Academic achievement in children with oral clefts versus unaffected siblings.
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ABSTRACT:
SUBMITTER: Collett BR
PROVIDER: S-EPMC4107579 | biostudies-literature | 2014 Aug
REPOSITORIES: biostudies-literature
Publications
Academic achievement in children with oral clefts versus unaffected siblings.
Collett Brent R BR Wehby George L GL Barron Sheila S Romitti Paul A PA Ansley Timothy N TN Speltz Matthew L ML
Journal of pediatric psychology 20140703 7
<h4>Objective</h4>To compare academic achievement in children with oral-facial clefts (OFC) with their unaffected siblings.<h4>Methods</h4>256 children with OFC were identified from the Iowa Registry for Congenital and Inherited Disorders, and 387 unaffected siblings were identified from birth certificates. These data were linked to Iowa Testing Programs achievement data. We compared academic achievement in children with OFC with their unaffected siblings using linear regression models, adjusted ...[more]
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Project description:Background and objectivePrevious studies of academic achievement of children with oral clefts have mostly relied on small, clinic-based 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.MethodsChildren 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.ResultsChildren 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.ConclusionsChildren 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.
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Project description:OBJECTIVES:To examine trajectories in academic achievement for children with oral clefts versus unaffected classmates and explore predictors of persistently low achievement among children with oral clefts. DESIGN:Longitudinal cohort study of academic achievement in a population-based sample. SETTING AND PARTICIPANTS:Children born from 1983 through 2003 with oral clefts were identified from the Iowa Registry for Congenital and Inherited Disorders and matched to unaffected classmates by sex, school/school district and month and year of birth. MAIN OUTCOME MEASURES:Academic achievement was measured from Iowa Testing Programs data. Outcomes included achievement scores in reading, language and mathematics. RESULTS:Academic achievement data were available for 586 children with oral clefts and 1873 unaffected classmates. Achievement trajectories were stable for both groups. Children with oral clefts were more likely than their classmates to be classified into persistent low achievement trajectories, including when adjusting for socioeconomic differences: OR=1.63, 95% CI 1.23 to 2.16 for reading; OR=1.73, 95% CI 1.29 to 2.31 for language; OR=1.45, 95% CI 1.05 to 1.99 for math. Predictors of low achievement were cleft palate only (vs other cleft types), adolescent mothers, low maternal education and less frequent use of prenatal care. CONCLUSIONS:Most children have steady academic trajectories and children with oral clefts are at greater risk for persistent low achievement in school than unaffected classmates. These findings support the need for routine, early screening for academic deficits in this population. Cleft palate only, low parental education and adolescent mothers are associated with increased risk for persistent low achievement.
| S-EPMC5018039 | biostudies-literature
Project description:ObjectiveEarly life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group to investigate whether outcome depends on timing and number of operations during childhood and/or type of oral cleft.DesignNationwide register-based follow-up study.SettingDanish birth cohort 1986 to 1990.ParticipantsFive hundred fifty-eight children with isolated CL (n = 171), CLP (n = 222), or CP (n = 195), of which 509 children had been exposed to anesthesia and one or more cleft operation(s), and a 5% sample of the birth cohort (n = 14,677).Main outcome measure(s)Test score in the Danish standardized ninth-grade exam and proportion of nonattainment, defined as "results for ninth-grade exam unavailable." Data adjusted for sex, birth weight, parental age, and parental level of education.ResultsCompared to controls, children with CL achieved higher scores (mean difference 0.12, 95% CI -0.05; 0.29) and children with CLP presented with lower scores (mean difference -0.06, 95% CI -0.21; 0.09), albeit both statistically insignificant. Children with CP achieved significantly lower scores, mean difference -0.20 (95% CI -0.38; -0.03). Odds ratios for nonattainment at final exam were: CL 0.79 (95% CI 0.46; 1.35), CLP 1.07 (95% CI 0.71; 1.61), CP 2.59 (95% CI 1.78; 3.76).ConclusionsOral cleft type rather than number and timing of anesthesia and operations associate to poorer academic performance. Although a potential neurotoxic effect due to anesthetic agents is not reflected in the data, it cannot be completely excluded.
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| S-EPMC9503174 | biostudies-literature
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