Retrospective Evaluation of Number of Surgeries and Parent Ratings of Academic and Behavioral Functioning Among Children With Isolated Oral Clefts

Abstract

Objective: The purpose of this study was to evaluate possible relationships between number of surgeries and parent ratings of academic functioning among children with isolated oral clefts. Design: Multicenter, retrospective cohort study including structured interviews, questionnaires, and chart reviews. Setting: Completion of questionnaires occurred during clinical visits at 6 different cleft centers across North America. Participants: Parents of 285 children with isolated clefts of the lip and/or palate, aged 8 to 10 years old, participated in structured interviews and completed questionnaires regarding the academic and behavioral functioning of their children. Main Outcome Measures: Parent interview and medical chart review of number of surgeries to date and parent ratings on the Adaptive Behavior Assessment System, Third Edition-Functional Academics Scale (ABAS-FA) and Child Behavior Checklist (CBCL) Total Competency Scale. Results: Parent ratings of ABAS-FA were at or above normative expectations, while ratings across CBCL Competency Scales were lower than normative expectations. Socioeconomic status (SES), age, and race were consistent predictors of parent ratings (higher SES, older age, and Caucasian race were associated with better functioning). Number of surgeries did not add significantly to academic ratings but did significantly contribute to ratings of social and activity participation. Patients with more surgeries were rated with lower functioning in these domains. Conclusions: Findings do not support a connection between number of surgeries and later ratings of academic functioning but do support a connection to social and activity involvement. Recommendations for conducting direct studies of the connection between surgeries and academic functioning as well as clinical considerations for surgeries and impact on social and activity involvement are discussed.

Revealing a Cleft in the Community: A Systematic Review of Sociodemographic Disparities Affecting the Care of Patients With Cleft Lip

“…Similarly, Conrad et al's questionnaire-based study found that white race was predictive of better parent-reported functioning, despite controlling for the amount of surgeries undergone. 31…”

Thematic Analysis of Parental Experiences of Patients’ Orthognathic Surgery

“…In patients with congenital anomalies, orthognathic surgery is one of a series of procedures over the course of their development, along with additional multidisciplinary treatment, and the history of complex care can be a psychosocial risk factor. For example, a greater number of surgeries has been linked to parental report of lower social and activity participation in children with a cleft 10 . The complexity of craniofacial care is also important to consider because trauma exposure before orthognathic treatment was found to be a risk factor for developing dental anxiety and PTSD symptoms 11 .…”

“…For example, a greater number of surgeries has been linked to parental report of lower social and activity participation in children with a cleft. 10 The complexity of craniofacial care is also important to consider because trauma exposure before orthognathic treatment was found to be a risk factor for developing dental anxiety and PTSD symptoms. 11 In addition, orthognathic surgeries occur in late adolescence or early adulthood, which is a developmental period of emerging independence that can make the treatment course challenging.…”