Children with oral clefts more likely to have academic problems

By Rob Goodier

NEW YORK (Reuters Health) - Children with oral clefts perform significantly worse in school than their peers, a new study has found.

Twenty years of data recorded in an Iowa registry shows that 588 children with clefts had a five-percentile deficit in scores compared with their classmates in all grade levels and across all academic subjects. They were about a half grade level behind their peers on average, researchers report in Pediatrics, online April 21.

"Many children with oral clefts will not experience academic deficits but some may," lead author Dr. George Wehby of the University of Iowa in Iowa City told Reuters Health by email. "Early screening could help to identify those at greatest risks and provide interventions to reduce risk of learning problems."

The patients included in this large population-based study had three types of clefts: cleft lip only, cleft lip and palate, and cleft palate only. Each patient was matched to two healthy classmates by gender, month of birth, school and other factors. The study group and the controls had similar demographic and socioeconomic backgrounds.

The children with oral clefts scored lower on every measure of academic performance, and the differences persisted in every school level and field of study.

The researchers also found that 20% of the children with oral clefts were placed in special education compared to 13% of their classmates.

It is not clear why there might be differences, but Dr. Wehby has four possible guesses.

"The association may be due to differences in family socioeconomic backgrounds not well captured in the analysis (e.g. income) or in unmeasured prenatal factors such as maternal nutrition, or it could be related to speech problems or social stigmatization (e.g. teasing because of facial scarring or speech). More research is needed to explain this association," Dr. Wehby said.

Past research has suggested a link between oral clefts and learning disabilities, so this study's results are not surprising, says Dr. Amy Conrad, a pediatric psychologist at the University of Iowa Children's Hospital who was not involved in this research.

"What this study adds to the literature is the finding that these deficits are not limited to language or reading domains (which have been over-represented in past literature in comparison to nonverbal domains)," Dr. Conrad said.

SOURCE: http://bit.ly/1hubFkd

Pediatrics 2014.

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