title: Use of special education services by children with orofacial clefts.
abstract: BACKGROUND
  Our objective was to evaluate the use of special education services by children with orofacial clefts (OFCs).
  
  
  METHODS
  We linked the birth certificates of children born from 1982-2001 in five counties of metropolitan Atlanta to a population-based birth defects surveillance system to identify children with OFCs, and to the special education files for the school years 1992-2004 to identify children who used special education services. The special education data contained exceptionalities and services rendered for each school year. Prevalence ratios (PRs) and 95% CIs were calculated. The data were stratified by race/ethnicity, maternal education, type of OFC, and the presence of associated major malformations. In addition, we assessed the age at which special education began and the amount of time spent receiving services.
  
  
  RESULTS
  Of the 777 children with OFCs, 201 (26%) were in special education at least 1 year compared with 8% of the children who had no major birth defects, yielding a PR of 3.2 (95% CI: 2.9-3.6). The most common exceptionality or service for children with an OFC was speech and language services. Compared with children with no birth defects, children with an OFC were four times more likely to be in this exceptionality (PR 3.8; 95% CI: 3.3-4.3). After excluding children in speech and language services, children with OFCs were still more likely to use special education services (PR 2.4; 95% CI: 1.7-3.2).
  
  
  CONCLUSIONS
  Children with OFCs used special education services more often than children without birth defects. This information can help in planning for future population needs.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Mahsa M
authors.initials: MM
authors.lastname: Yazdy
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Autry
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Honein
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Frias
mesh_terms: D001719:Birth Certificates; D002648:Child; D002971:Cleft Lip / Q000503:physiopathology*; D002972:Cleft Palate / Q000503:physiopathology*; D004519:Education, Special; D006801:Humans; D015995:Prevalence