Learning Disability, School Achievement, and Grade Retention among Children with Cleft: A Two-Center Study

1998 ◽  
Vol 35 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Hillary L. Broder ◽  
Lynn C. Richman ◽  
Pamela B. Matheson
Keyword(s):  
Cleft Palate ◽  
Learning Disability ◽  
Grade Retention ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
School Achievement ◽  
Subject Group ◽  
Age And Gender ◽  
And Gender ◽  
Center Study

Objective This study examined the prevalence of learning disability (LD), level of school achievement; and prevalence of grade retention by type of cleft and gender at two craniofacial centers. Setting The setting included two university-based craniofacial centers. Design/Patients Participants included 84 consecutively evaluated patients from one center who were matched by cleft type, age, and gender with 84 patients evaluated at the second center. Outcomes The outcomes included learning disability, school achievement, and grade retention. Results The results revealed that 46% of subjects with cleft had LD, 47% had deficient educational progress, and 27% had repeated a grade (excluding kindergarten) in school. Males with cleft palate only (CPO) had a significantly higher rate of LD than any other subject group. Males with CPO and females with cleft lip and palate (CLP) were more likely to repeat a grade in school than were females with CPO and males with CLP. Conclusions Children with cleft are at risk for learning disability, low school achievement, and grade retention.

Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate

2020 ◽  
pp. 105566562098024
Author(s):  
Kim Bettens ◽  
Laura Bruneel ◽  
Cassandra Alighieri ◽  
Daniel Sseremba ◽  
Duncan Musasizib ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Control Group ◽  
English Speaking ◽  
And Gender ◽  
Early Primary ◽  
Velopharyngeal Function ◽  
Normal Speech

Objective: To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). Design: Prospective case–control study. Setting: Referral hospital for patients with cleft lip and palate in Uganda. Participants: Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. Interventions: Comparison of speech outcomes of the patient and control group. Main Outcome Measures: Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. Results: Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children ( P < .05). Conclusions: Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.

Midfacial Growth in a Consecutive Series of Preadolescent Children with Complete Unilateral Cleft Lip and Palate following a One-Stage Simultaneous Repair

2008 ◽  
Vol 45 (6) ◽  
pp. 667-673 ◽  
Author(s):  
Piotr Fudalej ◽  
Barbara Obloj ◽  
Dorota Miller-Drabikowska ◽  
Anna Samarcew-Krawczak ◽  
Zofia Dudkiewicz
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Dental Arch ◽  
Consecutive Series ◽  
Age And Gender ◽  
Prepubertal Children ◽  
One Stage ◽  
Lateral Cephalograms ◽  
And Gender ◽  
Posterior Position

Objective: To evaluate midfacial growth in prepubertal children with complete unilateral cleft lip and palate following one-stage simultaneous repair. Subjects: A series of 28 consecutively treated subjects with complete unilateral cleft lip and palate were compared with age- and gender-matched controls with normal midfacial structure. Methods: On the lateral cephalograms taken at the age of approximately 10 years, size and position of the maxilla and upper dental arch were evaluated in vertical and horizontal planes. Statistical analysis included independent t tests and nonparametric Mann-Whitney tests. Results: The maxilla was found to be retruded (sella-nasion-point A angle decreased by 4.5° and nasion to point A distance increased by 4.2 mm) and rotated posteriorly (sella-nasion/palatal plane angle decreased by 4.5°) in the cleft group. Maxillary length (pterygomaxillare-point A distance) was diminished by approximately 2 mm. Upper incisors were found retroclined in comparison to controls (both upper incisor axis/sella-nasion and upper incisor axis/palatal plane angles were decreased by 10.7° and 6.1°, respectively). Conclusion: Maxillary prominence, as measured with the sella-nasion-point A angle and the condylion-point A and articulare-point A distances, was decreased. Shortened length and posterior position of the maxillary body were responsible at a ratio of 60% to 40% for a decreased prominence of the maxillary complex. The palatal plane demonstrated a larger inclination to the sella-nasion plane by 4.5° due to a decreased sella-posterior nasal spine distance.

