title: Behavioral adjustment of toddler and preschool-aged children with single-suture craniosynostosis.
abstract: BACKGROUND
  The purpose of this study was to confirm initial reports of elevated behavior problems in children with single-suture craniosynostosis, using multiple informants, longitudinal analyses, and a control group. The authors hypothesized that children with single-suture craniosynostosis would have higher levels of maladjustment than comparison children, particularly at the older age and in selected areas of previously observed vulnerability: attention and social adjustment.
  
  
  METHODS
  The Child Behavior Checklist was completed by 436 mothers (219 with single-suture craniosynostosis) and 371 fathers (177 with single-suture craniosynostosis) when children were aged approximately 19 months, and by 361 mothers (175 with single-suture craniosynostosis) and 303 fathers (142 with single-suture craniosynostosis) when children were aged approximately 37 months. A minimum of one caregiver/teacher report was available for 169 of these children (74 with single-suture craniosynostosis) using the Caregiver-Teacher Report Form.
  
  
  RESULTS
  Average Child Behavior Checklist/Caregiver-Teacher Report Form externalizing, internalizing, and total scores for all informants were consistently higher (worse) for children with single-suture craniosynostosis than for control group children, but most differences were small and statistically nonsignificant. No differences associated with suture site were found. At the oldest age point, both mothers and fathers (but not teachers) generated higher average scores for patients than for controls on scales measuring attention and social problems, with small to medium effect sizes (0.20 to 0.32).
  
  
  CONCLUSIONS
  On average, toddlers/preschoolers with single-suture craniosynostosis show behavioral development that is largely indistinguishable from same-aged peers of similar socioeconomic background. The predictive significance of small group differences in attention and social adjustment will be assessed in a follow-up of this cohort at age 7.
authors.affiliation: Chicago, Ill.; Seattle, Wash.; St. Louis, Mo.; and Atlanta, Ga. From the Department of Surgery, Northwestern University; Departments of Psychology and Plastic Surgery, Shriners Hospital for Children; Psychiatry and Behavioral Medicine, Seattle Children's Hospital; Departments of Psychiatry and Behavioral Sciences and Epidemiology, University of Washington; Department of Psychology, The Chicago School of Professional Psychology; Department of Psychology, St. Louis Children's Hospital; Department of Pediatrics, Washington University School of Medicine; Craniofacial Team, Children's Healthcare of Atlanta.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Kapp-Simon
authors.forename: Brent R
authors.initials: BR
authors.lastname: Collett
authors.forename: Michael A
authors.initials: MA
authors.lastname: Barr-Schinzel
authors.forename: Mary M
authors.initials: MM
authors.lastname: Cradock
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Buono
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Pietila
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Speltz
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001288:Attention; D057189:Checklist; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000523:psychology*; D002675:Child, Preschool; D015897:Comorbidity; D003393:Cranial Sutures; D003398:Craniosynostoses / Q000453:epidemiology* / Q000601:surgery*; D005220:Fathers / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology*; D012917:Social Adjustment