Social acceptance and facial behavior in children with oral clefts

Objective: To examine and compare social acceptance, social behavior, and facial movements of children with and without oral clefts in an experimental setting. Design: Two groups of children (with and without oral clefts) were videotaped in a structured social interaction with a peer confederate, when listening to emotional stories, and when told to pose specific facial expressions. Participants: Twenty-four children and adolescents ages 7 to 16 1/2 years with oral clefts were group matched for gender, grade, and socioeconomic status with 25 noncleft controls. Main Outcome Measures: Specific social and facial behaviors coded from videotapes; Harter Self-Perception Profile, Social Acceptance subscale. Results: Significant between-group differences were obtained. Children in the cleft group more often displayed "Tongue Out," "Eye Contact," "Mimicry," and "Initiates Conversation." For the cleft group, "Gaze Avoidance" was significantly negatively correlated with social acceptance scores. The groups were comparable in their ability to pose and spontaneously express facial emotion. Conclusions: When comparing children with and without oral clefts in an experimental setting, with a relatively small sample size, behavior analysis identified some significant differences in patterns of social behavior but not in the ability to express facial emotion. Results suggest that many children with oral clefts may have relatively typical social development. However, for those who do have social competence deficits, systematic behavioral observation of atypical social responses may help individualize social skills interventions.