title: When there is more than a cleft: psychological adjustment when a cleft is associated with an additional condition.
abstract: BACKGROUND
  In spite of studies reporting a relatively high frequency of additional conditions in children with a cleft lip and/or cleft palate (CL/P), almost no research has focused on this clinically important subgroup. The objective of this study was to compare psychosocial adjustment in children with CL/P with and without an additional condition.
  
  
  METHODS
  Cross-sectional data based on routine psychological assessments at age 10 years, with comparisons to national reference groups.
  
  
  METHODS
  Centralized treatment, Norway.
  
  
  METHODS
  Two hundred five children with CL/P (participation rate: 80.1%) from three consecutive birth cohorts.
  
  
  METHODS
  The Strengths and Difficulties Questionnaire (self-report and parent report) and the Child Experience Questionnaire (self-report).
  
  
  RESULTS
  Eighty-one children (39.5%) were identified as having at least one condition in addition to the cleft. These children reported significantly more psychosocial difficulties than children with a cleft alone. Differences between specific conditions were minor. Children with a cleft alone (n = 124) reported mean scores that were comparable to those reported by the reference group. There were no differences in adjustment between children with a visible versus a non-visible cleft.
  
  
  CONCLUSIONS
  The present study highlights the need for research to be conducted in children with CL/P who have additional conditions to provide better knowledge and clinical care for a potentially vulnerable subgroup of children and their parents.
authors.forename: Kristin Billaud
authors.initials: KB
authors.lastname: Feragen
authors.forename: Nicola Marie
authors.initials: NM
authors.lastname: Stock
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D002971:Cleft Lip / Q000523:psychology*; D002972:Cleft Palate / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D012917:Social Adjustment; D011795:Surveys and Questionnaires