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Parent-reported socioemotional and cognitive development in children with a cleft lip and/or palate at 18 months: Findings from a UK birth cohort

Costa, Bruna; White, Paul; Kiff, James D.; Davies, Amy; Stock, Nicola M.


Bruna Costa

Paul White
Professor in Applied Statistics

James D. Kiff

Amy Davies

Nicola Stock
Occasional Associate Lecturer - HAS - HSS



Background: One of the most common congenital conditions in the world, cleft lip and/or palate (CL/P) has been shown to potentially impact long-term physical and developmental outcomes in affected children. However, little is known about the factors that contribute to such outcomes, and there is a lack of consensus about which screening tools may be most effective. The aims of the current study were (a) to assess parent-reported socioemotional and cognitive development in children born with CL/P at 18 months of age; (b) to identify factors associated with the incidence of developmental concerns; and (c) to assess the utility of the widely recommended Ages and Stages Questionnaires (ASQs) in identifying developmental concerns from an early age in the CL/P population. Methods: Parent-reported questionnaire data were extracted from The Cleft Collective Cohort Study for 322 mothers of children with CL/P aged 18 months. Results: Mean scores across both ASQ measures indicated typical development in the study sample overall. However, 31.1% of children met a referral criterion on at least one domain. Child-related risk factors included problems with physical development and feeding method. Parent-related risk factors included the mother's levels of anxiety and depression and mother's marital status. Additional developmental concerns extracted from mothers' qualitative data included feeding difficulties, speech development, sleep patterns, aggressive behaviours, vision, oral health, hearing, breathing and motor skills. Conclusions: The majority of children in this study were developing as expected at 18 months of age. However, parent-reported developmental concerns were identified in a minority of children, suggesting a need to screen for potential risk factors in routine practice. Further, the ASQ appears to offer a viable option in the early identification of developmental concerns in children with CL/P. A combined medical and systemic approach to healthcare is recommended to support the prevention of long-term developmental concerns in the child and poor psychological adjustment in parents.


Costa, B., White, P., Kiff, J. D., Davies, A., & Stock, N. M. (2021). Parent-reported socioemotional and cognitive development in children with a cleft lip and/or palate at 18 months: Findings from a UK birth cohort. Child: Care, Health and Development, 47(1), 31-39.

Journal Article Type Article
Acceptance Date Oct 12, 2020
Online Publication Date Sep 29, 2020
Publication Date Jan 1, 2021
Deposit Date Oct 12, 2020
Publicly Available Date Feb 5, 2021
Journal Child: Care, Health and Development
Print ISSN 0305-1862
Electronic ISSN 1365-2214
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 47
Issue 1
Pages 31-39
Keywords Pediatrics, Perinatology, and Child Health; Public Health, Environmental and Occupational Health; Developmental and Educational Psychology
Public URL
Additional Information Received: 2020-06-23; Accepted: 2020-09-21; Published: 2020-09-29


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