Longitudinal educational attainment among children with isolated oral cleft: a cohort study

Objectives (1) To explore differences in educational attainment between children born with isolated clefts and the general population at ages 5, 7 and 11 years; (2) to describe longitudinal changes in attainment among children with cleft through primary education. Design Analysis of Cleft Registry and Audit Network data linked to national educational outcomes. Setting English state schools. Patients 832 children born with isolated cleft, aged 5 years in 2006-2008. Main outcome measures Difference in teacher-assessed attainment between children with a cleft and general population at each age, for all children and by cleft type. Percentage of children with low attainment at age 5 years who had low attainment at age 11 years, for all children and by cleft type. Results Children with a cleft had lower attainment than the general population in all subject areas (Z-score range: -0.29 (95% CI -0.36 to -0.22) to -0.22 (95% CI -0.29 to -0.14)). This difference remained consistent in size at all ages, and was larger among children with a cleft affecting the palate (cleft palate/cleft lip and palate (CP/CLP)) than those with a cleft lip (CL). Of 216 children with low attainment in any subject at age 5 years, 54.2% had low attainment in at least one subject at age 11 years. Compared with children with CL, those with CP/CLP were more likely to have persistent low attainment. Conclusions An educational attainment gap for children born with isolated clefts is evident throughout primary education. Almost half of children with low attainment at age 5 years achieve normal attainment at age 11 years.

Automated summary

This study analyzed the educational attainment differences between children born with clefts and the general population at ages 5, 7, and 11, and described the longitudinal changes in attainment among children with clefts during primary education. The results showed that children with clefts had lower attainment than the general population in all subject areas, and this difference remained consistent at all ages, with those affected in the palate having a larger gap compared to those with a cleft lip. Among children with low attainment at age 5, more than half still had low attainment in at least one subject at age 11. Therefore, there is an educational attainment gap for children born with clefts throughout primary education, but nearly half of those with low attainment at a young age can achieve normal levels by age 11.