School Absence And Achievement In Children With Isolated Orofacial Clefts

Objectives To examine school absence and academic achievement among 7-year-old children with isolated orofacial clefts in England.Design Analysis of educational data linked to national cleft registry and administrative hospital data.Setting English state schools.Patients 3523 children with isolated clefts aged 7 years between 2006 and 2014.Main outcome measures Annual school absence and reaching the national 'expected level' according to teacher-assessed academic achievement.Results Children 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%).Conclusions School 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.