{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:58:53Z","timestamp":1785797933017,"version":"3.56.0"},"reference-count":62,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study using questionnaire data from the Cleft Collective 5-Year-Old Cohort study and three general population samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>The Strengths and Difficulties Questionnaire (SDQ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Mothers of children (age: 4.9-6.8 years) born with CL\/P ( n\u2009\u2009=\u2009\u2009325). UK general population cohorts for SDQ scores were: Millennium Cohort Study (MCS) ( n\u2009\u2009=\u2009\u200912\u2009\u2009511), Office of National Statistics (ONS) normative school-age SDQ data ( n\u2009\u2009=\u2009\u20095855), and Avon Longitudinal Study of Parents and Children (ALSPAC) ( n\u2009\u2009=\u2009\u20099386).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2009\u2009=\u2009\u20092.05 [1.49-2.82], P\u2009&lt;\u20090.001), 9.8% of ONS (OR\u2009\u2009=\u2009\u20091.52 [1.10-2.09], P\u2009\u2009=\u2009\u20090.008), and 6.6% of ALSPAC (OR\u2009\u2009=\u2009\u20092.34 [1.70-3.24], P\u2009&lt;\u20090.001). 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656221119684","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T14:55:09Z","timestamp":1662735309000},"page":"40-51","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Prevalence and Factors Associated with Behavioral Problems in 5-Year-Old Children Born with Cleft Lip and\/or Palate from the Cleft Collective"],"prefix":"10.1177","volume":"61","author":[{"given":"Samantha","family":"Berman","sequence":"first","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"},{"name":"Population Health Sciences, Bristol Medical School, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma C.","family":"Sharp","sequence":"additional","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"},{"name":"Population Health Sciences, Bristol Medical School, Bristol, UK"},{"name":"MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"},{"name":"Population Health Sciences, Bristol Medical School, Bristol, UK"},{"name":"MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Blakey","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School, Bristol, UK"},{"name":"MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7234-0539","authenticated-orcid":false,"given":"Amy","family":"Davies","sequence":"additional","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry","family":"Humphries","sequence":"additional","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1575-453X","authenticated-orcid":false,"given":"Yvonne","family":"Wren","sequence":"additional","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"},{"name":"Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7144-9700","authenticated-orcid":false,"given":"Jonathan R.","family":"Sandy","sequence":"additional","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3586-0927","authenticated-orcid":false,"given":"Evie","family":"Stergiakouli","sequence":"additional","affiliation":[{"name":"Cleft Collective, University of Bristol, Bristol, UK"},{"name":"Population Health Sciences, Bristol Medical School, Bristol, UK"},{"name":"MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"bibr1-10556656221119684","unstructured":"The CRANE project team at the Clinical Effectiveness Unit otRCo, England So.\n                      Cleft Regis\n                      try and Audit NEtwork Database 2021 Annual Report\n                      . 2021. https:\/\/www.crane-database.org.uk\/content\/uploads\/2021\/12\/CRANE-2021-Annual-Report_23Dec21.pdf. 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