Developmental and Cognitive Outcomes in Children with Cleft Lip and Palate

Abstract Background: Cleft lip and palate are the most common congenital craniofacial anomalies worldwide. Beyond cosmetic and functional challenges, affected children may be at increased risk of neurodevelopmental delay and intellectual impairment. Data from Indian populations remain limited. Methods: This cross-sectional study included 120 children aged 6 months to 12 years with cleft lip, cleft palate, or both, attending a tertiary care center in Nagpur. Developmental assessment was performed using the Bayley Scales of Infant and Toddler Development (Bayley-III), Denver Developmental Screening Test II (DDST-II), and Wechsler Intelligence Scale for Children (WISC-IV), depending on age. Clinical data, socioeconomic background, and hearing status were documented. Statistical analysis was performed using Chi-square and Fisher’s exact tests. Results: Developmental delay or intellectual impairment was observed in 39 children (32.5%). Prevalence was significantly higher in children with cleft palate (isolated 40.7%, combined 44.4%) compared to cleft lip alone (18.7%) (p = 0.01). Speech and language delay (66.7%) was the most common domain, followed by cognitive delay (28.2%) and motor delay (15.4%). Hearing impairment was detected in 25.8% of children and was significantly associated with developmental delay (54.8% vs. 24.1%, p < 0.05). Syndromic clefts (66.6%) and lower socioeconomic status (38.7%) were also linked to higher rates of delay. Conclusions: Nearly one-third of children with cleft lip and/or palate exhibit developmental delay, with higher risk in those with cleft palate, hearing loss, syndromic features, and socioeconomic disadvantage. Early multidisciplinary intervention including screening, speech therapy and surveillance is necessary to optimise long-term outcomes.