Skip to main content

Behavioral functioning of school-aged children with non-syndromic craniosynostosis



This study investigated the risk for children with non-syndromic craniosynostosis to develop behavioral problems during school age determined by the type of craniosynostisis, age at first surgery, and number of surgeries.


Final sample consisted of 43 children aged between 6 years and 8 months and 17 years and 1 month (M = 10 years and 5 months). Behavioral problems were assessed with Child Behavioral Checklist (CBCL).


Our sample had higher scores on the CBCL than the general population; specific elevations were observed including somatic complaints, aggressive behavior, social problems, attention problems, and thought problems and rule-breaking behavior. Behavioral functioning varied by number of surgical procedures, type of craniosynostosis, and age at first surgery.


For school-aged NSC children’s behavioral functioning, diagnosis specific patterns especially impacted by the first age of the surgery and number of surgeries.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    Speltz ML, Kapp-Simon KA, Cunningham M, Marsh J, Dawson G (2004) Single-suture craniosynostosis: a review of neurobehavioral research and theory. J Pediatr Psychol 29(8):651–668.

    Article  PubMed  Google Scholar 

  2. 2.

    Da Costa AC (2004) Neuropsychological profiles of children and adolescents with craniosynostosis. Doctor of Psychology Thesis, Victoria University of Technology, Melbourne, Australia.

  3. 3.

    Bottero L, Lajeunie E, Arnaud E, Marchac D, Renier D (1998) Functional outcome after surgery for trigonocephaly. Plast Reconstr Surg 102:952–958.

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Da Costa AC, Anderson VA, Savarirayan R, Wrennall JA, Chong DK, Holmes AD, Greensmith AL, Meara JG (2012) Neurodevelopmental functioning of infants with untreated single-suture craniosynostosis during early infancy. Childs Nerv Syst 28:869–877.

    Article  PubMed  Google Scholar 

  5. 5.

    Ozgur B, Aryan HE, Ibrahim D, Soliman MA, Meltzer HS, Cohen SR, Levy ML (2006) Emotional and psychological impact of delayed craniosynostosis repair. Childs Nerv Syst 22:1619–1623.

    Article  PubMed  Google Scholar 

  6. 6.

    Bellew M, Liddington M, Chumas P, Russell J (2011) Preoperative and postoperative developmental attainment in patients with sagittal synostosis: 5-year follow-up. J Neurosurg Pediatr 7:121–126.

    Article  PubMed  Google Scholar 

  7. 7.

    Shipster C, Hearst D, Somerville A, Stackhouse J, Hayward R, Wade A (2003) Speech, language and cognitive development in children with isolated sagittal craniosynostosis. Dev Med Child Neurol 45:34–43.

    Article  PubMed  Google Scholar 

  8. 8.

    Starr J, Collett B, Gaither R, Kapp-Simon K, Cradock M, Cunningham M, Speltz M (2012) Multi-center study of neurodevelopment in 3-year-old children with or without single-suture craniosynostosis. Arch Pediatric Adolesc Med 166:536–542.

    Article  Google Scholar 

  9. 9.

    Foster KA, Frim DM, McKinnon M (2008) Recurrence of synostosis following surgical repair of craniosynostosis. Plast Reconstr Surg 121(3):70e–76e.

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Da Costa AC, Anderson VA, Holmes AD, Lo P, Wray AC, Chong DK, Greensmith AL, Meara JG (2013) Longitudinal study of the neurodevelopmental characteristics of treated and untreated nonsyndromic craniosynostosis in infancy. Childs Nerv Syst 29:985–995.

    Article  PubMed  Google Scholar 

  11. 11.

    Magge S, Westerveld M, Pruzinsky T, Persing J (2002) Long-term neuropsychological effects of sagittal craniosynostosis on child development. J Craniofac Surg 13:99–104.

    Article  PubMed  Google Scholar 

  12. 12.

