Objectives (1) To explore differences in educational attainment between children born with isolated clefts and the general population at ages 5, 7 and 11 years; (2) to describe longitudinal changes in attainment among children with cleft through primary education.
Design Analysis of Cleft Registry and Audit Network data linked to national educational outcomes.
Setting English state schools.
Patients 832 children born with isolated cleft, aged 5 years in 2006–2008.
Main outcome measures Difference in teacher-assessed attainment between children with a cleft and general population at each age, for all children and by cleft type. Percentage of children with low attainment at age 5 years who had low attainment at age 11 years, for all children and by cleft type.
Results Children with a cleft had lower attainment than the general population in all subject areas (Z-score range: −0.29 (95% CI −0.36 to −0.22) to −0.22 (95% CI −0.29 to −0.14)). This difference remained consistent in size at all ages, and was larger among children with a cleft affecting the palate (cleft palate/cleft lip and palate (CP/CLP)) than those with a cleft lip (CL). Of 216 children with low attainment in any subject at age 5 years, 54.2% had low attainment in at least one subject at age 11 years. Compared with children with CL, those with CP/CLP were more likely to have persistent low attainment.
Conclusions An educational attainment gap for children born with isolated clefts is evident throughout primary education. Almost half of children with low attainment at age 5 years achieve normal attainment at age 11 years.
- child development
- health services research
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Contributors MHP conceptualised and designed the study, carried out the analyses and interpretation of data, drafted the initial manuscript and revised and finalised the manuscript for submission, and is guarantor of this work. KJF acquired and processed the data, interpreted the data and edited the manuscript. SD, SB and CR interpreted the data, contributed clinical aspects and edited the manuscript. JM and MAHW acquired and processed the data, and edited the manuscript. JHvdM conceptualised the study, interpreted the data and edited the manuscript. All authors read and approved the final manuscript.
Funding Hospital Episode Statistics data were made available by NHS Digital; National Pupil Database data were made available by the Department for Education. The CRANE database was funded by the National Specialised Commissioning Group for England and the Wales Specialised Health Services Committee, and is overseen by the UKNHS Cleft Development Group.
Disclaimer The funders did not have a role in in study design; in the collection, analysis and interpretation of data; in the writing of the report and in the decision to submit the paper for publication.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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