“…Individuals with cleft had higher odds of receiving the lowest grade and/or reduced odds of receiving high grades among subjects analyzed, along with strong evidence of a lower grade point average in comparison with the population as a whole. This study is congruent with other studies that have identified greater prevalence of cognitive dysfunction and learning difficulties, lower school achievements, and greater use of special education services in individuals with cleft in comparison with individuals without cleft (Broder et al, 1998;Nopoulos et al, 2002;Richman et al, 2005;Eide et al, 2006;Yazdy et al, 2008). Furthermore, this study supports the need to consider cleft type in studies of cognitive and educational outcomes (Richman, 1980;Richman and Eliason, 1984;Richman et al, 1988;Broder et al, 1998), with individuals with CP having the most negative outcome, followed by individuals with CLP, and those with CL being the least affected in comparison with the control group.…”