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

Abstract

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

Risk and Protective Factors at Age 10: Psychological Adjustment in Children with a Cleft Lip and/or Palate

“…Social disadvantage due to a visible difference has been reported previously (Murray et al, 2010) and has been supported by neuropsychological findings related to social function (Boes et al, 2007). However, the current findings did not indicate that the children in this study were at social and emotional risk from cleft visibility.…”

The Relationship of Exposure to Anesthesia on Outcomes in Children With Isolated Oral Clefts

“…Identification of increased risk for later behavioral and cognitive deficits, including ADHD, 1–3 social withdrawal, 4–7 and learning disabilities, 8–11 has sparked interest in possible factors of etiology. Early work has focused on medical and social factors related to cleft (i.e., speech and hearing difficulties, 12–14 social stigma 15 ).…”

Comparative Effectiveness Studies Examining Patient-Reported Outcomes among Children with Cleft Lip and/or Palate

“…[24][25][26][27]34,35,45 The Culture Free Self-Esteem Inventory (n = 3), SelfPerception Profile for Adolescents (n = 3), and 36-Item Short Form Health Survey (n = 2) were also used frequently. Factors that affect the presence of behavior and mood disorders include age and sex.…”

“…The patient population for 18 studies consisted of cleft lip, cleft palate, and cleft lip and cleft palate patients. [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Cleft palate and cleft lip and cleft palate patients only were grouped together in three studies. [42][43][44] Cleft lip and cleft palate patients were included in seven studies.…”

“…24,25,33,36,38,45,47 In contrast, 15 studies used specific control groups. [26][27][28][29][30][31]37,40,46,[48][49][50][51][52][53] A total of seven studies compared various subgroups within the sample population. 32,34,35,[41][42][43][44] (Tables 3 and 4) (see Appendix, Supplemental Digital Content 1, for content analysis, http://links.lww.com/PRS/ B188).…”