Isolated, Non-Syndromic Craniosynostosis and Special Education Use in Metropolitan Atlanta Público

Abstract

Background: Craniosynostosis (CS) is known to result in delayed neurodevelopment. However, there are no population-based data on the utilization of special education services among children with CS compared to children without birth defects.

Methods: We linked data from the Metropolitan Atlanta Congenital Defects program and live birth certificates to create a cohort of children born from 1989-2004 with CS and children born with no major birth defects. To identify children receiving special education services, we linked birth certificate number to the Special Education Database of Metropolitan Atlanta from 1994-2012. Available data on special education exceptionalities only included the primary exceptionality assigned upon the most recent year of enrollment in special education. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs) comparing the odds of receiving special education services among children with CS to the odds of receiving special education services among children in the same birth cohort with no major birth defects. We also assessed the association between CS and common specific special education exceptionalities.

Results: Among all children with CS (n=217), 19.4% were enrolled in special education for at least one year between ages 3 through 10, while only 10.7% of children with no major birth defects (n=6,059) were in special education. Children with CS had nearly twice the odds (adjusted OR: 1.74 [95% CI: 1.19, 2.54]) of being enrolled in special education compared with children without any major birth defects. Children with sagittal CS had nearly twice the odds (1.89 [1.09, 3.27]) and children with metopic CS had nearly four times the odds (4.04 [2.08, 7.87]) of being enrolled in special education compared with children with no major birth defects.

Conclusion: Children with CS receive special education services more than children without birth defects. These results can better prepare providers, educators, and parents to help children with CS seek out early intervention special educational services. Additional work to understand longer-term developmental outcomes among children with CS is needed.

Table of Contents

Chapter 1...............................................................................1 Background............................................................................1

Types of Craniosynostosis .....................................................1

Etiology of Craniosynostosis..................................................2

Craniosynostosis and Neurodevelopment..............................2

Special Education Services and Exceptionalities....................3

Other Birth Defects and Special Education Services ..............5

Craniosynostosis and Special Education Services...................6 References...............................................................................7

Chapter 2.................................................................................9

Introduction ...........................................................................9

Methods .................................................................................10

Study Population....................................................................10

Receipt of Special Education Services.....................................11 Analysis...................................................................................12

Results ....................................................................................13 Discussion...............................................................................15 Conclusions.............................................................................17 References...............................................................................18

Table 1.....................................................................................19

Figure 1 ...................................................................................20

Table 2.....................................................................................21

Table 3.....................................................................................22

Table 4.....................................................................................23

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Education, Early Childhood Health Sciences, Epidemiology
Palavra-chave	Birth defects Craniosynostosis Special education
Committee Chair / Thesis Advisor	Howards, Penelope, Emory University
Committee Members	Gilboa, Suzanne, CDC
Partnering Agencies	CDC

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