The psychosocial challenges of adolescents and teens after cleft lip and cleft palate repair with Craniofacial Team of Texas (CTOT) can be one of the greatest concerns for the parents of our patients with these facial anomalies.
Psychosocial Challenges of Adolescents and Teens with Cleft Lip and Palate
The psychosocial challenges of adolescents and teens with a cleft lip and cleft palate can be a factor affecting their self-esteem and how they engage in social relationships, as well as adjustment to adulthood and how they perceive themselves as adults. Studies involving adolescents and teens affected by cleft lips or palates reveal that many felt uncomfortable interacting in their communities due to concern over how others would view the facial difference. Younger adolescents report a greater amount of negative social experiences than older teens, and boys typically have more adjustment difficulties than girls.
Overcoming Negative Social Attitudes about Cleft Lip/Palate
While cleft lip/palate study participants reported negative experiences associated with their facial conditions, these adolescents and teens often sought to minimize the social stigma of cleft lip and cleft palate by adopting a positive view of themselves.
Problems encountered by adolescents and teens with cleft lip/palate include:
- Bullying/teasing
- Staring
- Name-calling
- Questions concerning the cleft lip/palate
- Difficulty being understood
- Self-consciousness
- Overprotection of parents
- Discomfort in new social settings
Adolescents and teen patients resisted negative social attitude through:
- Social support networks
- Coping strategies
- Timely intervention (Cleft lip and cleft palate surgery)
Coping strategies that adolescents and teens found helpful include:
- Problem solving
- Restructuring thoughts
- Regulating emotions, such as letting feelings out or using methods of self-calming
Many coping strategies for adolescents and teens with cleft lips and palates can be found at changingfaces.org.
Positive Study Outcomes for Adolescents and Teens with Cleft Lip or Palate
Studies involving the psychosocial challenges of adolescents and teens affected by cleft lip or palate reveal positive results concerning self-esteem, especially for those patients with high family/parental support.
Support from family and friends resulted in:
- Less family stress felt
- Better ability to adjust in social situations
- Lower psychological distress
While most study participants did express some dissatisfaction regarding their facial differences, they had greater satisfaction with other facial features (such as hair, eyes, teeth) than their peers who had no facial anomaly. One of the main avenues of raising adolescent/teen self-confidence levels is reconstructive surgery. Because many adolescents and teens have undergone significant corrective surgical procedures, self-esteem levels may be heightened by a comparison of past feelings about appearance prior to surgery.
Research also suggests that coping strategies for cleft lip/palate patients evolve over the adolescent to teen years. As children mature and formal operational thinking develops, they are able to adjust the coping strategy to the social situation.
Helping Teen Cleft Lip and Palate Patients Transition to Adulthood
Teens affected by cleft lip and palate transitioning to adulthood may experience fear or anxiety as they venture outside the safety net of friends and family. Social comfort levels are often put to the test when delving into new experiences such as:
- Job interviews
- Romantic relationships/marriage
- Meeting new people in a work environment
Several studies related to the psychosocial effects of cleft lip/palate on adults found that many of these patients (in relation to a control group of peers) reported:
- Higher social anxiety and depression
- Concerns about appearance, speech, and dentition
- Desire for further treatment
- Lower self-esteem
However, young adults with cleft lip/palate who felt that they received recognition from significant others had greater coping skills and higher self-esteem. Giving your support and making sure that your teen has access to the many available social support groups for patients with cleft lip/palate can help build self-esteem and confidence that will last a lifetime.
Your doctors and staff at the Craniofacial Team of Texas are always available to answer questions or address concerns that you may have concerning any aspect of your child’s facial anomaly.
Transitioning from Pediatric to Adult Care for Cleft Lip and Palate
Once your teen begins to establish the independence of adulthood, he/she will need to begin to take responsibility for his/her own medical care. Making sure that your teen has a complete understanding of his/her facial condition will assist with a smooth transition. Keeping a detailed medical journal or file concerning the cleft lip/palate treatment that your teen can take over will ensure that he/she can answer questions at any future medical appointments.
Other tips for transitioning to adult care for cleft lip/palate patients include:
- Stress the importance of your teen being an active partner in his/her medical care.
- Be sure your teen has a working knowledge of special health needs concerning cleft lip/palate that may arise.
Begin planning for adult medical care before you need it. Do not wait until your teen is moving out to give counsel on future medical care. Being able to handle his/her own medical appointments will start your teen on the road to independence, as well as boost self-confidence. The Craniofacial Team of Texas is committed to meeting the needs of all our patients and their families through a multidisciplinary approach which addresses all facets of the condition we are treating and the health of each patient physically and emotionally.
If you would like more information about the psychosocial challenges of adolescents and teens with a cleft lip and cleft palate, please contact the Craniofacial Team of Texas by calling 512-377-1142 or toll free 877-612-7069 to schedule an appointment or complete an online appointment request. 
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