PSYCHOSOCIAL EVALUATION OF CRANIOFACIAL PATIENTS

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Current research is demonstrating modest limitations in the psychosocial functioning of patients with craniofacial disorders evaluated and undergoing surgery between the ages of 6 and 13. Follow-up of these patients 1 to 2 years postoperatively reveals only limited improvement in some psychosocial measures and possible deterioration in others. In recent years another craniofacial group has been formed, children who underwent surgery before the age of 4 and who are now old enough to be evaluated psychosocially (ages 6 to 13). These children merit study in their own right as they represent a major segment of the craniofacial population. They also provide an interesting complement to a similar aged craniofacial group who received surgery later. Comparison of these groups will provide information on the significance of timing of surgery on psychosocial adjustment in craniofacial patients. In addition, psychosocial measures of the early operated patients will be compared with data from two other groups to be studied, a normal comparison group and a group of patients with a history of congenital urologic malformations surgically corrected before the age of 4. Specific questions to be addressed are: 1) whether children having the congenital anomalies of the two post-surgical groups of this study will be at a disadvantage psychosocially relative to normal children; 2) whether children with a clearly visible congenital defect (craniofacial malformations) will be at a disadvantage psychosocially relative to children with a non-visible defect and normal children; 3) whether craniofacial children having surgery done at age 3 or before will demonstrate better psychosocial adjustment in comparison to children having corrective surgery later; 4) whether measures of psychosocial adjustment for these groups are correlated with rated appearance. Psychosocial status will be assessed by means of interview with subject and parent(s), and completion of psychometric instruments by subject, parent and teacher reflecting the child's self concept, mood, introversion-extroversion, social experiences, perceived appearance, behavior in the home and classroom.