title: Laterality of Oral Clefts and Academic Achievement.
abstract: OBJECTIVE
  Children with isolated oral clefts have lower academic performance when compared with unaffected peers, yet few studies have examined specific attributes of clefts that may modify this risk. Oral clefts have nonrandom laterality, with left-sided clefts being more common than right-sided clefts, a pattern that may be genetically or environmentally influenced. The objective of this study was to evaluate the association between cleft laterality and academic achievement in a population-based sample of children with and without isolated oral clefts.
  
  
  METHODS
  The study included 292 children with isolated unilateral cleft lip with or without cleft palate identified by using the Iowa Registry for Congenital and Inherited Disorders matched with 908 unaffected classmates. This group provided 1953 child-grade observations for cases and 6829 for classmates. Academic achievement was evaluated by using high-quality standardized test data on multiple academic domains as well as use of special education.
  
  
  RESULTS
  We found that children with right-sided clefts had similar achievement scores and usage of special education services compared with their unaffected classmates. Children with left-sided clefts had lower reading scores than children with right-sided clefts by nearly 7 percentiles (P < .05). They also had lower scores on all evaluated domains by 4 to 6 percentiles and greater use of special education services by 6 percentage points than their classmates.
  
  
  CONCLUSIONS
  Children with left-sided clefts had poorer academic performance than their classmates or children with right-sided clefts, who showed similar academic achievement compared with their unaffected classmates.
authors.affiliation: Departments of Pediatrics and.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Gallagher
authors.affiliation: Psychiatry and Behavioral Sciences, Child Psychiatry at Seattle Children's Hospital, University of Washington, Seattle, Washington.
authors.forename: Brent R
authors.initials: BR
authors.lastname: Collett
authors.affiliation: Iowa Testing Programs, and.
authors.forename: Sheila
authors.initials: S
authors.lastname: Barron
authors.affiliation: Departments of Epidemiology.
authors.forename: Paul
authors.initials: P
authors.lastname: Romitti
authors.affiliation: Iowa Testing Programs, and.|Psychological and Quantitative Foundations, and.
authors.forename: Timothy
authors.initials: T
authors.lastname: Ansley
authors.affiliation: Health Management and Policy, Economics, and Preventive and Community Dentistry, and Public Policy Center, University of Iowa, Iowa City, Iowa; and george-wehby@uiowa.edu.|National Bureau of Economic Research, Cambridge, Massachusetts.
authors.forename: George L
authors.initials: GL
authors.lastname: Wehby
mesh_terms: D000293:Adolescent; D002648:Child; D002971:Cleft Lip / Q000175:diagnosis* / Q000453:epidemiology*; D002972:Cleft Palate / Q000175:diagnosis* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007484:Iowa; D008297:Male; D010379:Peer Group; D012016:Reference Values; D012042:Registries