Psychological Issues in Craniofacial Care: State of the Art

Endriga, Marya C.; Kapp-Simon, Kathleen A.

doi:10.1597/1545-1569(1999)036<0001:piiccs>2.3.co;2

Cited by 119 publications

(101 citation statements)

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“…Regardless of the origins of academic differences, our findings of prominent group differences beginning in the second grade support previous recommendations [23][24][25] for routine, early screening of children with oral clefts, ideally before school entry, allowing for intervention when it is most likely to be effective, which is consistent with recent proposals and implementation of universal screening through "Response to Intervention" school programs. 26 Screening would ideally involve collaborations between schools and craniofacial teams, typically staffed by psychologists and other health care providers who could conduct screening, because nearly all children with clefts are seen by such teams in early childhood.…”

Section: Discussionsupporting

confidence: 89%

Academic Achievement of Children and Adolescents With Oral Clefts

Wehby

Collet

Barron³

et al. 2014

Pediatrics

129

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WHAT'S KNOWN ON THIS SUBJECT: Previous studies that reported learning deficits among children with oral clefts mostly used small, clinic-based samples prone to ascertainment bias. No previous studies in the United States have used a populationbased sample and direct testing of academic achievement. WHAT THIS STUDY ADDS:Using a large population-based sample from the United States and standardized school tests for achievement, we found that children with oral clefts scored significantly lower than their classmates on all evaluated domains of achievement and had higher rates of learning disability. abstract BACKGROUND AND OBJECTIVE: Previous studies of academic achievement of children with oral clefts have mostly relied on small, clinicbased samples prone to ascertainment bias. In the first study in the United States to use a population-based sample with direct assessment, we evaluated the academic achievement of children with oral clefts relative to their classmates. METHODS:Children born with isolated oral clefts in Iowa from 1983 to 2003 were identified from the Iowa Registry for Congenital and Inherited Disorders and matched to unaffected classmates by gender, school/school district, and month and year of birth. Academic achievement was assessed by using standardized tests of academic progress developed by the Iowa Testing Programs. Iowa Testing Programs data were linked to birth certificates for all children. Regression models controlled for household demographic and socioeconomic factors. The analytical sample included 588 children with clefts contributing 3735 child-grade observations and 1874 classmates contributing 13 159 child-grade observations. RESULTS: Children with oral clefts had lower scores than their classmates across all domains and school levels, with a 5-percentile difference in the overall composite score. Children with clefts were approximately one-half grade level behind their classmates and had higher rates of academic underachievement and use of special education services by 8 percentage points. Group differences were slightly lower but remained large and significant after adjusting for many background characteristics.CONCLUSIONS: Children with oral clefts underperformed across all academic areas and grade levels compared with their classmates. The results support a model of early testing and intervention among affected children to identify and reduce academic deficits. Pediatrics 2014;133:785-792

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Section: Discussionsupporting

confidence: 89%

Academic Achievement of Children and Adolescents With Oral Clefts

Wehby

Collet

Barron³

et al. 2014

Pediatrics

129

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“…Contrary to the expectations of the lay public and many health care providers, important findings from research, clinical practice, and personal accounts suggest that the extent, type, and severity of a disfigurement are not consistently strong predictors of adjustment; however, the visibility of the condition may exacerbate distress. 4 There is a consensus amongst researchers and practitioners that individual adjustment is affected by a complex interplay of physical, socio-cultural, and psychosocial factors, [4][5][6][7] in which some factors contribute to distress, whereas others seem to 'buffer' a person against the stresses and strains of living with a disfigurement.…”

Section: Introductionmentioning

confidence: 99%

Appearance concerns in ophthalmic patients

James

Jenkinson

Harrad

et al. 2011

Eye

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Aims This study aimed to determine the psychosocial and appearance-related concerns of a sample of ophthalmic patients by measuring a range of psychological, social, and demographic factors. Methods Standardized psychological measures including anxiety, depression, appearance-related distress, self-discrepancy, appearance salience and valence were administered to 98 participants attending ophthalmic outpatient clinics in either London, Bristol, Sheffield or Bradford. Differences between groups were explored using t-tests and ANOVA, relationships between all variables were investigated using Pearson's correlation coefficient. Results Although mean scores for psychological adjustment were within the normal range, some participants were experiencing considerable levels of generalized anxiety. Being older, male, and married or living with a partner was related to significantly better adjustment. Better adjustment was also related to a less visible area of concern, greater disguisability of the affected area, a more positive evaluation of their own appearance, less engagement in comparing themselves with others, greater feelings of being accepted by others, appearance being less important to their selfconcept, and a smaller discrepancy between the persons ideal and actual appearance. Conclusions A majority of ophthalmic patients adjust positively to the demands placed on them. By identifying the variables that are associated with successful adaptation, the specific psychological interventions and appropriate systems of support can be put in place to help those who are adversely affected.

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“…In addition to the cognitive deficits, social dysfunction has been identified repeatedly and in high frequency in individuals with ICLP, as recently reviewed [38]. In general, individuals with ICLP are more likely to be socially inhibited or shy and report fewer friends than noncleft controls [17,31,41,42,50,58]. They are also less likely to join clubs or societies in school and less likely to marry [19,48].…”

Section: Introductionmentioning

confidence: 99%

Social function in boys with cleft lip and palate: Relationship to ventral frontal cortex morphology

Boes

Murko

Wood

et al. 2007

Behavioural Brain Research

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Isolated clefts of the lip and/or palate (ICLP) are developmental craniofacial abnormalities that have consistently been linked to increased social inhibition or shyness. Two explanations have been proposed: 1) psychosocial factors related to differences in facial appearance may lead to low selfconcept and subsequent shyness, or 2) abnormal development of brain structures involved in social function, such as the ventral frontal cortex (VFC), may underlie the difference. To investigate these two possibilities this study was designed to evaluate measures of social function in relation to measures of self-concept and VFC morphology. Subjects included 30 boys (age 7-12) with ICLP and a comparison group of 43 boys without cleft in the same age category. Social function and selfconcept were assessed using questionnaires with standardized scoring filled out by subjects and one of their parents. The cortical volume and surface area of the VFC, composed of the orbitofrontal cortex (OFC) and straight gyrus (SG), were evaluated using structural magnetic resonance imaging. The ICLP subjects had significantly impaired social function relative to the comparison group. No difference in self-concept was identified. VFC morphology revealed significant differences between groups, particularly decreased volume and surface area in the left SG of the ICLP group. Moreover, abnormal VFC measures were correlated with social dysfunction but measures of self-concept were

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Psychological Issues in Craniofacial Care: State of the Art

Cited by 119 publications

References 0 publications

Academic Achievement of Children and Adolescents With Oral Clefts

Academic Achievement of Children and Adolescents With Oral Clefts

Appearance concerns in ophthalmic patients

Social function in boys with cleft lip and palate: Relationship to ventral frontal cortex morphology

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