Parent Reports of the Psychosocial Functioning of Children With Cleft Lip and/or Palate

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doi: 10.1597/05-205
The Cleft Palate-Craniofacial Journal: Vol. 44, No. 3, pp. 304–311.

Parent Reports of the Psychosocial Functioning of Children With Cleft Lip and/or Palate

Orlagh Hunt, Ph.D., M.Sc., B.Sc.
Donald Burden, Ph.D., M.Sc., B.D.S., F.D.S.R.C.P.S., F.F.D.R.C.S.I., F.D.S.R.C.S., D.Orth.R.C.S., M.Orth.R.C.S.
Peter Hepper, Ph.D., B.Sc., C.Psychol. F.B.Ps.S.
Mike Stevenson, B.Sc., F.S.S.
Chris Johnston, Ph.D., B.Sc., B.D.S., M.Orth., F.D.S.R.C.S.

Dr. Hunt is Lecturer, School of Dentistry, Queen's University Belfast. Dr. Burden is Senior Lecturer and Consultant Orthodontist, School of Dentistry, Queen's University Belfast. Dr. Hepper is Professor, School of Psychology, Queen's University Belfast. Dr. Stevenson is Senior Lecturer, Epidemiology and Public Health, Queen's University Belfast. Dr. Johnston is Senior Lecturer and Consultant Orthodontist, School of Dentistry, Queen's University Belfast

Submitted July 2006; Accepted September 2006.

Objectives: (1) to determine the opinion of parents regarding the psychosocial functioning of their child with cleft lip and/or palate (CLP); (2) to identify predictors of psychosocial functioning; and (3) to determine the level of agreement between children with CLP and their parents.
Participants: One hundred twenty-nine parents of children with CLP and 96 parents of children without CLP participated in this cross-sectional study.
Outcome measures: Parental opinion of the child's self-esteem, anxiety, happiness, and problems caused by facial appearance were assessed using visual analogue scales. Parents completed the Child Behavior Checklist and were interviewed.
Results: Children with CLP were more anxious (p < 0.05), less happy with their appearance (p < 0.001), and in general (p < 0.05) had lower self-esteem (p < 0.05) and greater behavioral problems (p < 0.001) compared with non-CLP children. Parents reported that their child with CLP was teased more often (p < 0.001) and was less satisfied with his/her speech (p < 0.01) compared with reports of parents in the control group. A number of factors affected parents' ratings of their child's psychosocial functioning (presence of CLP, appearance happiness, previous history of CLP, and visibility of scar). Children who had been teased were more anxious (p 0.01), less happy with their appearance (p < 0.001) and had greater behavioral problems (p < 0.001).
Conclusions: Parents of children with CLP reported various psychosocial problems among their children. Parents considered children who had been teased to have greater psychosocial problems.

KEY WORDS: cleft, psychosocial, teasing