RT Journal Article
SR Electronic
T1 Early academic achievement in children with isolated clefts: a population-based study in England
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP archdischild-2017-313777
DO 10.1136/archdischild-2017-313777
A1 Kate Jane Fitzsimons
A1 Lynn P Copley
A1 Efrosini Setakis
A1 Susan C Charman
A1 Scott A Deacon
A1 Lorraine Dearden
A1 Jan H van der Meulen
YR 2017
UL http://adc.bmj.com/content/early/2017/11/02/archdischild-2017-313777.abstract
AB Objectives We used national data to study differences in academic achievement between 5-year-old children with an isolated oral cleft and the general population. We also assessed differences by cleft type.Methods Children born in England with an oral cleft were identified in a national cleft registry. Their records were linked to databases of hospital admissions (to identify additional anomalies) and educational outcomes. Z-scores (signed number of SD actual score is above national average) were calculated to make outcome scores comparable across school years and across six assessed areas (personal development, communication and language, maths, knowledge of world, physical development andcreative development).Results 2802 children without additional anomalies, 5 years old between 2006 and 2012, were included. Academic achievement was significantly below national average for all six assessed areas with z-scores ranging from −0.24 (95% CI −0.32 to −0.16) for knowledge of world to −0.31 (−0.38 to −0.23) for personal development. Differences were small with only a cleft lip but considerably larger with clefts involving the palate. 29.4% of children were documented as having special education needs (national rate 9.7%), which varied according to cleft type from 13.2% with cleft lip to 47.6% with bilateral cleft lip and palate.Conclusions Compared with national average, 5-year-old children with an isolated oral cleft, especially those involving the palate, have significantly poorer academic achievement across all areas of learning. These outcomes reflect results of modern surgical techniques and multidisciplinary approach. Children with a cleft may benefit from extra academic support when starting school.