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The Impact of Cleft Lip/Palate and Surgical Intervention on Adolescent Life Outcomes: Evidence from Operation Smile in India

  • Author(s): Wydick, Bruce
  • Zahid, Mustafa
  • Manning, Sam
  • Maller, Jeremiah
  • Evsanaa, Kira
  • Skjoldhorne, Susann
  • Bloom, Matthew
  • Das, Abhishek
  • Deshpande, Gaurav
  • et al.

Published Web Location

https://doi.org/10.26085/C3F30B
Abstract

Cleft Lip/Palate (CLP) is a congenital orofacial anomaly appearing in approximately one in 700 births worldwide. While in high-income countries CLP is normally addressed surgically during infancy, in developing countries CLP is often left unoperated, potentially impacting multiple dimensions of life quality. Previous research has frequently compared CLP outcomes to those of the general population. But because local environmental and genetic factors both contribute to the risk of CLP and also may influence life outcomes, such studies may present a downward bias in estimates of both CLP status and restorative surgery. Working with the non- profit organization Operation Smile, this research uses quasi-experimental causal methods on a novel data set of 1,118 Indian children to study the impact of CLP status and CLP correction on the physical, psychological, and social well-being of Indian teenagers. Our results indicate that adolescents with median-level CLP severity show statistically significant losses in indices of speech quality (-1.55), academic and cognitive ability (-0.43), physical well-being (-0.35), psychological well-being (-0.23), and social inclusion (-0.35). We find that CLP surgery improves speech if carried out at an early age, and that it significantly restores social inclusion.

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