scholarly journals Comparative analysis of pubertal growth spurt predictors: Martins and Sakima method and Grave and Brown method

2005 ◽  
Vol 13 (1) ◽  
pp. 58-61 ◽  
Author(s):  
Karina Emy Iguma ◽  
Orivaldo Tavano ◽  
Izabel Maria Marchi de Carvalho
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Female Gender ◽  
Male Gender ◽  
Growth Spurt ◽  
Pubertal Growth Spurt ◽  
Age And Gender ◽  
Pubertal Growth ◽  
And Gender ◽  
Initial Peak

The aim of this study was to evaluate whether Martins and Sakima and Grave and Brown methods are useful for the study of pubertal growth spurt in children with cleft lip and palate. A total of 132 hand-wrist radiographs of patients from HRAC/USP aged 7 to 17 years old were analyzed, including girls and boys. Six radiographs of each age and gender were employed. These methods were applied to evaluating the stages of the hand-wrist ossification and epiphyseal formation, by graphic representation. The Martins and Sakima and the Grave and Brown methods revealed that the initial, peak and final stages of pubertal growth spurt occurred between 9 to 10, 12 and 15 years old, respectively, in the female gender. Similarly, in the male gender, both Martins and Sakima and Grave and Brown methods showed similar mean ages: 12, 14 and 16 years old for initial, peak and final stages of pubertal growth spurt, respectively. The Pearson's correlation test showed high and significant correlation (r = 0.99 and p < 0.001) between the methods investigated. In conclusion, the methods appeared to be highly and significantly correlated as regards the analysis of children with cleft lip and palate. Moreover, based on the literature and present results, it is possible to suggest that the two methods have shown similar pattern and may be used with equal efficiency for assessment of the pubertal growth spurt in children with cleft lip and palate.

Size and Form of the Cranial Base in Isolated Cleft Lip and Palate

1993 ◽  
Vol 30 (2) ◽  
pp. 170-174 ◽  
Author(s):  
Edward F. Harris
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Cranial Base ◽  
Size Difference ◽  
Growth Disturbance ◽  
Age And Gender ◽  
Size And Shape ◽  
And Gender ◽  
Shape Controlling ◽  
Time Specific

Most cases with cleft lip and palate (CLP) have no other obvious malformation and are termed isolated CLP. The implication is that these individuals experienced a time-specific and anatomically-localized disturbance during palatogenesis but are otherwise normal. The cranial base was studied from cephalograms in subadults with isolated CLP (n = 43) to test for alterations in size and shape. Controlling for age and gender, analyses showed no size difference, but flexure of the cranial base was significantly greater in the CLP group. Taken in conjunction with increased risks of other conditions with prenatal onsets, it appears that “isolated CLP” is a misnomer and the cleft should be viewed as an overt manifestation of a more generalized growth disturbance.

Correlation between Facial Morphology and Esthetics in Patients with Repaired Complete Unilateral Cleft Lip and Palate

2009 ◽  
Vol 46 (3) ◽  
pp. 319-325 ◽  
Author(s):  
K. A. Russell ◽  
B. Tompson
Keyword(s):  
Outcome Measures ◽  
Analysis Of Variance ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Facial Morphology ◽  
Age And Gender ◽  
Visual Analog Scales ◽  
Subjective Assessments ◽  
And Gender ◽  
2D And 3D

