Attention Skills in Children With Nonsyndromic Cleft Lip and Palate

Objective To describe attention skills in children with cleft lip and palate across auditory and visual domains and investigate associations with cleft subtype, biological sex, socioeconomic status, and speech and language. Design A cross-sectional observation study. Setting Participants from regional cleft lip and palate centers seen in schools and home. Participants Eighty-one children aged 5 years 0 months to 7 years 11 months with non-syndromic cleft palate +/- lip. Main outcome measure Auditory and visual attention skills including measures of distractibility, impulsivity and focus across both domains. Results Mean average scores for all measures of auditory and visual attention were below one standard deviation from the normative average (standard score <85). There was no main effect of cleft subtype. Boys had significantly lower scores for visual distractibility than girls. There was no statistically significant effect of socioeconomic status, but those from higher socioeconomic groups had scores up to 10 standard points higher in some measures than those in the middle or lower groups. Weak, significant correlations were observed between language skills and measures of attention. Conclusions A range of both auditory and visual attention skills were low in this group raising the question of potential generalised attention difficulties in children with CLP. Attention skills were correlated with language. Professionals working with children with CLP should be aware that attention difficulties are prevalent and advise families and educators accordingly. Further research including intervention studies would increase our understanding.