The Cleft Care <scp>UK</scp> study. Part 4: perceptual speech outcomes

Sell, Debbie; Mildinhall, Sue; Albery, Liz; Wills, Andrew K; Sandy, Jonathan R; Ness, Andy R

doi:10.1111/ocr.12112

Cited by 114 publications

(117 citation statements)

References 48 publications

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“…The Cleft Care UK (CCUK) study is a United Kingdom (UK)‐wide cross‐sectional study of 5‐year‐old children born with complete unilateral cleft lip and palate (cUCLP) . Recently reported findings from CCUK showed that outcomes in speech and dentoalveolar and facial form following treatment of cUCLP in the UK have improved since services were reorganized to a more centralized model of care . This reorganization of cleft services in the UK achieved a more multidisciplinary and audited service with designated cleft surgeons performing at least ~40 primary cleft repair operations (including all cleft types) per year .…”

Section: Introductionmentioning

confidence: 99%

Range and timing of surgery, and surgical sequences used, in primary repair of complete unilateral cleft lip and palate: The Cleft Care UK study

Slator

Perisanidou

Waylen

et al. 2019

Orthod Craniofacial Res

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Objects To describe the range of surgery used to repair the lip and palate in the UK with specific interest in the sequence/timing used in complete unilateral cleft lip and palate (cUCLP). Setting and Sample Population The Cleft Care UK study, a cross‐sectional study of 268 5‐year‐olds, born from 2005 to 2007, with complete unilateral cleft lip and palate. Materials & Methods Information on surgery was extracted from medical notes by surgeons during research clinics and transcribed onto a standardized questionnaire. Results Surgical data were available for 251 (94%) children from all cleft centres in the UK (n = 18). Over a two‐year period, 32 surgeons used 10 different surgical sequences in primary repair of the cleft lip and palate. The most frequently used sequence was repair of cleft lip and anterior hard palate followed by repair of posterior hard palate and soft palate (70%). Four surgical sequences were used only once. Most surgeons had a preferred sequence, but 38% (11/29) used more than one sequence during the study period. The timing of repair of the lip, the hard palate and the soft palate varied with surgical sequence, and also between surgeons, even adjusting for the different sequences used. Conclusion Despite centralization of cleft services in the UK, there remains considerable variation in both the sequence and timing of surgical repair of cleft lip and palate in infancy. Further work is required to understand whether these factors are associated with differences in outcome.

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Section: Introductionmentioning

confidence: 99%

Range and timing of surgery, and surgical sequences used, in primary repair of complete unilateral cleft lip and palate: The Cleft Care UK study

Slator

Perisanidou

Waylen

et al. 2019

Orthod Craniofacial Res

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“…However, children born with cleft have a much higher rate of persistent speech problems with approximately 50% showing difficulties with making themselves understood at age 5 (Sell et al . ). Additional risk factors for suboptimal speech and language outcomes in this population include the size of the cleft and the timing and methods of surgical intervention.…”

Section: Discussionmentioning

confidence: 97%

“…The primary driver of the initial collection of the data in the CC-SL study is the imperative to identify the precursors and risk factors associated with poor speech outcome at age 3 years and of later persistent speech disorder, given that children born with cleft palate are a high-risk group for both outcomes (Sell et al 2015). Whilst the type and degree of cleft are undoubtedly important in speech outcome, other factors related to the child's physical and psychosocial development as well as environmental and genetic factors are also thought to play a part.…”

Section: The Cleft Collective Speech and Language (Cc-sl) Studymentioning

confidence: 99%

“…Factors including gender, socioeconomic status, motor and cognitive skills, hearing status, and history and family history could all influence outcomes in early development in speech (Wren et al 2016). However, children born with cleft have a much higher rate of persistent speech problems with approximately 50% showing difficulties with making themselves understood at age 5 (Sell et al 2015). Additional risk factors for suboptimal speech and language outcomes in this population include the size of the cleft and the timing and methods of surgical intervention.…”

Section: Opportunitiesmentioning

confidence: 99%

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Setting up a cohort study in speech and language therapy: lessons from The UK Cleft Collective Speech and Language (CC‐SL) study

Wren

Humphries

Stock

et al. 2017

Intl J Lang & Comm Disor

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“…Children born with a cleft, particularly involving the palate, are at higher risk of poor speech outcomes at three-years-old (i.e. before entering school) and persistent speech disorder 24 , both of which are strongly associated with lower educational attainment 41 . Teasing and bullying by peers is common in children born with clefts 22 , which can affect psychological wellbeing, enjoyment of school and attainment 42 .…”

Section: Comparison To Previous Evidencementioning

confidence: 99%

Cleft lip/palate and educational attainment: cause, consequence, or correlation? A Mendelian randomization study

Dardani

Howe

Stergiakouli

et al. 2018

Preprint

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AbstractImportancePrevious studies have found that children born with a non-syndromic form of cleft lip and/or palate have lower-than-average educational attainment. These differences could be due to a genetic predisposition to low intelligence and academic performance, factors arising due to the cleft phenotype (such as school absence, social stigmatization and impaired speech and language development), or confounding by the prenatal environment. A clearer understanding of this mechanism will inform development of interventions to improve educational attainment in individuals born with a cleft, which could have wide-ranging knock-on effects on their quality of life.ObjectiveTo assess evidence for the hypothesis that common variant genetic liability to non-syndromic cleft lip with or without cleft palate (nsCL/P) influences educational attainment.DesignUsing summary data from genome-wide association studies (GWAS), we performed Linkage Disequilibrium (LD)-score regression and two-sample Mendelian randomization to evaluate the relationship between genetic liability to nsCL/P (GWAS n=3,987) and educational attainment (GWAS n=766,345), and intelligence (GWAS n=257,828).ResultsThere was little evidence for shared genetic aetiology between nsCL/P and educational attainment (rg −0.03, 95% CI −0.14 to 0.08, P 0.58; βMR 0.002, 95% CI −0.001 to 0.005, P 0.417) or intelligence (rg −0.01, 95% CI −0.12 to 0.10, P 0.85; βMR 0.002, 95% CI −0.010 to 0.014, P 0.669).Conclusions and relevanceCommon genetic variants are unlikely to predispose individuals born with nsCL/P to low educational attainment or intelligence. This information will help tailor clinical-, school-, social- and family-level interventions to improve educational attainment in this group.Key PointsQuestionDo children born with a non-syndromic cleft lip with or without palate (nsCL/P) have lower-than average academic achievement because of an underlying genetic predisposition to educational attainment and/or intelligence?FindingsThere was little evidence for shared common variant genetic correlation between nsCL/P, educational attainment and intelligence.MeaningCommon genetic variants are unlikely to predispose individuals born with nsCL/P to low educational attainment or intelligence. This information will help tailor clinical-, school-, social- and family-level interventions to improve educational attainment in this group.

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The Cleft Care UK study. Part 4: perceptual speech outcomes

Cited by 114 publications

References 48 publications

Range and timing of surgery, and surgical sequences used, in primary repair of complete unilateral cleft lip and palate: The Cleft Care UK study

Range and timing of surgery, and surgical sequences used, in primary repair of complete unilateral cleft lip and palate: The Cleft Care UK study

Setting up a cohort study in speech and language therapy: lessons from The UK Cleft Collective Speech and Language (CC‐SL) study

Cleft lip/palate and educational attainment: cause, consequence, or correlation? A Mendelian randomization study

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