Cognitive functioning and clinical characteristics of children with non-syndromic orofacial clefts: A case-control study

Abstract

IntroductionThe higher rate of neuropsychiatric disorders in individuals with non-syndromic orofacial clefts has been well documented by previous studies. Our goal was to identify children with non-syndromic orofacial clefts that are at risk for abnormal neurodevelopment by assessing their developmental history and present cognitive functioning.Materials and methodsA single-center, case-controlled study was carried out at the Department of Pediatrics of the University of Pécs in Hungary. The study consisted of three phases including questionnaires to collect retrospective clinical data and psychometric tools to assess IQ and executive functioning.ResultsForty children with non-syndromic oral clefts and 44 age-matched controls participated in the study. Apgar score at 5 min was lower for the cleft group, in addition to delays observed for potty-training and speech development. Psychiatric disorders were more common in the cleft group (15%) than in controls (4.5%), although not statistically significant with small effect size. The cleft group scored lower on the Continuous Performance Test. Subgroup analysis revealed significant associations between higher parental socio-economic status, academic, and cognitive performance in children with non-syndromic orofacial clefts. Analyzes additionally revealed significant associations between early speech and language interventions and higher scores on the Verbal Comprehension Index of the WISC-IV in these children.DiscussionChildren with non-syndromic orofacial clefts seem to be at risk for deficits involving the attention domain of the executive system. These children additionally present with difficulties that affect cognitive and speech development. Children with non-syndromic orofacial clefts show significant skill development and present with similar cognitive strengths as their peers. Longitudinal studies with larger sample sizes are needed to provide more conclusive evidence on cognitive deficits in children with non-syndromic orofacial clefts at risk for neurodevelopmental difficulties.

Neuropsychiatric Disorders In Non-Syndromic Orofacial Clefts: A Follow-Up Study

“…An additional parental questionnaire was developed for the study to collect demographic data. This questionnaire was used in a previous publication (4).…”

“…Non-syndromic orofacial clefts are a known at-risk population for neuropsychiatric disorders; about 15-20% higher rate is observed in cleft individuals versus non-cleft controls (4)(5)(6)(7). Recent data-including cleft registries, atypical neurodeveloping toddlers with OFCs, brain structural differences, and animal studies-suggest an early maldevelopment of both cerebral and facial structures which may explain the observed higher risk for neuropsychiatric disorders in this patient population (4,(7)(8)(9).…”

“…In a previously studied cohort of Hungarian children, we have observed a signi cantly higher proportion of previous psychiatric care, special education needs, and cognitive di culties in children with cleft compared to their non-cleft controls (4). Psychiatric and developmental data were collected retrospectively in this study; however, retrospective data heavily relies on the available and accessible medical charts, quality of the available data, and parental factors when using a parental questionnaire.…”