Objective: The purpose of this study was to determine if there were correlations between anthropometric nasolabial measurements and subjective assessments of nasal esthetics in individuals with repaired complete unilateral cleft lip and palate (CUCLP). Participants: The sample consisted of 28 individuals with repaired CUCLP and 20 age- and gender-matched individuals without clefts. Outcome Measures: Nasolabial morphology was assessed using 2D and 3D measurements made on frontal photographs, lateral cephalometric radiographs, and plaster nose casts. A panel of orthodontists rated nasal esthetics from frontal, lateral, three-quarter, and basal view photographs and plaster nose casts using visual analog scales, and they also order ranked the nose casts. Based on the nasal esthetics ratings and rankings, two groups that had the best and the worst esthetics representing the extremes of nasolabial esthetics were statistically identified. Measurements were compared between the cleft and noncleft and the best and worst groups using t tests and analysis of variance. Results: Differences in anthropometric measurements between the groups were identified. The columellar width and nose base and nasolabial angles significantly differed between the best and worst groups (p < .05). Differences in panel ratings of nasolabial esthetics between the best and worst groups were statistically detected using lateral and three-quarter view photographs (p < .05). Conclusions: Although morphologic differences between the cleft and noncleft and between the best and worst groups were identified, the slight morphologic differences noted were not sufficient to explain the subjective esthetic evaluation by the panel.

scholarly journals Evaluasi Hasil Labioplasti Menggunakan Skor CLEFT-Q

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 561
Author(s):  
Feldy Deki ◽  
Mendy Hatibie ◽  
Maximillian Ch. Oley ◽  
Fredrik G. Langi
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Patient Reports ◽  
A Value ◽  
Preliminary Study ◽  
And Gender ◽  
The Relationship ◽  
Normative Value ◽  
Variable Analysis

Abstract: Application of CLEFT-Q score instrument in the assessment of surgical outcomes for cleft lip and/or cleft palate based on patient reports is still relatively new. This study was aimed to establish the normative value of the Indonesian version of CLEFT-Q score in post-cleft lip surgery patients and to differentiate the results of cleft lip surgery according to the score based on the type of cleft, age, and sex. This was a preliminary study using the Indonesian CLEFT-Q instrument. Patients were interviewed for filling out the Indonesian version of CLEFT-Q after surgery. There were 75 samples in this study. Significant results were found in the association between age and CLEFT-Q score (p<0.05 and R>0.35). Variable selection for multi-variable analysis included cleft type and age in the model, where age alone indicated a significant relationship. The linear regression model involved the relationship between CLEFT-Q scores and gender, age, and cleft type as covariates. The correlation shown was classified as having moderate strength (R=0.46) for all covariates. In conclusion, the normative value of the Indonesian version of CLEFT-Q score with an approach to post-cleft lip surgery patients got a value that was in accordance with the highest standard in the literature, namely 91. The results of cleft lip surgery according to the Indonesian version of CLEFT-Q score based on the type of cleft, age and gender can be applied according to the literature.Keywords: cleft lip; cleft palate; cleft lip and palate; Indonesian version of CLEFT-Q Abstrak: Penerapan skor CLEFT-Q dalam penilaian luaran operasi bibir sumbing dan/atau langit-langit terbelah berdasarkan laporan pasien masih relatif baru. Penelitian ini bertujuan untuk mene-gakkan nilai normatif skor CLEFT-Q berbahasa Indonesia pada pasien pasca operasi bibir sum-bing serta membedakan hasil operasi bibir sumbing menurut skor tersebut berdasarkan tipe cleft, usia, dan jenis kelamin. Jenis penelitian ialah studi pendahuluan penggunaan CLEFT-Q berbahasa Indonesia. Pasien diwawancarai untuk melakukan pengisian CLEFT-Q berbahasa Indonesia setelah operasi. Hasil penelitian mendapatkan total 75 sampel. Hasil bermakna ditemukan pada hubungan antara usia dan skor CLEFT-Q (p <0,05 dan R > 0,35). Seleksi variabel untuk analisis multivariabel mengikutsertakan tipe cleft dan usia di dalam model, dan variabel usia saja yang mengindikasikan adanya hubungan bermakna (95% CI 1,15-2,33; p=0,006). Model regresi linear melibatkan hubungan antara skor CLEFT-Q dengan jenis kelamin, usia, dan tipe cleft sebagai kovariat dan mendapatkan korelasi kekuatan sedang (R=0,46) untuk semua kovariat. Simpulan penelitian ini ialah nilai normatif skor CLEFT-Q berbahasa Indonesia dengan pendekatan terhadap pasien pasca operasi bibir sumbing mendapatkan nilai yang sesuai dengan standar tertinggi pada kepustakaan yaitu 91. Hasil operasi bibir sumbing menurut skor CLEFT-Q berbahasa Indonesia berdasarkan tipe cleft, umur dan jenis kelamin dapat diterapkan sesuai kepustakaan.Kata kunci: cleft lip; cleft palate; cleft lip and palate; skor CLEFT-Q berbahasa Indonesia

