title: Negative social reaction to strabismus in school children ages 8-12 years.
abstract: OBJECTIVE
  To investigate children's willingness to sit next to a child with noticeable exotropia as a measure of social alienation.
  
  
  METHODS
  This was a cross-sectional, mixed-design study. Children in primary grades 3-6 (8-12 years old) were asked to view 8 digitally modified images of exotropic or orthotropic children in classroom settings and rate their willingness to sit next to the child in each image.
  
  
  RESULTS
  A total of 157 children participated. A 4 × 2 × 2 mixed-design analysis of variance revealed a significant main effect for primary level (F [3, 151] = 4.06, P = .01, partial η(2) = .08) and for image type, exotropic versus orthotropic, (F [1, 151] = 108.45, P = .00, partial η(2) = .42). The results of the main effects were qualified by a significant primary level X image type interaction (F [3, 151] = 4.00, P = .01, partial η(2) = .08). Children were less willing to sit next to a person with noticeable exotropia. Although this phenomenon was consistent across all primary levels, the magnitude of the effect diminished in strength for children in higher primary levels.
  
  
  CONCLUSIONS
  This study further strengthens existing evidence for strabismus-related prejudice that suggests that children with noticeable strabismus may be subjected to social alienation by other children.
authors.affiliation: Department of Psychology, Faculty of Behavioural Sciences, HELP University College, Kuala Lumpur, Malaysia. heral@help.edu.my
authors.forename: Hera
authors.initials: H
authors.lastname: Lukman
authors.forename: John E
authors.initials: JE
authors.lastname: Kiat
authors.forename: Asha
authors.initials: A
authors.lastname: Ganesan
authors.forename: Wei Ling
authors.initials: WL
authors.lastname: Chua
authors.forename: Kheng Leik
authors.initials: KL
authors.lastname: Khor
authors.forename: Yee Fong
authors.initials: YF
authors.lastname: Choong
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D005099:Exotropia / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D011287:Prejudice; D012918:Social Alienation / Q000523:psychology*; D012919:Social Behavior