title: The effect of cleft lip and palate, and the timing of lip repair on mother-infant interactions and infant development.
abstract: BACKGROUND
  Children with cleft lip and palate are at risk for psychological problems. Difficulties in mother-child interactions may be relevant, and could be affected by the timing of lip repair.
  
  
  METHODS
  We assessed cognitive development, behaviour problems, and attachment in 94 infants with cleft lip (with and without cleft palate) and 96 non-affected control infants at 18 months; mother-infant interactions were assessed at two, six and 12 months. Index infants received either 'early', neonatal, lip repair, or 'late' repair (3-4 months).
  
  
  RESULTS
  Index infants did not differ from controls on measures of behaviour problems or attachment, regardless of timing of lip repair; however, infants having late lip repair performed worse on the Bayley Scales of Mental Development; the cognitive development of early repair infants was not impaired. Difficulties in early mother-infant interactions mediated the effects of late lip repair on infant cognitive outcome.
  
  
  CONCLUSIONS
  Early interaction difficulties between mothers and infants having late repair of cleft lip are associated with poor cognitive functioning at 18 months. Interventions to facilitate mother-infant interactions prior to surgical lip repair should be explored.
authors.affiliation: Winnicott Research Unit, School of Psychology, University of Reading, Reading RG66AL, UK. lynne.murray@rdg.ac.uk
authors.forename: Lynne
authors.initials: L
authors.lastname: Murray
authors.forename: Françoise
authors.initials: F
authors.lastname: Hentges
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hill
authors.forename: Janne
authors.initials: J
authors.lastname: Karpf
authors.forename: Beejal
authors.initials: B
authors.lastname: Mistry
authors.forename: Marianne
authors.initials: M
authors.lastname: Kreutz
authors.forename: Peter
authors.initials: P
authors.lastname: Woodall
authors.forename: Tony
authors.initials: T
authors.lastname: Moss
authors.forename: Tim
authors.initials: T
authors.lastname: Goodacre
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D002653:Child Behavior Disorders; D002657:Child Development; D002971:Cleft Lip / Q000523:psychology* / Q000601:surgery*; D002972:Cleft Palate / Q000523:psychology* / Q000601:surgery*; D003071:Cognition; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D009034:Mother-Child Relations; D015999:Multivariate Analysis; D009769:Object Attachment; D012044:Regression Analysis; D016037:Single-Blind Method; D013997:Time Factors; D006113:United Kingdom