Self-reports of psychosocial functioning among children and young adults with cleft lip and palate

Objective: A cross-sectional study was employed to determine the psychosocial effects of cleft lip and/or palate among children and young adults, compared with a control group of children and young adults without cleft lip and palate. Participants: The study comprised 160 children and young adults with cleft lip and/or palate and 113 children and young adults without cleft lip and/or palate. All participants were between 8 and 21 years of age. Outcome measures: Psychological functioning (anxiety, self-esteem, depression, and behavioral problems) was assessed using validated psychological questionnaires. Happiness with facial appearance was rated using a visual analog scale. Social functioning, including experience of teasing/bullying and satisfaction with speech, was assessed using a semistructured interview. Results: Participants with cleft lip and/or palate reported greater behavioral problems (p <.001) and more symptoms of depression (p <.01); they were teased more often (p <.001) and were less happy with their facial appearance (p <.01) and speech (p <.001), compared with controls. There were no significant difference between subjects with cleft lip and/or palate and subjects without cleft lip and/or palate in terms of anxiety (p >.05) or self-esteem (p >.05). Having been teased was a significant predictor of poor psychological functioning, more so than having a cleft lip and/or palate per se (p <.001). Conclusions: Teasing was greater among participants who had cleft lip and/ or palate and it was a significant predictor of poorer psychosocial functioning. Children and young adults with cleft lip and/or palate require psychological assessment, specifically focusing on their experience of teasing, as part of their routine cleft care.