Body Image and Age Effects in the Pediatric Cleft Population

BACKGROUND: While orofacial clefts affect the facial appearance of many children and adolescents with this birth defect, there has not been specific research examining the impact of orofacial clefts on developing body image. Body image development in the general population follows a trend in which adolescence is characterized by more negative body image than in prepubescent children. However, as children with orofacial clefts have altered appearances from birth, their body image may differ from that of the general population. This study aims to examine the relationship between orofacial clefts and body image throughout childhood and adolescence. PARTICIPANTS: Participants included children and adolescents who were seen in the multidisciplinary craniofacial clinic at Children's Health/Children's Medical Center between March 2011 and April 2015. Patients included in the sample had a diagnosis of cleft lip and/or palate (CL/P), were between the ages of 8 and 18 years of age, and had no complex medical or genetic diagnoses. METHOD: This study utilized a retrospective chart review of patients seen in the craniofacial clinic at Children's Health from March 2011 to April 2015. Data collected from the patient charts included demographic information, medical and surgical history, and history of speech intervention and recommendations. Each patient was interviewed by a clinician and filled out self-report questionnaires. Items from the self-report questionnaires relevant to body image and self-perception were used in this study along with a body image concern item asked during the clinician interview. Participants were separated into groups based on orofacial cleft diagnosis (bilateral CL/P, unilateral CL/P, cleft lip only, and cleft palate only). RESULTS: There was no significant relationship found between body image and category of orofacial cleft diagnosis. Age also did not correlate with body image scores. Body image scores that were taken from the body image-related items were also not highly correlated.
DISCUSSION: There were no significant relationships found between the variables of interest in this study. However, orofacial clefts are unique conditions that may necessitate ongoing surgical and related medical intervention throughout childhood and adolescence. For patients with CL/P, body image development may not follow a typical trend and may fluctuate rapidly depending on the success of their treatment, how well treatment outcomes meet expectations, as well as patients' adaptability to their changing appearance. As a result, there may not be a clearly identifiable correlation between age and body image scores. Other factors such as the orofacial cleft diagnostic categories used for this study, the uneven group sizes, and the body image-related items used as a measure of body image may have impacted the results. As the body image-related items were not significantly correlated, another measure that has been validated to assess body image may be more efficient and necessary in future studies so that the relationship between age, orofacial cleft condition, and body image can be more precisely examined.