title: The psychosocial effects of cleft lip and palate in non-Anglo populations: a cross-cultural meta-analysis.
abstract: OBJECTIVE
  A meta-analytic study was conducted to examine the cross-cultural psychosocial impact of cleft lip and/or palate in non-Anglo populations.
  
  
  METHODS
  A total of 333 citations were initially identified for review using electronic and hand-search strategies. Of the six studies that met inclusion criteria, two were later excluded due to insufficient data. The four remaining studies represented a combined sample size of 2276 adolescents and adults with cleft lip and/or palate from China, Hong Kong, Taiwan, and Norway.
  
  
  METHODS
  Effect size using Cohen's d and confidence intervals were estimated using data from four studies of empirical, controlled study designs.
  
  
  RESULTS
  The magnitude of effect sizes indicated that men (d = -0.75) with cleft lip and/or palate in non-Anglo cultures are more prone to psychosocial issues than women (d = -0.33). Adults (d = -0.50) are more impacted than adolescents (d = -0.04). Overall, regardless of age, gender, or culture, individuals with cleft lip and/or palate have lower psychosocial development than individuals without cleft lip and/or palate (d = -0.42).
  
  
  CONCLUSIONS
  The effects for the cross-cultural comparisons were moderated by the age group and gender of the participants; however, most studies resulted in negative effect sizes. Health care teams for cleft lip and/or palate should recognize the importance of psychological intervention and family support in the treatment of all patients with cleft lip and/or palate throughout the life span.
authors.affiliation: Department of Speech Pathology and Audiology, 2 Bachelor Hall, Miami University, Oxford, OH 45056, USA. Hutchik@muohio.edu
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hutchinson
authors.forename: Maria A
authors.initials: MA
authors.lastname: Wellman
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Noe
authors.forename: Alice
authors.initials: A
authors.lastname: Kahn
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D002971:Cleft Lip / Q000208:ethnology* / Q000523:psychology*; D002972:Cleft Palate / Q000208:ethnology* / Q000523:psychology*; D003431:Cross-Cultural Comparison; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D009664:Norway; D012737:Sex Factors; D012917:Social Adjustment; D013624:Taiwan