Orofacial Clefts Linked to Worse Neurodevelopmental, Academic Outcomes

By Anne Harding

June 15, 2019

NEW YORK (Reuters Health) - Children with orofacial clefts (OFCs) have worse neurodevelopmental and academic outcomes than their peers, from infancy through adolescence, according to a new systematic review.

But the findings should not be interpreted to mean that all children with OFCs will have learning problems or do poorly at school, Dr. Emily R. Gallagher of the University of Washington in Seattle, the study's lead author, told Reuters Health by email.

"As a group, children with clefts have increased risk of lower neurodevelopmental and academic outcomes and should therefore have appropriate monitoring and support when needed (such as access to early intervention services or academic support at school). Many people with clefts excel academically and go on to have any number of careers," Dr. Gallagher added.

While several studies have found deficits in development and achievement in children with OFCs, Dr. Gallagher and her University of Washington colleague Dr. Brent R. Collett note in their June 12 report in Pediatrics, age-related trends have not been investigated.

They reviewed 31 studies including 10,143 OFC patients and more than 2 million controls. The 10 studies in infants and toddlers found differences in cognition, motor skills and receptive and expressive language between those with and without OFC.

The remaining studies (14 in early school-age children, seven in adolescents) found students with OFC had deficits in language and math skills, worse grades and standardized test scores, more absenteeism, and greater use of special-education services.

Overall, children with cleft palate seemed to have the worst outcomes compared to those with other types of OFCs, but the findings were inconsistent and not all studies were large enough to look at cleft subtypes.

"The factors that contribute to the observed differences in neurodevelopmental and academic outcomes are clearly multifactorial," Dr. Gallagher said. "Future studies would help us better understand these factors so that we can design and study appropriate interventions to help children with clefts reach their full academic potential."

SOURCE: https://bit.ly/2F5Qerm

Pediatrics 2019.