A registry study on nonsyndromic craniosynostosis: Long-term associations with academic achievement

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To assess the association between nonsyndromic craniosynostosis (NSC) and academic achievement. Registry data were analyzed on demographic background, presence of craniosynostosis and other comorbidities, grades, and results on national standardized tests (NSTs) across primary and upper secondary school, as well as the presence of academic degrees. The analysis used regression modeling on a sample of N=1110 individuals with NSC and a matched cohort of N=10,654 individuals. There was a significant negative association between NSC and NST scores in third grade for both mathematics (aOR 0.76, 95% CI 0.60-0.99, p=.020) and Swedish (aOR 0.69, 95% CI 0.54-0.89, p=.004). The association seemed to primarily be carried by females with NSC (aORs for the interaction term 0.26-0.45, all ps <.05). Further, a slightly stronger negative association was observed in individuals with psychiatric comorbidities (aOR 0.44, 95% CI 0.22-0.90, p=.025 for mathematics; aOR 0.45, 95% CI 0.21-0.98, p=.045 for Swedish). No statistically significant association was found between NSC and NST scores or grades in later school years, or with academic degrees. There is evidence for a limited temporary negative association between NSC and academic achievement. A stronger negative association between NSC and academic achievement seems to be present in girls, and for individuals with psychiatric comorbidities. This has important implications for clinical management and provision of support in educational contexts.