Objective
To examine family functioning related to sociodemographic and clinical
characteristics in youth with cleft lip and/or palate (CL/P).
Design
Cross-sectional, multisite investigation.
Setting
Six U.S. cleft centers.
Patients/Participants
A diverse sample of 1200 children with CL/P and their parents.
Main Outcome Measure
Parents completed the Family Environment Scale (FES), which assesses three
domains of family functioning: cohesion (or closeness), expressiveness (open expression
of feelings), and conflict. Demographic and clinical characteristics were also assessed
including race, ethnicity, type of insurance, and surgical recommendations.
Results
The FES scores for families seeking team evaluations for their youth with CL/P
(mean age = 11.6 years) fall within the average range compared with normative samples.
Families receiving surgical recommendations for their youth also had FES scores in the
average range, yet families of children recommended for functional surgery reported
greater cohesion, expressiveness, and less conflict compared with those recommended for
aesthetic surgery (P < .05). For cohesion and expressiveness,
significant main effects for race (P = .012, P
< .0001, respectively) and ethnicity (P =.004,
P < .0001, respectively) were found but not for their
interaction. No significant differences were found on the conflict domain. Families with
private insurance reported significantly greater cohesion (P <
.001) and expressiveness (P < .001) than did families with
public insurance.
Conclusions
Family functioning across domains was in the average range. However, observed
differences by race, ethnicity, type of insurance, and surgical recommendation may
warrant consideration in clinical management for patients and families.