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Academic achievement and needs of school-aged children born with selected congenital anomalies: A systematic review and meta-analysis

Lay Summary

In this review we aimed to summarise published research papers examining school outcomes and the need for special education services of school-aged children born with selected major congenital anomalies, also known as birth defects.

We searched the international literature using several electronic literature databases and other sources for articles published from 1990-2020. We only included studies on children with selected congenital anomalies, and excluded children with syndromes such as Down syndrome. All studies had to report school test results, questionnaire-based standardised tests and/or data on whether a child was supported through special education.

Out of 11,303 papers published between 1 January 1990 and 30 November 2020, we found 39 relevant studies that included 21,066 children with spina bifida (six studies), congenital heart defects (15 studies) or craniofacial anomalies which includes orofacial clefts (15 studies), craniosynostosis (two studies) and craniofacial microsomia (one study). Sixteen studies were included in the quantitative analysis.

Children with the congenital anomalies that we studied, were at a higher risk of underperforming at school than their peers. Children with a severe congenital heart defect needed special education support twice as often than their peers. Among children with orofacial clefts, in particular among children with cleft palate or cleft lip with cleft palate, the number of children who needed special education support was three to four times higher than their peers.

More studies involving children with different types of congenital anomalies, including large registry-based studies, are needed. To ensure timely support for children with congenital anomalies and their families and to promote progress at all school levels, it is important that early monitoring and early identification of special education needs take place.


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