samplementioning

confidence: 99%

“…[3][4][5] Several studies have shown that children with isolated clefts have an increased incidence of learning problems and academic underachievement. 6 This work focused primarily on reading and, although there are exceptions, 7 most studies reported that affected children score lower than expected compared with test norms and unaffected controls. [8][9][10][11][12] However, population-based investigations are rare, and most studies have included small, clinicbased patient samples.…”

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confidence: 99%

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Academic Achievement of Children and Adolescents With Oral Clefts

Wehby

Collet

Barron³

et al. 2014

Pediatrics

129

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WHAT'S KNOWN ON THIS SUBJECT: Previous studies that reported learning deficits among children with oral clefts mostly used small, clinic-based samples prone to ascertainment bias. No previous studies in the United States have used a populationbased sample and direct testing of academic achievement. WHAT THIS STUDY ADDS:Using a large population-based sample from the United States and standardized school tests for achievement, we found that children with oral clefts scored significantly lower than their classmates on all evaluated domains of achievement and had higher rates of learning disability. abstract BACKGROUND AND OBJECTIVE: Previous studies of academic achievement of children with oral clefts have mostly relied on small, clinicbased samples prone to ascertainment bias. In the first study in the United States to use a population-based sample with direct assessment, we evaluated the academic achievement of children with oral clefts relative to their classmates. METHODS:Children born with isolated oral clefts in Iowa from 1983 to 2003 were identified from the Iowa Registry for Congenital and Inherited Disorders and matched to unaffected classmates by gender, school/school district, and month and year of birth. Academic achievement was assessed by using standardized tests of academic progress developed by the Iowa Testing Programs. Iowa Testing Programs data were linked to birth certificates for all children. Regression models controlled for household demographic and socioeconomic factors. The analytical sample included 588 children with clefts contributing 3735 child-grade observations and 1874 classmates contributing 13 159 child-grade observations. RESULTS: Children with oral clefts had lower scores than their classmates across all domains and school levels, with a 5-percentile difference in the overall composite score. Children with clefts were approximately one-half grade level behind their classmates and had higher rates of academic underachievement and use of special education services by 8 percentage points. Group differences were slightly lower but remained large and significant after adjusting for many background characteristics.CONCLUSIONS: Children with oral clefts underperformed across all academic areas and grade levels compared with their classmates. The results support a model of early testing and intervention among affected children to identify and reduce academic deficits. Pediatrics 2014;133:785-792

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Section: Study Samplementioning

confidence: 99%

mentioning

confidence: 99%

Academic Achievement of Children and Adolescents With Oral Clefts

Wehby

Collet

Barron³

et al. 2014

Pediatrics

129

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“…Among the interfering conditions concerning reading and writing, the cognitive-linguistic disabilities are present, resulting from alterations in the language components. Longitudinal researches in literature show that children with cleft lip and palate present increased risk for language deficits, since they exhibit significantly lower scores in receptive and expressive language, when compared to children without cleft lip and palate [4][5][6] . The children with cleft lip and palate may present speech 7 , orthodontic 8 and emotional 3 , disabilities, and therefore these conditions are considered as risk factors for low academic performance 9 .…”

Section: Introductionmentioning

confidence: 99%

Desempenho cognitivo-linguístico de crianças com fissura labiopalatina em fase de aquisição da leitura e escrita

