Frequency and socio-psychological impact of taunting in school-age patients with cleft lip-palate surgical repair

Background:Clefts of the lip and/or palate (CL/P) carry a social stigma that often causes psychosocial stress. The purpose of this study was to consider the association of cleft phenotype and age with self-reported aspects of psychosocial stress.Methods:Children with nonsyndromic CL/P and unaffected children born between 1997 and 2003 were identified through the North Carolina Birth Defects Monitoring Program and North Carolina birth records, respectively. The psychosocial concerns of children with CL/P were assessed via a 29-question subset of a larger survey. Responses were analyzed according to school age and cleft phenotype (cleft lip with/without cleft alveolus, CL ± A; cleft palate only, CP; or cleft lip with cleft palate, CL + P).Results:Surveys were returned for 176 children with CL/P and 333 unaffected children. When compared with unaffected children, responses differed for CL ± A in 4/29 questions, for CP in 7/29 questions, and for CL + P in 8/29 questions (P < 0.05). When stratified by school age, children with CL/P in elementary, middle, and high school differed from unaffected children by 1/29, 7/29, and 2/29 questions, respectively. Middle school–aged children with CL/P were more affected by aesthetic concerns, bullying, and difficulties with friendship, and social interaction. Children with CL + P reported more severe aesthetic-related concerns than children with CL ± A or CP but experienced similar speech-related distress as children with CP only.Conclusion:Social implications associated with CL/P are most pronounced during middle school, and less so during elementary and high school. This information identifies areas of social improvement aimed at reducing the stigma of CL/P.

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“…There are studies that have found cleft type to influence social stigmata, 29,31 as well as studies that state there is no impact. 3,26,32,34,39 …”

Section: Discussionmentioning

confidence: 99%

“…This study reported a similar bearing on “bullying” for all 3 deformity types, a comparable finding to a study that explained this phenomenon by concluding that bullying/taunting is not solely directed at the physical and visible defect. 39 …”

Section: Discussionmentioning

confidence: 99%

A Population-Based Exploration of the Social Implications Associated with Cleft Lip and/or Palate

Glener

Allori

Shammas

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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“…This may result in significant psychosocial impairment related to school (bullying, verbal or physical abuse, relationship building issues with teachers or peers) and family life (feeling or looking different than siblings or family members). 52,53 From the donor perspective, the donor's family may view the transplanted body part (e.g. face) as a means of continuing their child's life and hence may expect to relate to the recipient.…”

Section: Special Note: Pediatric Patientsmentioning

confidence: 99%

<p>Public attitudes toward vascularized composite allograft donation: a literature review</p>

Kaur¹,

Thoma²

2019

TRRM

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Vascularized composite allotransplantation (VCA) is the transplantation of anatomical or functional structures composed of multiple types of tissues. The technical advancement of solid organ transplantation and replantation instigated the development of the skills required for successful VCA several years ago; however, the recent advancements in immunosuppression therapy have renewed the interest in this field. As VCAs are primarily life-enhancing procedures, the perception and attitudes of the general public (i.e. potential donors and candidates) and the health care professionals is extremely relevant in terms of health policy and funding decision allocations, availability of donor tissue and ethical and legal implications. In this article, we review the current evidence to assess the sociocultural and demographic factors that influence the growth and success of VCA procedures.

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“…Such factors include time spent under anaesthesia 21 , a high number of school absences due to healthcare appointments, social stigmatization (e.g. due to teasing by peers 22 , or perceptions and expectations of teachers 23 ), lower self-esteem, or impaired speech 24 , or delayed language development 25 .…”

Section: B)mentioning

confidence: 99%

“…before entering school) and persistent speech disorder 24 , both of which are strongly associated with lower educational attainment 41 . Teasing and bullying by peers is common in children born with clefts 22 , which can affect psychological wellbeing, enjoyment of school and attainment 42 . There is also some evidence that teachers perceive the behaviour and abilities of children born with a cleft differently from their classmates 23,43 .…”

Section: Comparison To Previous Evidencementioning

confidence: 99%

Cleft lip/palate and educational attainment: cause, consequence, or correlation? A Mendelian randomization study

Dardani

Howe

Stergiakouli

et al. 2018

Preprint

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AbstractImportancePrevious studies have found that children born with a non-syndromic form of cleft lip and/or palate have lower-than-average educational attainment. These differences could be due to a genetic predisposition to low intelligence and academic performance, factors arising due to the cleft phenotype (such as school absence, social stigmatization and impaired speech and language development), or confounding by the prenatal environment. A clearer understanding of this mechanism will inform development of interventions to improve educational attainment in individuals born with a cleft, which could have wide-ranging knock-on effects on their quality of life.ObjectiveTo assess evidence for the hypothesis that common variant genetic liability to non-syndromic cleft lip with or without cleft palate (nsCL/P) influences educational attainment.DesignUsing summary data from genome-wide association studies (GWAS), we performed Linkage Disequilibrium (LD)-score regression and two-sample Mendelian randomization to evaluate the relationship between genetic liability to nsCL/P (GWAS n=3,987) and educational attainment (GWAS n=766,345), and intelligence (GWAS n=257,828).ResultsThere was little evidence for shared genetic aetiology between nsCL/P and educational attainment (rg −0.03, 95% CI −0.14 to 0.08, P 0.58; βMR 0.002, 95% CI −0.001 to 0.005, P 0.417) or intelligence (rg −0.01, 95% CI −0.12 to 0.10, P 0.85; βMR 0.002, 95% CI −0.010 to 0.014, P 0.669).Conclusions and relevanceCommon genetic variants are unlikely to predispose individuals born with nsCL/P to low educational attainment or intelligence. This information will help tailor clinical-, school-, social- and family-level interventions to improve educational attainment in this group.Key PointsQuestionDo children born with a non-syndromic cleft lip with or without palate (nsCL/P) have lower-than average academic achievement because of an underlying genetic predisposition to educational attainment and/or intelligence?FindingsThere was little evidence for shared common variant genetic correlation between nsCL/P, educational attainment and intelligence.MeaningCommon genetic variants are unlikely to predispose individuals born with nsCL/P to low educational attainment or intelligence. This information will help tailor clinical-, school-, social- and family-level interventions to improve educational attainment in this group.

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Frequency and socio-psychological impact of taunting in school-age patients with cleft lip-palate surgical repair

Cited by 71 publications

References 26 publications

A Population-Based Exploration of the Social Implications Associated with Cleft Lip and/or Palate

A Population-Based Exploration of the Social Implications Associated with Cleft Lip and/or Palate

<p>Public attitudes toward vascularized composite allograft donation: a literature review</p>

Cleft lip/palate and educational attainment: cause, consequence, or correlation? A Mendelian randomization study

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