Social-Emotional Development of Infants and Young Children With Orofacial Clefts

Abstract

Children with orofacial clefts are believed to have distinctly elevated risk for a variety of adverse social-emotional outcomes including behavior problems, poor self-concept, and parent-child relationship difficulties. This assumption has been based primarily on theories of facial appearance and social bias, a handful of empirical studies, and clinical impressions. Studies of these children have been limited by methodological problems such as diagnostic heterogeneity, ascertainment bias, and absent or poorly matched control groups. In an attempt to address at least some of these methodological problems, the longitudinal research described in this article examined the developmental course of infants with unilateral cleft lip & palate (CLP) and cleft palate only (CPO). We followed these infants to age 7, with ongoing comparisons to a demographically matched group of typical children. Outcome measures targeted child attachment, maternal/child interaction during feeding and teaching tasks, parent satisfaction with surgical outcomes, parent and teacher behavior rating scales, and child self-concept and behavioral adaptation. Although our findings have provided limited support for the hypothesis that infants and young children with CLP/CPO are at greater risk for social-emotional problems than their peers, we have found that among infants with clefts, early assessment can predict subsequent social-emotional outcomes. In this article, we review theory and data in this area of study, summarize our longitudinal findings, describe our success and failures with respect to methodological rigor, and discuss emerging research and areas for further inquiry.

Psychometric Evaluation of the Stress Scale for Parents with Cleft Lip and/or Palate Children—A Preliminary Study

“…(Young et al, 2001). From a cultural perspective, we did find that parents have a superstition problem in Taiwan; there is support for this in the literature (Collett and Speltz, 2006;Olasoji et al, 2007). One of the items in the SSPCC, S29, which emerged from phase 1, is ''the cause of the condition is misunderstood as a result of superstitions,'' and in response to this, one of the participants mentioned that ''someone said that if you have done something wicked in your previous life or invaded the God of fetus during pregnancy, and you will give birth to a child with CL/P.''…”

Self‐Concept in Youth with Congenital Facial Differences: Development and Recommendations for Medical Providers

“…Self‐concept and its associated outcomes in youth with craniofacial differences, especially cleft lip and palate, have been examined extensively, although results have been inconsistent. In their 2006 review, Collett and Speltz (23) found that a handful of studies supported the long‐believed notion that children with clefts had lower ratings of self‐worth (24–26); but, this finding has not been consistent across studies or across subdomains of self‐concept. Others have found that those children with clefts have average (27–29) to above‐average (30) self‐concept when compared with youth without clefts.…”

Language and Early Reading among Children with Orofacial Clefts

“…Environmental factors also may place children with clefts at risk. The quality of mother-child interactions has been the focus of several investigations (see review by Collett and Speltz, 2006). Findings from these studies have been inconsistent; however, there is some indication that the mothers of preschoolers with clefts are more directive than the mothers of unaffected controls, particularly during teaching interactions (e.g., Allen et al, 1990; Wasserman and Allen, 1985).…”