The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) application is to support the further training and research activities of Dr. Amy L. Conrad in the neurobiology of cognition and the application of this research to patients with non-syndromic oral clefts. Dr. Conrad is a pediatric psychologist trained in the assessment of developmental learning and attention disorders. She has worked on research projects investigating cognitive functioning in children and adolescents with non-syndromic cleft lip and/or palate, as well as other pediatric conditions. Recent work has hypothesized abnormal brain development as a potential primary factor in cognitive and behavioral skills within these children. This opens a new venue of research in cognitive skills. While her training in psychology and learning disabilities is extensive, her education in neurobiology and imaging has been limited. In order to appropriately investigate neurodevelopment in subjects with non-syndromic cleft, she has the short term goals to: 1) obtain in-depth training in neurobiology/development, 2) obtain training in the application and interpretation of neuroimaging in connection with cognition, and 3) extend her education in statistics. This will be achieved through coursework, directed readings, focused lectures/conferences, and mentorship by professionals with strong backgrounds in neurodevelopment, imaging, and statistics. Through the research project and short-term learning goals, Dr. Conrad will progress toward her long-term goal of evaluating neurodevelopment in children with various disorders through assessment and imaging procedures and contributing to effective intervention/care/treatment plans. Oral clefts are among the most common congenital malformation and the majority of these occur in isolation, without a known genetic cause. Research has reported a high incidence of specific learning disabilities (most notably language or reading deficits) among this population. These disabilities, while not in the range of Intellectual Dysfunction, do result in academic achievement problems and may be related to later low college entry rates. Recent work has suggested that these outcomes may be due to abnormal brain structure and function, rather than environmentally influenced. The proposed study will evaluate reading proficiency in subjects with non-syndromic cleft of the lip and/or palate and investigate links to previous hypothesized areas of influence (i.e., early hearing and speech), cognitive skills (i.e., phonemic awareness, rapid labeling, orthographic awareness, visual/verbal memory, and attention), and neurocircuitry involved (as related to previous research on dyslexia). The increased understanding of these skills and the factors influencing them will improve early identification, treatment plans, and will guide appropriate accommodations.
High incidence of specific learning disabilities has been reported within the non-syndromic clefting population. These can cause achievement issues in school and later in life. Understanding the interplay of environmental, medical, and neurobiological factors on cognitive outcomes can improve early identification and accuracy of diagnosis, and guide appropriate treatment / interventions.