Children with Craniofacial Anomalies: Developmental risk over time

Introduction: Children born with craniofacial abnormalities are reported to be at risk for neurodevelopmental delays. However, few studies have examined risk over time. The purpose of this study was to assess change in risk from initial (T1) to subsequent visit (T2).

Methodology: The Bayley Infant Neurodevelopmental Screener(BINS) was administered to children (0-2 years) as part of routine care at a Craniofacial Team Clinic. Children with more than one screening were included (N = 76). A repeated measures ANOVA was calculated to analyze change in risk level as measured by BINS.

Results: There was significant amelioration in level of risk. The main effect for time was significant (F(1,66)=10.56, p=.002). Closer examination revealed that children initially assessed at 3-4 months old who showed low levels of risk demonstrated increased risk over time (F(1,17)=9.66, p=.006). All other age groups showed improvement in risk level from T1 to T2. Diagnosis was not a predictor of change.

Discussion: Children in this study showed improvement in risk for neurodevelopmental delay. However, children screened at ages 3-4 months with low risk were at increased risk at T2. This may be indicative of a more global need for early intervention in clinical groups and less concern/intervention from caregivers when risk is minimal. It may also reflect that children over time may grow ‘into' the developmental risk thus supporting the need for surveillance of development in clinical populations. Further studies are necessary to address development, risk and change in order to provide the most effective intervention.