[Abstract] ((Catherine L. Maris et al. Are Infants with Orofacial Clefts at Risk for Insecure
Mother-Child Attachments? The Cleft Palate-Craniofacial Journal. May 2000. 37(3):257‚ €265))
Objective: Several risk factors in the early lives of children with clefts are believed to
interfere with their development of secure attachments to parents; however, this possibility
has rarely been studied empirically. This study compared 12- and 24-month attachment
classifications of infants with cleft palate (CP), infants with cleft lip and palate (CLP),
and a comparison group of unimpaired infants (COMP).
Method: Twenty-two CP infants, 24
CLP infants, and 61 matched COMP infants were assessed at 12 and 24 months of age in an
urban children’s hospital. At both visits, mothers and infants participated in the Strange
Situation(1), which was videotaped and subsequently coded for patterns of attachment
behavior.
Results: CP infants displayed a lower rate of 12-month attachment security than
infants in the CLP or COMP groups. By 24 months, no diagnostic group differences in
attachment classification were found. Stable 12- to 24-month attachment classifications were
less likely in the CP group (36.3%) than in the COMP (62.3%) group. CP infants who were
insecure at 12 months were more likely to become secure by 24 months than were CLP or COMP
group infants.
Conclusions: In contrast to previous theory and clinical speculation, the
facial appearance of infants with CLP does not appear to affect the early mother-infant
relationship adversely. The infancy period is marked by attachment instability for infants
with CP, who demonstrated lower-than-expected rates of security at 12 months. However, these
problems resolved in nearly all cases by 24 months of age. Most infants with clefts emerged
from the first 2 years of life with secure maternal attachments.
Notes:
1. The ‘Strange Situation’ procedure examines an infant‚ response to a
series of increasingly stressful separations from the caregiver.