Oral clefts and behavioral health of young children


George L. Wehby, MPH, PhD, Department of Health Management and Policy, College of Public Health, University of Iowa, E205 GH, 200 Hawkins Drive, Iowa City, IA 52242, USA. Tel: 319 384 5133, Fax: 319 384 5125, E-mail: george-wehby@uiowa.edu


Oral Diseases (2011) 18, 74–84

Objectives:  This study examined the behavioral health of young children with oral clefts, and effects of satisfaction with facial appearance, cleft team care, number of cleft-related surgeries, and socioeconomic status (SES).

Subjects and Methods:  The study included a population-based sample of 104 children aged 2–12 years with isolated oral clefts from the state of Iowa. Behavior was evaluated with the Child Behavior Checklist or the Pediatric Behavior Scale 30, depending on age, compared with normative samples.

Results:  Risks of behavioral problems were not significantly different from normative samples except for higher inattention/hyperactivity risks at age 6–12 years. Low satisfaction with facial appearance was associated with behavioral problems in all domains, except aggression. Team-care effects were not associated with behavioral problems. Number of cleft-related surgeries was associated with increased anxiety/depression and somatic symptom risks. Higher SES was associated with reduced inattention/hyperactivity, aggressive/oppositional behavior, and somatic symptoms.

Conclusions:  Most children with oral clefts may have similar behavioral health outcomes to unaffected children, except for increased inattention/hyperactivity risks at older ages. However, low satisfaction with facial appearance, increased exposure to surgeries, and lower SES may significantly increase behavioral problems. Also, the findings emphasize the need to study the representation of behavioral health professionals on cleft teams and access to behavioral health care.