When there is more than a cleft: psychological adjustment when a cleft is associated with an additional condition

Cleft Palate Craniofac J. 2014 Jan;51(1):5-14. doi: 10.1597/12-328. Epub 2013 Apr 26.

Abstract

Background: In spite of studies reporting a relatively high frequency of additional conditions in children with a cleft lip and/or cleft palate (CL/P), almost no research has focused on this clinically important subgroup. The objective of this study was to compare psychosocial adjustment in children with CL/P with and without an additional condition.

Design: Cross-sectional data based on routine psychological assessments at age 10 years, with comparisons to national reference groups.

Setting: Centralized treatment, Norway.

Participants: Two hundred five children with CL/P (participation rate: 80.1%) from three consecutive birth cohorts.

Outcome measures: The Strengths and Difficulties Questionnaire (self-report and parent report) and the Child Experience Questionnaire (self-report).

Results: Eighty-one children (39.5%) were identified as having at least one condition in addition to the cleft. These children reported significantly more psychosocial difficulties than children with a cleft alone. Differences between specific conditions were minor. Children with a cleft alone (n = 124) reported mean scores that were comparable to those reported by the reference group. There were no differences in adjustment between children with a visible versus a non-visible cleft.

Conclusions: The present study highlights the need for research to be conducted in children with CL/P who have additional conditions to provide better knowledge and clinical care for a potentially vulnerable subgroup of children and their parents.

MeSH terms

  • Adaptation, Psychological
  • Child
  • Cleft Lip / psychology*
  • Cleft Palate / psychology*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Norway
  • Social Adjustment*
  • Surveys and Questionnaires