Cleft Palate Outcome Study

Children with cleft palate and their families face various challenges in the early years of the child’s life, ranging from the stress surrounding surgery to long-term difficulties with speech and hearing.  Clinically, the issues are tackled on a routine basis, with regular clinic visits and check-ups assessing the child’s dentition, hearing and general progress.experimenter

Previous research has shown that some children with cleft palate may encounter difficulties in early development, such as slower language learning and cognitive progression. This aspect of the child’s care and follow-up post-surgery has previously been comparatively neglected, despite its importance in the day to day life of the child. We believe that assessing a child’s behaviour, social skills and everyday conduct is no less important than monitoring their hearing and physical development.

This study focused on cognitive and behavioural outcomes in children with cleft palate between the ages of two and ten years.

The assessment used was the well-established Strengths and Difficulties Questionnaire1 (SDQ) which is a frequently used parent report measure exploring the following five domains, which cover 25 positive and negative attributes:

  • Emotional symptoms
  • Conduct problems
  • Hyperactivity/inattention
  • Peer relationship problems
  • Prosocial behaviour

What did we find?

Parents and guardians of children with cleft palate aged between two and ten years were invited to fill in the questionnaire assessing these areas and the results were collated. The results supported previous findings, with a higher rate of adjustment difficulties present in the cleft palate cohort compared to the published norms. However we didn’t find any differences betwen the subgroups of the cleft palate cohort.  In our study, the specific type of cleft didn’t effect outcome.  One possible explanation for this however, is that we didn’t have enough children in the study to detect what might be a small, but important differences. We are now preparing the results of this study for publication.

The research was carried out by Emily Thiede, a fourth year medical student at the University of Edinburgh who was working on this project for her student-selected component. Emily has an interest in surgery and previously completed a BSc in psychology in her intercalated year. In the future she hopes to work in the developing world.

For this research Emily was working with Dr Felicity Mehendale, the clinical lead of the East of Scotland Cleft Lip and Palate Service, and Dr Sue Fletcher-Watson, a developmental psychologist and researcher. We all have an interest in the developmental aspect of cleft palate and the implications for management and future research.

As this is the first study of its kind in the UK, it is hoped that the results of the study will trigger further research, thus enabling a greater impact on the management of children with cleft palate.

1 Goodman, R. (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of child psychology and psychiatry38(5), 581-586.