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Speech, Language and Cognitive Delays in Patients with Non-Syndromic Craniosynostosis
Sanjay Naran MD, Matthew Miller BS, Benjamin Ware BS, Lilianna Camison MD, Jesse Goldstein MD, Joseph Losee MD
Department of Plastic Surgery, University of Pittsburgh School of Medicine
2015-03-09
Presenter: Sanjay Naran, MD
Affidavit:
I attest that the project here in listed is the original work of the submitting resident.
Director Name: Joseph Losee
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Children with non-syndromic craniosynostosis (NSCS) are considered high risk for neurodevelopmental delay. While many metrics for such delays have been analyzed, few have directly examined early language acquisition and speech development. Our purpose was to determine whether infants with NSCS have normal language acquisition and speech development.
We identified patients with NSCS from 2000-2014. Patients with a syndrome, or diagnosis of a sub-mucous cleft palate, were excluded. Data elements included; age, gender, Pittsburgh Weighted Speech Score (PWSS), evaluation for anatomic motor delay, language/speech delay, articulation/phoneme deficiency, hypernasality, velopharangeal insufficiency (VPI) or borderline competency, and whether speech therapy was recommended. All patients were evaluated by certified speech and language pathologists.
65 patients met criteria, 58.5% were male. Average age at most recent evaluation was 6.24yrs (Range: 2.31-17.95). The majority of patients (53.85%) had normal speech/language metrics. The remainder (43.85%) had one or more abnormalities, including anatomic motor delay (1.54%), speech/language delay (24.62%), articulation/phoneme deficiency (10.77%), hypernasality (3.08%), and VPI or borderline competency (15.38%). In all, 27.69% (n=18) of patients were recommended to have speech therapy. Of those, the average PWSS was 2.7 (Range 0-5). Two patients were documented to have global cognitive delay.
Many studies indicate that children with NSCS are at increased risk for difficulties in cognitive, language, and motor domains during infancy and childhood. Looking at 7 objective speech metrics, we found that defective speech and language development occurred in 1 in 4 patients with NSCS; a prevalence 2-3 times higher compared to the general population.
