Abstract
OBJECTIVES: To determine the UK prevalence of behavioral problems in 5-year-old children born with isolated or syndromic cleft lip and/or palate (CL/P) compared to the general population and identify potentially associated factors.
DESIGN: Observational study using questionnaire data from the Cleft Collective 5-Year-Old Cohort study and three general population samples.
MAIN OUTCOME MEASURE: The Strengths and Difficulties Questionnaire (SDQ).
PARTICIPANTS: Mothers of children (age: 4.9-6.8 years) born with CL/P (n = 325). UK general population cohorts for SDQ scores were: Millennium Cohort Study (MCS) (n = 12 511), Office of National Statistics (ONS) normative school-age SDQ data (n = 5855), and Avon Longitudinal Study of Parents and Children (ALSPAC) (n = 9386).
RESULTS: By maternal report, 14.2% of children born with CL/P were above clinical cut-off for behavioral problems, which was more likely than in general population samples: 7.5% of MCS (OR = 2.05 [1.49-2.82], P < 0.001), 9.8% of ONS (OR = 1.52 [1.10-2.09], P = 0.008), and 6.6% of ALSPAC (OR = 2.34 [1.70-3.24], P < 0.001). Children in the Cleft Collective had higher odds for hyperactivity, emotional and peer problems, and less prosocial behaviors. Maternal stress, lower maternal health-related quality of life and family functioning, receiving government income support, and maternal smoking showed evidence of association (OR range: 4.41-10.13) with behavioral problems, along with maternal relationship status, younger age, and lower education (OR range: 2.34-3.73).
CONCLUSIONS: Findings suggest elevated levels of behavioral problems in children born with CL/P compared to the general population with several associated maternal factors similar to the general population.
| Original language | English |
|---|---|
| Article number | 10556656221119684 |
| Number of pages | 12 |
| Journal | Cleft Palate-Craniofacial Journal |
| Early online date | 9 Sept 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 9 Sept 2022 |
Bibliographical note
Funding Information:The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Sammy Berman was supported by the US-UK Fulbright Commission and IIE (University of Bristol Partnership Award) and Foundation for Faces of Children (Dr John Mulliken Award). Rachel Blakey was supported by grant 204895/Z/16/Z from the Wellcome Trust, which was awarded to Anita Thapar, Kate Tilling, Evie Stergiakouli, and George Davey Smith. For the purpose of Open Access, the authors have applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. The Medical Research Council (MRC) and the University of Bristol support the MRC Integrative Epidemiology Unit (Grant: MC_UU_00011/1). The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. Gemma C Sharp is financially supported by the Medical Research Council (New Investigator Research Grant: MR/S009310/1) and the European Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL, NutriPROGRAM project, UK MRC MR/S036520/1).
Funding Information:
This publication involves data derived from independent research funded by The Scar Free Foundation (REC approval 13/SW/0064). We are grateful to the families who participated in the study, the UK NHS cleft teams, and The Cleft Collective team, who helped facilitate the study. The views expressed in this publication are those of the authors and not necessarily those of The Scar Free Foundation or The Cleft Collective Cohort Studies team. We are extremely grateful to all the families who took part in the ALSPAC study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. We are grateful to the Centre for Longitudinal Studies (CLS), UCL Social Research Institute for the use of the MCS data and to the UK Data Service for making them available. However, neither CLS nor the UK Data Service bear any responsibility for the analysis or interpretation of these data. We acknowledge the University of Bristol and the MSc Public Health program for their support.
Publisher Copyright:
© 2022, American Cleft Palate-Craniofacial Association.
Keywords
- ALSPAC
- behavioral difficulties
- behavioral problems
- cleft collective
- cleft lip and palate
- emotional difficulties
- hyperactivity
- sociodemographic factors
- strengths and difficulties questionnaire (SDQ)
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