Objective : The main objective of this study was to assess mother-child patterns of interaction in relation to later quality of attachment in a group of children with an orofacial cleft compared with children without cleft. Design : Families were contacted when the child was 2 months old for a direct assessment of mother-child interaction and then at 12 months for a direct assessment of the child's attachment. Data concerning socioeconomical information and posttraumatic stress symptoms in mothers were collected at the first appointment. Participants : Forty families of children with a cleft and 45 families of children without cleft were included in the study. Families were recruited at birth in the University Hospital of Lausanne. Results : Results showed that children with a cleft were more difficult and less cooperative during interaction at 2 months of age with their mother compared with children without a cleft. No significant differences were found in mothers or in dyadic interactive styles. Concerning the child's attachment at 12 months old, no differences were found in attachment security. However, secure children with a cleft were significantly more avoidant with their mother during the reunion episodes than secure children without cleft. Conclusion : Despite the facial disfigurement and the stress engendered by treatment during the first months of the infant's life, children with cleft and their mothers are doing as well as families without cleft with regard to the mothers' mental health, mother-child relationships, and later quality of attachment. A potential contribution for this absence of difference may be the pluridisciplinary support that families of children with cleft benefit from in Lausanne.

Objective :  The main objective of this study was to assess mother-child patterns of interaction in relation to later quality of attachment in a group of children with an orofacial cleft compared with children without cleft. Design :  Families were contacted when the child was 2 months old for a direct assessment of mother-child interaction and then at 12 months for a direct assessment of the child's attachment. Data concerning socioeconomical information and posttraumatic stress symptoms in mothers were collected at the first appointment. Participants :  Forty families of children with a cleft and 45 families of children without cleft were included in the study. Families were recruited at birth in the University Hospital of Lausanne. Results :  Results showed that children with a cleft were more difficult and less cooperative during interaction at 2 months of age with their mother compared with children without a cleft. No significant differences were found in mothers or in dyadic interactive styles. Concerning the child's attachment at 12 months old, no differences were found in attachment security. However, secure children with a cleft were significantly more avoidant with their mother during the reunion episodes than secure children without cleft. Conclusion :  Despite the facial disfigurement and the stress engendered by treatment during the first months of the infant's life, children with cleft and their mothers are doing as well as families without cleft with regard to the mothers' mental health, mother-child relationships, and later quality of attachment. A potential contribution for this absence of difference may be the pluridisciplinary support that families of children with cleft benefit from in Lausanne.

À partir d’une analyse clinique du discours de parents d’enfants nés avec une fente labio-palatine et en nous aidant des théories psychodynamiques actuelles, nous nous sommes interrogés sur la place de la honte et de la culpabilité au sein du traumatisme que représente un tel diagnostic et sur le travail psychique que ces deux affects imposent et permettent. Nous mettons en avant l’importante expression de ces émotions, même si difficile, afin qu’un travail d’élaboration du traumatisme puisse se mettre en route.

La naissance d’un enfant avec une fente oro-faciale est souvent vécue comme un événement à portée traumatique pour les parents, pouvant avoir un impact sur les représentations de l’enfant et la mise en place de la relation. Cet article propose un bilan des dix années de recherche lausannoise sur le développement de la parentalité et des liens précoces, auprès des familles d’enfants naissant avec une fente, depuis l’annonce du diagnostic jusqu’à l’âge préscolaire. Des aspects tels que les représentations parentales, les interactions précoces, ainsi que la qualité de l’attachement sont investigués.

La zone bucco-labiale est l’un des relais principaux de la construction de l’environnement spatial et affectif dans les premiers mois de vie. Or, dans le cas d’une naissance avec une fente orofaciale, cette zone est mise précocement à rude épreuve, risquant de provoquer un désinvestissement ou, au contraire, une hypersensibilisation pouvant entraîner un certain de nombre de conséquences à long terme. Le but de ce travail est d’investiguer le développement sensori-moteur d’enfants nés avec une fente orofaciale et de les comparer à des enfants nés sans fente, à l’âge de 5 ans. Même si aucune différence importante n’est mise en évidence, les résultats montrent quelques zones grises dans le développement sensori-moteur des enfants nés avec une fente, telles que l’articulation des différents espace entre eux, pouvant faire apparaître ces enfants comme maladroits.

No abstract