Cleft Condition Awareness Quiz
Test your knowledge and help raise awareness about cleft conditions. Please answer all questions to the best of your ability.
Participant Name
*
First Name
Last Name
Email Address
*
example@example.com
How familiar are you with cleft conditions?
*
Not at all familiar
1
2
3
4
Very familiar
5
1 is Not at all familiar, 5 is Very familiar
Which of the following best describes a cleft condition?
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A gap or opening in the upper lip and/or roof of the mouth (palate)
A birthmark on the skin
A type of bone fracture
Other
Cleft conditions can affect:
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Speech and communication
Feeding and nutrition
Hearing
Dental health
All of the above
Other
What is the estimated global prevalence of cleft conditions?
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1 in 700 births
1 in 7,000 births
1 in 70,000 births
Not sure
Which of the following statements are true about treatment for cleft conditions?
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Surgery is often required
Speech therapy may be needed
Treatment is only cosmetic
Lifelong care may be necessary
Other
Please indicate your level of agreement with the following statements about cleft conditions.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Cleft conditions are caused by something the parents did or did not do.
1
2
3
4
5
Children with cleft conditions can lead healthy, fulfilling lives.
6
7
8
9
10
Cleft conditions can be successfully treated with medical care.
11
12
13
14
15
Which of the following is a common myth about cleft conditions?
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They are always preventable
They can be treated with surgery
They affect both boys and girls
They can impact speech
What would you like to learn more about regarding cleft conditions? (Optional)
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