Effects of Visible and Invisible Orofacial Defects on Self-Perception and Adjustment across Developmental Eras and Gender

1994 ◽  
Vol 31 (6) ◽  
pp. 429-436 ◽  
Author(s):  
Hillary L. Broder ◽  
Fraser B. Smith ◽  
Ronald P. Strauss
Keyword(s):  
Problem Solving ◽  
Cleft Palate ◽  
Least Squares ◽  
Cleft Lip ◽  
Weighted Least Squares ◽  
Age And Gender ◽  
Dental Patients ◽  
School Aged Children ◽  
Logistic Regressions ◽  
And Gender

Self-ratings of satisfaction with appearance and accomplishment of psychosocial tasks were examined by age and gender among school aged children with visible defects (cleft lip and/or palate, n = 272), or Invisible defects (cleft palate only, n = 159), and dental patients (n = 128) without clefts. Using weighted least squares ANOVA and logistic regressions, the results revealed that subjects with visible defects expressed greater dissatisfaction with their appearance than those subjects with invisible defects (p < .001). Subjects with Invisible defects consistently expressed lower problem solving ability than subjects with visible defects (p < .001) and dental patients with no defects (p < .05). Both groups with clefts expressed less social independence (p < .001); and subjects with clefts reported having more friends than other children (p < .01). Implications for clinicians and further research are discussed.

scholarly journals Speech in a consecutive series of children born with cleft lip and palate with and without syndromes and/or additional malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Klintö ◽  
Maria Sporre ◽  
Magnus Becker
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Consecutive Series ◽  
Total Group ◽  
One Stage ◽  
Audio Recordings ◽  
Bilateral Cleft Lip ◽  
Palatal Surgery ◽  
Group Comparisons

Abstract Background When evaluating speech in children with cleft palate with or without cleft lip (CP/L), children with known syndromes and/or additional malformations (CP/L+) are usually excluded. The aim of this study was to present speech outcome of a consecutive series of 5-year-olds born with CP/L, and to compare speech results of children with CP/L + and children with CP/L without known syndromes and/or additional malformations (CP/L-). Methods One hundred 5-year-olds (20 with CP/L+; 80 with CP/L-) participated. All children were treated with primary palatal surgery in one stage with the same procedure for muscle reconstruction. Three independent judges performed phonetic transcriptions and rated perceived velopharyngeal competence from audio recordings. Based on phonetic transcriptions, percent consonants correct (PCC) and percent non-oral errors were investigated. Group comparisons were performed. Results In the total group, mean PCC was 88.2 and mean percent non-oral errors 1.5. The group with bilateral cleft lip and palate (BCLP) had poorer results on both measures compared to groups with other cleft types. The average results of PCC and percent non-oral errors in the CP/L + group indicated somewhat poorer speech, but no significant differences were observed. In the CP/L + group, 25 % were judged as having incompetent velopharyngeal competence, compared to 15 % in the CP/L- group. Conclusions The results indicated relatively good speech compared to speech of children with CP/L in previous studies. Speech was poorer in many children with more extensive clefts. No significant differences in speech outcomes were observed between CP/L + and CP/L- groups.

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