By: Hunter Doiron
Hunter Doiron is an undergraduate Senior majoring in
Theology while also minoring in Philosophy and Psychology. His interest in
Child Developmental Psychology stems from a hope and passion for teaching. He
enjoys reading, writing, and doing research in both the fields of Theology and
Psychology.
I’ll never forget
the first time I saw my nephew smile. I had flown into North Carolina to visit
my sister and see the first child that would call me “Uncle!” He was a cute
little baby even though he did not look like a “normal” baby with his cleft
lip. You can see him in the picture I have, and when I saw this little smile in
person, I knew I wanted to help ensure he has a full and fun time growing up. I
knew that he would go through surgery and have some physical changes to come,
but there were still questions about the social development that he would go
through as he develops certain skills like speaking. I will provide the
scholarly research I have found from empirical studies that have looked at
certain aspects of growing up with a cleft lip/palate (CLP). I hope for this
research to not only be helpful for parents with children who have CLP, like my
sister, but also for any parent or caretaker that can learn to better
understand and assist other children and they may see with CLP and their
parents.
Fear of Lagging Behind
Any
parent has faced the fear of their child lagging behind their peers. I can
remember my parents telling me how they were concerned about whether I would be
better off in the grade above or below based off my birthday. I was only five
years old, but there was still genuine concern for how a young child will be
set up for the future. It can seem like a child having CLP could lag behind
their peers which would be concerning for their social development. Looking at research
done by Collett and Speltz (2006), they found that from a longitudinal study of
children starting at 3 months old going to seven years old with 76 children
with CLP and 76 without, there was some lagging behind for the children with
CLP until they were about five years old. Luckily, after that, they stayed very
similar to their peers through to age seven. The initial lagging was for
neurocognitive function and academic achievement. A child’s performance in
school is not just influential on their cognitive development but also their
social development because it will determine what grade they are in and who
their peers will be. Just as my parents knew that keeping me in a grade with peers
similar in age would help me, this research can help to reassure parents of
children with CLP that their child may initially lag behind but will most
likely catch back up to their peers soon. Regardless, knowing and understanding
this is just one way that anyone can help those parents as they make decisions
for their child.
Interacting with Peers
As
parents begin making decisions for their child that determine what peers they
will be with, it is important to keep in mind what attitudes their peers may
have of children with CLP. Of course, we want to assume all kids are little
angels and would never discriminate anyone, but everyone knows about the fear
kids have about standing out too much such as having different hair, being too
short (that was my fear!), or sounding different. Even though modern healthcare
has been able to work miracles allowing children with CLP to look just like
their peers, not every child is fortunate to have that opportunity. Even
children with it can still have slight scars or subtle differences in speech that
they and their peers may one day question. Bettens et al. (2020) decided to
research these potential peer attitudes with 69 typically developing children aged
seven to twelve years old by showing them audio recordings of children with and
without CLP. Unfortunately, there was a more positive attitude for the better a
child could speak and more negative the worse a child was at speaking, but this
is not an insurmountable result. Their research should reveal the importance of
teaching children how to care about others no matter their differences. We can
definitely look at this determination and say that speech help should be given
to children with CLP, but I would also suggest that all parents can see the
importance of making sure that every child feels included by their peers,
especially when it comes down to something a child cannot control.
Social Motivation as a Cause for Difficulties
As
we continue to discuss the social development of children with CLP, I want us
to really try to empathize with what children are feeling as they grow up. This
empathy can be an important step in learning how to help and walk with any
child through development. I believe the research from van der Plas et al.
(2013) did an excellent job at this because they really wanted to look at the fundamental
cause of struggling with social development and feeling isolated. Putting
together 20 males 13-25 years old having CLP along with 20 males without, they used
questionnaires and games to determine if their social motivation played a
factor in their attitude towards social activities, which turned out to be
true. Social motivation is an internal factor that any child, with or without
CLP, has to learn to develop because it refers to how willing a child is to
interact with others and be social. From this research, we can better
understand what children are feeling as they grow up and know that even if we
change external factors, like what school grade they are in, we still need to
consider internal motivations to help children socially develop.
How Parents/Caretakers Can Make a Difference
Next, I want to hone in more particularly on the parents. Now that we have looked at some of the circumstances surrounding social development such as peers and individual motivation, there is a need to give extra attention to the parents. As I have alluded to by pointing out how much my parents had on their shoulders making a decision for me, parents face many stressful and crucial decisions for their children’s social development. An interesting study done by Costa et al. (2021) wanted to determine some factors contributing to the socioemotional development of children with CLP by looking at how parents view their child with CLP. Through a questionnaire given to 322 mothers having children with CLP at 18 months old, they found out how these mothers viewed the development of their child in areas such as communication skills, problem-solving, and personal-social skills. Essentially, they wanted to find out how the children were doing based on what the mothers said. What they found from this type of study was that a parent’s levels of anxiety and depression were influential on a child’s social development. This is important to consider because children requiring extra care and concern, such as those with CLP, can cause higher levels of anxiety or depression for the parents. We know how critical the role of the parents or caregivers is for the social development of their child, but we can always benefit from being reminded of specific factors, like anxiety and depression, that can make matters more difficult for parents so that we can all learn to better understand and assist every parent going through a stressful time.
The Importance of Support
Finally,
I have concluded each section noting how we can assist because of a study done
by Benson et al. (1991). Every family learns of the importance of having
support in crucial times, but the researchers pointed out that sometimes those
families that need it most, such as those raising a child with CLP, may not
find it. With 36 children aging one month to five years old having CLP and 36 the
same age not having it as a control, they gave a questionnaire to the primary
caregivers in order to determine the extent of their social support network. It
was unfortunate that their results indicated that parents of children with CLP
reported lower qualities of living and lower socio-economic status. From this,
parents of children with CLP can be faced with the struggle of having deficient
social support networks at a time when they need it most. Luckily, I know my
sister has been able to find much support from my parents and other family, but
I know how hard it has been for them to find competent daycares willing to have
a child with extra needs.
Conclusion
From
all the studies along with our life experiences, I think we can all agree that more
needs to always be done for families and children with CLP. We may become
complacent to the idea that modern healthcare can seem to “fix” the problem physically
through surgeries, but there are still social and emotional developmental
concerns that this research points out. For me, it is a reminder that I need to
always reach out to my sister and be there to assist in any way as her son
grows up. While that may seem like a challenge, I am happy to accept it and have
the opportunity to see his beautiful smile more and more because that smile
will always reflect just how much of a gift he and every child, no matter their
facial structures, truly is.
