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A person with CLS may have craniofacial, skeletal, or cardiac abnormalities, as well as hearing impairment and cognitive, behavioral, and mobility issues. The traits common to all persons with CLS are tapered fingers, downward slanting eyes, and delayed bone development. Distal tufting of the fingertip bones is also highly diagnostic, but this is only visible on X-ray. It is important to remember that each person is unique and that their own genetic makeup will also be a factor.