Psychosocial Adjustment in Children and Adolescents with a Craniofacial Anomaly: Age and Sex Patterns

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Abstract
Objective: To examine rates of psychosocial adjustment problems and competencies in a sample of children with congenital craniofacial anomalies (CFAs). Methods: Retrospective chart review. Setting: Urban hospital plastic surgery primary care unit. Patients: A total of 724 children aged 2 to 18 years with completed Child Behavior Checklists in their medical charts. Main Outcome Measure: Child Behavior Checklist. Results: Higher rates of problems in the clinical range were seen for withdrawn, attention, social, thought, and internalizing problems and lower rates for externalizing and somatic complaints; specific patterns varied according to age and sex. Elevated rates of competency deficits were seen in some groups. Conclusions: Most children with CFAs do not appear to experience psychosocial adjustment problems. Although elevated risk may be seen for certain problems, this group may be protected in other areas. Research identifying the mechanisms responsible for varying age and sex patterns of adjustment is needed.