Neurodevelopmental disorders in children with cleft lip and palate: a systematic review.

This study looked at whether children born with cleft lip and/or palate are more likely to have autism or ADHD. Researchers found that children with clefts may have higher rates of autism compared to other children, but the results for ADHD were mixed. Children with cleft palate only, or clefts related to genetic syndromes, appeared to have the highest risk. However, more research is needed to better understand these connections.

This systematic review examined autism spectrum disorder (ASD) and ADHD prevalence in children with orofacial clefts (OFCs) compared to the general population. Nine studies were included from 1025 screened papers. ASD prevalence in children with clefts ranged from 0-50% (mean 2.87%) compared to ~1% globally, while ADHD prevalence ranged from 2.34-31.71% (mean 3.63%) compared to ~5% globally. Children with isolated cleft palate showed higher rates than those with isolated cleft lip or combined cleft lip and palate.

Syndromic clefts were associated with even higher prevalence (mean 14.80% for ASD). The findings suggest increased ASD risk in children with OFCs, though ADHD evidence was less clear with varying rates across studies.

Children with orofacial clefts, particularly isolated cleft palate or syndromic clefts, may benefit from routine neurodevelopmental screening including autism assessment. Early identification could facilitate timely intervention and support services. Further research needed to establish clear screening guidelines.

Only nine studies met inclusion criteria from 1025 screened papers. Wide variation in prevalence rates (0-50% for ASD) suggests methodological differences between studies. Small sample sizes for syndromic cleft populations limit generalizability of findings.

Individuals with orofacial clefts (OFCs) may be at an increased risk of developing autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This systematic review provides a summary of the most recent data regarding the prevalence of ASD and ADHD in the OFC population and compares this to the general paediatric population. Multiple databases were searched including PubMed/Medline and Embase in July 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and was registered in PROSPERO (CRD42024565219). 1025 papers were identified for screening, of which nine were included in the report. Percentage prevalence was calculated and compared to global prevalence or control populations where available.

Overall, ASD prevalence among children with a cleft ranged from 0 to 50% (Mean = 2.87%; SD = 5.40) compared to ~ 1% globally (WHO) and ADHD prevalence ranged from 2.34 to 31.71% (Mean = 3.63%; SD = 4.30) compared to ~ 5% globally (NICE). Matched control populations showed larger differences. Isolated cleft palate was associated with higher rates than isolated cleft lip or combined cleft lip and palate. Prevalence in individuals with syndromic clefts appeared greater still (Mean = 14.80%; SD = 16.58) although populations were small.

Children with OFCs demonstrate increased prevalence of ASD compared to the average paediatric population. Evidence for increased prevalence of ADHD is less clear, with varying rates across studies. Children with isolated cleft palate or cleft associated with genetic syndromes appear most at risk, although further research is needed.