{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:42:09Z","timestamp":1777524129732,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,12,15]],"date-time":"2017-12-15T00:00:00Z","timestamp":1513296000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Children with orofacial clefts (OFCs) may experience poor reading proficiency, learning disabilities, and academic underachievement. We examined the association between nonsyndromic (NS) OFCs and end-of-grade (EOG) performance in reading and math from third through eighth grade in a sample subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>We identified a cohort of 559 children with NS-OFCs and 6822 children without birth defects, classifying cleft type by cleft lip alone, with or without cleft alveolar ridge (CL); cleft lip with cleft palate (CL+P); and cleft palate only (CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>Using logistic regression, we estimated the odds of not meeting grade-level standards among children with NS-OFCs compared to unaffected peers. Using longitudinal analyses, we estimated the odds of not meeting grade-level standards and average change in test scores through eighth grade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Children with NS-OFCs were 1.22 (95% CI: 0.96, 1.83) times as likely not to meet grade-level standards in reading compared to unaffected peers. The effect was similar for math (OR: 1.17; 95% CI: 0.92, 1.48). Children with CL+P were 1.33 (95% CI: 0.86, 1.83) and 1.74 (95% CI: 1.19, 2.56) times as likely not to meet grade-level standard in reading and in both subjects, respectively, compared to unaffected peers. The average rate of change in both scores was similar for children with and without OFCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Poor academic performance appears greatest for children with CL+P, a finding compatible with previous observations and hypothesized mechanisms associating orofacial clefts with subtle abnormalities in brain development. Academic performance monitoring and referral for academic assistance is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665617718823","type":"journal-article","created":{"date-parts":[[2018,1,5]],"date-time":"2018-01-05T14:32:19Z","timestamp":1515162739000},"page":"12-20","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["Academic Achievement Among Children With Nonsyndromic Orofacial Clefts"],"prefix":"10.1177","volume":"55","author":[{"given":"Stephanie E.","family":"Watkins","sequence":"first","affiliation":[{"name":"Women\u2019s and Children\u2019s Health Section, Division of Public Health, Raleigh, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Birth Defects Monitoring Program, Division of Public Health, State Center for Health Statistics, Raleigh, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur S.","family":"Aylsworth","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey R.","family":"Marcus","sequence":"additional","affiliation":[{"name":"Division of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander C.","family":"Allori","sequence":"additional","affiliation":[{"name":"Division of Plastic, Maxillofacial, and Oral Surgery, Duke University, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz","family":"Pimenta","sequence":"additional","affiliation":[{"name":"School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Lipinski","sequence":"additional","affiliation":[{"name":"Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, WI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald P.","family":"Strauss","sequence":"additional","affiliation":[{"name":"School of Dentistry and Office of the Provost, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,12,15]]},"reference":[{"key":"bibr35-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1159\/000365389"},{"key":"bibr1-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.36333"},{"key":"bibr2-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23415"},{"key":"bibr3-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.1925"},{"key":"bibr4-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1597\/07-165.1"},{"key":"bibr5-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1597\/1545-1569_1998_035_0127_ldsaag_2.3.co_2"},{"key":"bibr34-1055665617718823","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1542\/peds.34.2.256","volume":"34","author":"Demyer W","year":"1964","journal-title":"Pediatrics"},{"key":"bibr6-1055665617718823","first-page":"763","volume":"7","author":"Estes RE","year":"1970","journal-title":"Cleft Palate J"},{"key":"bibr7-1055665617718823","first-page":"171","volume":"163470","author":"Glatz P","year":"2017","journal-title":"JAMA Pediatr"},{"key":"bibr8-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2011.02375.x"},{"key":"bibr9-1055665617718823","first-page":"10","volume":"0120517","author":"Heyne GW","year":"2015","journal-title":"PLoS One"},{"key":"bibr10-1055665617718823","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1542\/peds.97.4.529","volume":"97","author":"Jocelyn LJ","year":"1996","journal-title":"Pediatrics"},{"key":"bibr11-1055665617718823","doi-asserted-by":"publisher","DOI":"10.1597\/13-293"},{"key":"bibr12-1055665617718823","first-page":"9","volume":"102603","author":"Lipinski RJ","year":"2014","journal-title":"PLoS One"},{"key":"bibr13-1055665617718823","first-page":"895","volume":"100","author":"Mai CT","year":"2014","journal-title":"Birth defects data from population-based birth defects surveillance programs in the United States, 2007 to 2011: highlighting orofacial clefts. 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