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Developmental Risk for Infants with Cleft Lip with or Without Cleft Palate Based on Caregiver-Proxy Reports
Kathleen A Kapp-Simon1,2, Meredith Albert1,2, Todd C Edwards3
1Cleft/Craniofacial Center, Shriners Children's, Chicago, Chicago, IL, USA.
Insights
Infants with cleft lip and palate (CLP) and male infants show higher developmental risks, particularly in communication and motor skills. Regular developmental screening is crucial for early intervention in these high-risk populations.
Area of Science:
- Pediatric Development
- Craniofacial Anomalies
- Developmental Pediatrics
Background:
- Cleft lip ± alveolus (CL ± A) and cleft lip and palate (CLP) are common congenital anomalies affecting infant development.
- Early identification of developmental risks is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To assess caregiver-reported development in infants with CL ± A and CLP.
- To identify factors associated with increased developmental risk.
- To evaluate the consistency of developmental risk before and after cleft lip surgery.
Main Methods:
- Prospective, longitudinal study assessing development at two time points: pre-surgery and 2 months post-surgery.
- Utilized the Ages and Stages Questionnaire-3 (ASQ-3) across five developmental domains.
- Included 123 caregivers reporting on infants from three US craniofacial centers and online support groups.
Main Results:
- A significant proportion of infants with CL ± A and CLP did not pass all developmental domains at either time point (47% pre-surgery, 42% post-surgery).
- Infants with CLP were at higher risk for communication and gross motor delays.
- Male infants demonstrated increased risk in fine motor and problem-solving domains.
Conclusions:
- Caregiver reports indicate a high rate of infants with CL ± A and CLP meeting developmental referral criteria.
- Infants with CLP and male infants represent key subgroups at elevated developmental risk.
- Routine developmental screening is recommended for infants with clefts to facilitate early support.
Abstract:
Objectives(1) Assess caregiver-reported development in infants born with cleft lip ± alveolus (CL ± A) and cleft lip and palate (CLP); (2) determine factors associated with increased developmental risk; and (3) determine consistency of developmental risk before and after surgery for cleft lip.DesignProspective, longitudinal assessment of development. Time (T) 1, prior to lip closure; T2, 2 months post lip closure.SettingThree US craniofacial teams and online parent support groups.Participants123 total caregivers (96% mothers); 100 at T1, 92 at T2, and 69 at both T1 and T2.MeasureAges and Stages Questionnaire-3 (ASQ-3): Communication, Gross Motor, Fine Motor, Problem Solving, Personal Social Domains.ResultsAt T1 47%; at T2 42% passed all 5 Domains; 36% of infants pass all 5 Domains at both T1 and T2. Infants with CLP were at greatest risk on Communication [B = 1.449 (CI = .149-20.079), p = .038; Odds Ratio (OR) = 4.3 (CI = .923-19.650)] and Gross Motor Domains [B = 1.753 (CI = .316-20.605), p = .034; OR = 5.8 (CI = 1.162-28.671)]. Male infants were at greatest risk on Fine Motor [B = 1.542 (CI = .495-20.005), p = .009; OR = 4.7 (CI = 1.278-17.101)] and Problem Solving Domains [B = 1.200 (CI = .118-19.708), p = .044; OR = 3.3 (CI = .896-12.285)].ConclusionsBased on caregiver report, infants with CL ± A and CLP meet referral criteria at a high rate. Infants with CLP and male infants were at greatest risk. Regular developmental screening is recommended.
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