Gallagher Emily R, Collett Brent R, Barron Sheila, Romitti Paul, Ansley Timothy, Wehby George L
Departments of Pediatrics and.
Psychiatry and Behavioral Sciences, Child Psychiatry at Seattle Children's Hospital, University of Washington, Seattle, Washington.
Pediatrics. 2017 Feb;139(2). doi: 10.1542/peds.2016-2662. Epub 2017 Jan 4.
Children with isolated oral clefts have lower academic performance when compared with unaffected peers, yet few studies have examined specific attributes of clefts that may modify this risk. Oral clefts have nonrandom laterality, with left-sided clefts being more common than right-sided clefts, a pattern that may be genetically or environmentally influenced. The objective of this study was to evaluate the association between cleft laterality and academic achievement in a population-based sample of children with and without isolated oral clefts.
The study included 292 children with isolated unilateral cleft lip with or without cleft palate identified by using the Iowa Registry for Congenital and Inherited Disorders matched with 908 unaffected classmates. This group provided 1953 child-grade observations for cases and 6829 for classmates. Academic achievement was evaluated by using high-quality standardized test data on multiple academic domains as well as use of special education.
We found that children with right-sided clefts had similar achievement scores and usage of special education services compared with their unaffected classmates. Children with left-sided clefts had lower reading scores than children with right-sided clefts by nearly 7 percentiles (P < .05). They also had lower scores on all evaluated domains by 4 to 6 percentiles and greater use of special education services by 6 percentage points than their classmates.
Children with left-sided clefts had poorer academic performance than their classmates or children with right-sided clefts, who showed similar academic achievement compared with their unaffected classmates.
与未受影响的同龄人相比，患有单纯口腔裂隙的儿童学业成绩较低，但很少有研究考察可能改变这种风险的口腔裂隙的具体特征。口腔裂隙具有非随机的侧别性，左侧裂隙比右侧裂隙更常见，这种模式可能受遗传或环境影响。本研究的目的是在有和没有单纯口腔裂隙的儿童的基于人群的样本中评估裂隙侧别与学业成绩之间的关联。
该研究纳入了292名患有单纯单侧唇裂伴或不伴腭裂的儿童，这些儿童通过爱荷华州先天性和遗传性疾病登记处确定，并与908名未受影响的同班同学进行匹配。该组为病例提供了1953个儿童年级观察数据，为同班同学提供了6829个观察数据。通过使用多个学术领域的高质量标准化测试数据以及特殊教育的使用情况来评估学业成绩。
我们发现，与未受影响的同班同学相比，患有右侧裂隙的儿童的成绩得分和特殊教育服务的使用情况相似。患有左侧裂隙的儿童的阅读分数比患有右侧裂隙的儿童低近7个百分点（P <.05）。他们在所有评估领域的得分也比同班同学低4至6个百分点，特殊教育服务的使用比同班同学多6个百分点。
患有左侧裂隙的儿童的学业成绩比同班同学或患有右侧裂隙的儿童差，而患有右侧裂隙的儿童与未受影响的同班同学相比表现出相似的学业成绩。
