Cognitive functioning and clinical characteristics of children with non-syndromic orofacial clefts: A case-control study

Kinga Amália Sándor-Bajusz; Tímea Dergez; Edit Molnár; Kinga Hadzsiev; Ágnes Till; Anna Zsigmond; Attila Vástyán; Györgyi Csábi

doi:10.3389/fpsyg.2023.1115304

Cognitive functioning and clinical characteristics of children with non-syndromic orofacial clefts: A case-control study

Front Psychol. 2023 Feb 28:14:1115304. doi: 10.3389/fpsyg.2023.1115304. eCollection 2023.

Authors

Kinga Amália Sándor-Bajusz¹, Tímea Dergez², Edit Molnár¹, Kinga Hadzsiev³, Ágnes Till³, Anna Zsigmond³, Attila Vástyán⁴, Györgyi Csábi¹

Affiliations

¹ Division of Child and Adolescent Psychiatry, Department of Pediatrics, Medical School and Clinical Center, University of Pécs, Pécs, Hungary.
² Institute of Bioanalysis, Medical School and Clinical Center, University of Pécs, Pécs, Hungary.
³ Department of Medical Genetics, Medical School and Clinical Center, University of Pécs, Pécs, Hungary.
⁴ Division of Pediatric Surgery, Department of Pediatrics, Medical School and Clinical Center, University of Pécs, Pécs, Hungary.

Abstract

Introduction: The higher rate of neuropsychiatric disorders in individuals with non-syndromic orofacial clefts has been well documented by previous studies. Our goal was to identify children with non-syndromic orofacial clefts that are at risk for abnormal neurodevelopment by assessing their developmental history and present cognitive functioning.

Materials and methods: A single-center, case-controlled study was carried out at the Department of Pediatrics of the University of Pécs in Hungary. The study consisted of three phases including questionnaires to collect retrospective clinical data and psychometric tools to assess IQ and executive functioning.

Results: Forty children with non-syndromic oral clefts and 44 age-matched controls participated in the study. Apgar score at 5 min was lower for the cleft group, in addition to delays observed for potty-training and speech development. Psychiatric disorders were more common in the cleft group (15%) than in controls (4.5%), although not statistically significant with small effect size. The cleft group scored lower on the Continuous Performance Test. Subgroup analysis revealed significant associations between higher parental socio-economic status, academic, and cognitive performance in children with non-syndromic orofacial clefts. Analyzes additionally revealed significant associations between early speech and language interventions and higher scores on the Verbal Comprehension Index of the WISC-IV in these children.

Discussion: Children with non-syndromic orofacial clefts seem to be at risk for deficits involving the attention domain of the executive system. These children additionally present with difficulties that affect cognitive and speech development. Children with non-syndromic orofacial clefts show significant skill development and present with similar cognitive strengths as their peers. Longitudinal studies with larger sample sizes are needed to provide more conclusive evidence on cognitive deficits in children with non-syndromic orofacial clefts at risk for neurodevelopmental difficulties.

Keywords: cleft lip; cleft palate; developmental outcomes; executive function; neurodevelopment.