2017

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Purpose: to identify the cognitive-linguistic skills necessary for children with cleft lip and palate, in order to learn how to read and write. Methods: 120 children, with 5 and 6 years old, attending Kindergarten II and 1st grade of primary school, were divided into two groups: G1, consisting of 60 children with cleft lip and palate, and G2, with 60 children without developmental alterations. The Raven Colored Progressive Matrices, the Phonological Skills Profile and the Boston Naming Test were employed. Results: comparing the performances of the groups, there was statistical difference in intellectual functions, indicating loss in cognitive abilities of G1 (p = 0.019). The cognitive-linguistic skills were classified as "Under Attention" for both groups, and discrepancy in G1 was more representative, with 66.7%. Conclusion: the language skills necessary for reading and writing acquisition proved to be deficient in the cleft lip and palate population, presenting levels of cognitive performance lower than expected for the age and education in most of the modalities evaluated. Limiting environmental factors and low socio-cultural status of the sample were suggestive of additional interference to the acquisition of cognitive-linguistic pre-skills necessary for satisfactory performance of the academic tasks, such as reading and writing. Therefore, this study aimed to identify the cognitivelinguistic skills necessary for children with cleft lip and palate to learn how to read and write. METHODSInitially, ethical research procedures were adopted according to the National Council of Health CNS466 / 2012, approval n° 517168 by the Ethics Committee on Human Research of the Craniofacial Anomalies Rehabilitation Hospital HRAC / USP, and subsequent signature of the Informed Consent by the participants of the study.The sample consisted of 120 participants, both genders, aged between 5 years and 6 years and 11 months, attending kindergarten II and the 1st grade of elementary public schools in a town in the interior of São Paulo State, forming two groups: G1, comprising 60 participants with cleft lip and palate, 23, with pre-foramen type, 13, post-foramen and 24, transforamen; and G2, comprising 60 participants without craniofacial abnormalities or other alterations in development, as the comparison group. For inclusion criteria, participants of G1 had to be enrolled in the rehabilitation hospital where the research was conducted; and G2, had to be enrolled in the public school. Both groups should be aged as required and should have signed the consent for spontaneous participation in the research. Children diagnosed with neurological, psychiatric, sensory or syndrome alterations, limited to instrumentation, were excluded of the study.For intellectual resources evaluation, the psychometric standardized test Raven´s Colored Progressive Matrices -Especial Scale 15 was employed, consisting of three sets of 12 items: A, Ab and B, arranged in an ascending degree of difficulty. The interpretation of results followed the norma...

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“…These conditions arise from developmental failures of neural crest cells during gestation, resulting in deformities of the oral and/or facial structure. Developmentally, these conditions are characterized by an increased incidence of developmental problems including language and intellectual impairment, learning disabilities, attentional deficits and impaired social function [1,2,3,4,5,6,7]; for a review, see Richman et al [8]. To date, the underlying etiology of these deficits remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Regional Brain Morphometric Characteristics of Nonsyndromic Cleft Lip and Palate

et al. 2014

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Nonsyndromic cleft lip and palate (NSCLP) encompasses a group of orofacial abnormalities. Emerging evidence has revealed the presence of structural brain abnormalities in affected individuals. Previous studies have performed structure-based volumetric analysis of the brain assessing gross lobular subdivisions of the cerebral cortex and white matter which may have only vague relationships to the functional subregions implicated in behavioral and cognitive deficits observed in NSCLP patients. High-resolution magnetic resonance imaging structural data were acquired to provide a detailed characterization of the brain with respect to both regional cortical volume and thickness in 26 children with NSCLP and 26 age- and demographically matched typically developing children. Children with NSCLP exhibited abnormally large cerebral cortex grey matter volumes with decreased volumes of subcortical grey matter and cerebral white matter structures. Hemisphere-specific patterns of cortical volume and thickness abnormalities were identified. This study is the first to examine cortical thickness abnormalities in NSCLP. Overall, these findings suggest that the brains of children with NSCLP are less mature than those of their age-matched peers. Gender-specific comparisons reveal that NSCLP females were more immature compared to their typically developing peers compared to NSCLP males.

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Neuropsychological, Behavioral, and Academic Sequelae of Cleft: Early Developmental, School Age, and Adolescent/Young Adult Outcomes

Cited by 107 publications

References 76 publications

Academic Achievement of Children and Adolescents With Oral Clefts

Academic Achievement of Children and Adolescents With Oral Clefts

Desempenho cognitivo-linguístico de crianças com fissura labiopalatina em fase de aquisição da leitura e escrita

Regional Brain Morphometric Characteristics of Nonsyndromic Cleft Lip and Palate

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