title: Frequency and socio-psychological impact of taunting in school-age patients with cleft lip-palate surgical repair.
abstract: OBJECTIVE
  Cleft lip-palate (CLP) is a "social" pathology because of its impact on the child's facial appearance and speech. School is the first place where children are confronted to others and when they start socializing. Taunting and bullying are common and their psychological impact remains hard to assess. The aim of this study was to evaluate the importance of taunting in school and its impact in CLP patients who had surgical repair.
  
  
  METHODS
  We conducted a multicenter prospective study where we consecutively included patients ≥ 12 years who had CLP repair. During a multidisciplinary consultation they were asked to complete a questionnaire (3 parts: surgical outcomes, taunting and its impact, socio-economic status) previously approved by our psychologists.
  
  
  RESULTS
  55 patients were included (37 B, 18 G) (mean age 15.5 years): 11 CL, 13 CP and 31 CLP. 69% of patients reported having suffered from taunting and peer victimization in school. In 84% of the cases, taunting was linked to the CLP defect itself. The teasing started in primary school to reach a peak of aggressiveness in middle school. 42% of patients reported that bullying occurred at least once a day (16/38). Regarding the psychological impact of taunting, 50% of patients reported sadness, 31% depression and 26.3% were marked for life. At one time or another 29% of patients did not want to attend school because of the teasing. The grade retention rate amounted to 37.7% (20/53), and 2 patients were in special education classes. As a matter of fact, 50% of these children repeated their 1st or 2nd year of primary school. Furthermore, 47% of patients wanted to change something to their face, but 63% of them never spoke to their surgeon about additional surgeries even though they were teased in school.
  
  
  CONCLUSIONS
  Taunting is common in children with CLP. This study highlights the high frequency and impact of taunting on the daily lives and self-perception of patients with CLP or CLP repair. It is important for healthcare professionals to be aware of this issue in the context of a multidisciplinary approach.
authors.affiliation: Department of Pediatric Surgery, American Memorial Hospital, CHU, Reims, France.
authors.forename: A
authors.initials: A
authors.lastname: Lorot-Marchand
authors.affiliation: National Reference Center for Rare Crano-maxillo-facial Malformations, Lille, France; Department of Plastic and Reconstructive Surgery, Hôpital Salengro CHU, Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Guerreschi
authors.affiliation: National Reference Center for Rare Crano-maxillo-facial Malformations, Lille, France; Department of Plastic and Reconstructive Surgery, Hôpital Salengro CHU, Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Pellerin
authors.affiliation: National Reference Center for Rare Crano-maxillo-facial Malformations, Lille, France; Department of Plastic and Reconstructive Surgery, Hôpital Salengro CHU, Lille, France.
authors.forename: V
authors.initials: V
authors.lastname: Martinot
authors.affiliation: Department of Maxillofacial and Stomatology, CHU, Amiens Nord, Amiens, France.
authors.forename: C C
authors.initials: CC
authors.lastname: Gbaguidi
authors.affiliation: Department of Maxillofacial and Stomatology, CHU, Amiens Nord, Amiens, France.
authors.forename: C
authors.initials: C
authors.lastname: Neiva
authors.affiliation: Department of Maxillofacial and Stomatology, CHU, Amiens Nord, Amiens, France.
authors.forename: B
authors.initials: B
authors.lastname: Devauchelle
authors.affiliation: National Reference Center for Rare Crano-maxillo-facial Malformations, Lille, France; Department of Plastic and Reconstructive Surgery, Hôpital Salengro CHU, Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Frochisse
authors.affiliation: Department of Pediatric Surgery, American Memorial Hospital, CHU, Reims, France.
authors.forename: M L
authors.initials: ML
authors.lastname: Poli-Merol
authors.affiliation: Department of Pediatric Surgery, American Memorial Hospital, CHU, Reims, France; Department of Plastic Surgery, Hopital Maison Blanche, CHU, Reims, France; EA 3801 Laboratory Champagne Ardenne University, SFR CAP santé Reims-Amiens, Reims, France. Electronic address: carolinefiquet@me.com.
authors.forename: C
authors.initials: C
authors.lastname: Francois-Fiquet
mesh_terms: D000293:Adolescent; D000328:Adult; D058445:Bullying; D002648:Child; D002971:Cleft Lip / Q000523:psychology* / Q000601:surgery; D002972:Cleft Palate / Q000523:psychology* / Q000601:surgery; D003863:Depression / Q000209:etiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D008297:Male; D011446:Prospective Studies; D012574:Schools; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Cleft lip; Cleft palate; School; Self-perception; Stigmatization; Teasing