Peer-reviewed article
School results in single-suture craniosynostosis: what should we tell parents at the first consultation?
Liberati L, Moriconi F, Marfoli A, Dall'Olio G, Chieffo DPR ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This is a medical review about school outcomes in children with single-suture craniosynostosis, a birth defect affecting skull bone development. The authors reviewed evidence on academic performance, learning, and behaviour in affected children to guide what doctors should tell parents. Most children perform within normal ranges, but some experience difficulties with mathematics, language, attention, and behaviour regulation. The review suggests doctors should provide realistic reassurance while monitoring for learning needs as academic demands increase.
Key points
- Mean intellectual and academic scores fall within normative ranges with substantial overlap with peers
- A clinically meaningful subgroup shows learning vulnerabilities or requires educational supports
- Mathematics, language-based learning, attention, executive function, and behaviour regulation are recurrent areas of concern
- Educational needs may emerge or become more visible as academic demands increase
- Evidence for independent effects of surgical timing or technique on school-age cognition remains mixed
Limitations
This is a clinical review focused on a specific medical condition rather than evaluating an intervention for child well-being. It does not assess the effectiveness of any programme, policy, or treatment to improve outcomes.
Abstract
Background Parents of children diagnosed with nonsyndromic single-suture craniosynostosis (SSC) frequently ask whether school difficulties should be expected and what type of monitoring is appropriate over time. Objective To synthesize evidence on school-related outcomes in SSC and translate it into counselling guidance for the first consultation. Methods We conducted a structured narrative review with a systematic literature search. PubMed/MEDLINE and Scopus were searched from database inception to January 2026 using terms related to craniosynostosis, single-suture disease, school achievement, learning, cognition, attention, executive function, behaviour, and educational supports. Reference lists of included studies and relevant reviews were hand-searched. Eligible sources included controlled cohorts, longitudinal studies, population or registry studies, systematic reviews/meta-analyses, and clinically relevant studies reporting academic, neuropsychological, behavioural, or educational service outcomes in children with nonsyndromic SSC. Results were narratively synthesized by school-relevant domains. Results Mean intellectual and academic scores in SSC generally fall within normative ranges, with modest group differences and substantial overlap with peers. However, variability is increased, and a clinically meaningful subgroup shows learning vulnerabilities or requires educational supports. Mathematics, language-based learning processes, attention/executive function, and behaviour regulation are recurrent areas of concern. Population-linked and registry studies suggest that many children meet grade-level standards, while educational needs may emerge or become more visible as academic demands increase. Evidence for independent effects of surgical timing or technique on school-age cognition remains mixed and confounded. Conclusions School outcomes in nonsyndromic SSC are generally favourable but heterogeneous. First-consultation counselling should combine realistic reassurance with anticipatory monitoring, attention to risk modifiers, and early collaboration with schools.