OBJECTIVE: The focus of this study was to determine whether there were any significant differences in academic achievement between students with a cleft and the general population of Swedish students at the typical time of graduation from compulsory school (usually 16 years of age).

DESIGN: A retrospective population-based study. Data were obtained from the Swedish Medical Birth Register for the years 1973 through 1986 and were linked to the Swedish School-Grade Register.

PARTICIPANTS: A total of 511 individuals with cleft palate (CP), 651 individuals with cleft lip (CL), and 830 individuals with cleft lip and palate (CLP) were compared with a control group consisting of 1,249,404 individuals.

MAIN OUTCOME MEASURES: (1) Not receiving school leaving certificate; (2) odds of receiving lowest grade and reduced odds of receiving a high grade in the following subjects: (a) Mathematics, (b) English, (c) Swedish, (d) Physical Education, and (e) grade point average (GPA).

RESULTS: The group with cleft had higher odds of not receiving leaving certificates in comparison with the general population. They also had higher odds of receiving the lowest grade and/or reduced odds of receiving a high grade in the subjects analyzed together, with strong evidence of lower GPA in comparison with the general population. Individuals with CP were affected the most, followed by individuals with CLP; least affected were individuals with CL.

CONCLUSION: This study clearly indicates that adolescents with cleft lip and/or palate in Sweden experience significant deficits in their educational achievements in compulsory school.