Functional Outcomes and Family Counselling in Single-Suture Craniosynostosis: Cognitive, Behavioural, and...

This review aimed to synthesise current evidence on neurodevelopmental, cognitive, and behavioural outcomes in children with non-syndromic craniosynostosis (NSC), and to examine the implications of these findings for clinical practice and family counselling.

A scoping review was conducted in accordance with PRISMA-ScR guidelines. A structured search of PubMed, Scopus, and Web of Science identified studies published between 2010 and 2025. Eligible studies included children with NSC and reported cognitive, behavioural, or socio-communicative outcomes. Thirteen studies met inclusion criteria and were analysed using a narrative synthesis approach. Given the heterogeneity of study designs, populations, and outcome measures, a formal meta-analysis was not performed.

Across studies, children with NSC generally demonstrated cognitive functioning within the average range, but with a consistent pattern of subtle, domain-specific vulnerabilities, particularly in visuospatial processing, language, attention, and executive functions. Behavioural findings indicated increased rates of internalising symptoms, attentional difficulties, and subclinical autism-related traits. These differences were present across developmental stages and showed considerable inter-individual variability. Evidence did not support a global impairment profile, but rather a pattern of mild neurodevelopmental variability with potential functional implications. However, findings should be interpreted with caution given the methodological heterogeneity and variability in study populations and assessment approaches.

NSC is linked to selective neurodevelopmental differences rather than global deficits, emphasizing the need for early identification, longitudinal monitoring, and multidisciplinary care. Clear communication with families is crucial for supporting adaptive development and informed clinical decisions. Additionally, integrating neurodevelopmental perspectives into routine craniofacial care is vital.