    Becker DB, Petersen JD, Kane AA, Cradock MM, Pilgram TK, Marsh JL (2005) Speech, cognitive, and behavioral outcomes in nonsyndromic craniosynostosis. Plast Reconstr Surg 116:400–407.

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Cloonan YK, Collett B, Speltz ML, Anderka M, Werler MM (2013) Psychosocial outcomes in children with and without non-syndromic craniosynostosis: findings from two studies. Cleft Palate-Cran J 50:406–413.

    Article  Google Scholar 

  14. 14.

    Speltz ML, Collett BR, Wallace ER, Kapp-Simon K (2016) Behavioral adjustment of school-age children with and without single-suture craniosynostosis. Plast Reconstr Surg 138:435–445.

    CAS  Article  PubMed  Google Scholar 

  15. 15.

    Kapp-Simon KA, Collett BR, Barr-Schinzel MA, Cradock MM, Buono LA, Pietila KE, Speltz ML (2012) Behavioral adjustment of toddler and preschool-aged children with single-suture craniosynostosis. Plast Reconstr Surg 130:635–647.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Cradock MM, Gray KE, Kapp-Simo KA, Collett BR, Buono LA, Speltz ML (2015) Sex differences in the neurodevelopment of school-age children with and without single-suture craniosynostosis. Childs Nerv Syst 31:1103–1111.

    Article  PubMed  Google Scholar 

  17. 17.

    Millichap JG (2015) Cognitive development of children with craniosynostosis. Pediatr Neurol Briefs 29:47–47.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Aslan C, Olgun ZD, Ertas ES, Ozusta S, Demirkiran G, Unal F, Yazici M (2017) Psychological profile of children who require repetitive surgical procedures for early onset scoliosis: is a poorer quality of life the cost of a straighter spine? Spine Deformity 5:334–341.

    Article  PubMed  Google Scholar 

  19. 19.

    Achenbach TM, Rescorla LA (2001) Manual for ASEBA school-age forms & profiles. University of Research Center for Children, Youth & Families, Burlington

    Google Scholar 

  20. 20.

    Erol N, Simsek Z, Munir K (2009) Mental health of adolescents reared in institutional care in Turkey: challenges and hope in the twenty-first century. Eur Child Adoles Psy 19:113–124.

    Article  Google Scholar 

  21. 21.

    Erol N, Şimşek Z (2010) Okul Çağı Çocuk ve Gençler için Davranış Değerlendirme Ölçekleri El Kitabı (CBCL, YSR ve TRF). Mentis, Ankara

    Google Scholar 

  22. 22.

    DeSimone JA, Harms PD (2017) Dirty data: the effects of screening respondents who provide low-quality data in survey research. J Bus Psychol 33:559–577.

    Article  Google Scholar 

  23. 23.

    Graham JW, Cumsille PE, Elek-Fisk E (2003) Methods for handling missing data. In: Schinka JA, Velicer WF (eds) Handbook of psychology: research methods in psychology 2:87–114. Wiley, Hoboken

    Google Scholar 

  24. 24.

    Liakhovitski D, Stone-Romero EF, Jaccard JJ (2008) Strategies for detecting joint dichotomous moderators in human resource management research. Hum Resour Manag Rev 18:164–179.

    Article  Google Scholar 

  25. 25.

    Soper DS (2015) Interaction (Software Program),

  26. 26.

    Collett BR, Kapp-Simon KA, Wallace E, Cradock MM, Buono L, Speltz ML (2017) Attention and executive function in children with and without single-suture craniosynostosis. Child Neuropsychology 23:83–98.

    Article  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Senem Zeytinoğlu-Saydam.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zeytinoğlu-Saydam, S., Özek, M.M., Marcus, J. et al. Behavioral functioning of school-aged children with non-syndromic craniosynostosis. Childs Nerv Syst 36, 783–792 (2020).

Download citation


  • Trigonocephaly
  • Scaphocephaly
  • Plagiocephaly
  • Psychology