School absence and achievement in children with isolated orofacial clefts

Abstract

ObjectivesTo examine school absence and academic achievement among 7-year-old children with isolated orofacial clefts in England.DesignAnalysis of educational data linked to national cleft registry and administrative hospital data.SettingEnglish state schools.Patients3523 children with isolated clefts aged 7 years between 2006 and 2014.Main outcome measuresAnnual school absence and reaching the national ‘expected level’ according to teacher-assessed academic achievement.ResultsChildren with isolated clefts had higher mean annual school absence (10.5 days) than their peers in the national population (8.9 days). Total absence was higher in children with a cleft lip and palate (CLP; 11.3 days) or with a cleft palate only (CPO; 10.5 days) than in children with a cleft lip only (CLO; 9.5 days). The percentage reaching the expected academic level decreased with increasing school absence (from 77.4% (923/1192) with annual school absence ≤5 days to 43.4% (193/445) with annual school absence >20 days). However, differences in school absence did not explain that children with CPO (65.9% reaching expected level) or CLP (66.1% reaching expected level) had poorer levels of academic achievement than children with CLO (73.5% reaching expected level). Children with a cleft were twice as often recognised as having special education needs (40.5%) than their peers (21.6%).ConclusionsSchool absence and cleft type are both independently associated with school attainment at 7 years. Children with an isolated cleft, especially when the palate is involved, and those with high levels of school absence may benefit from increased support addressing their educational needs.