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Are infants with orofacial clefts at risk for insecure mother-child attachments?
C L Maris1, M C Endriga, M L Speltz
1Maternal and Child Health Program, University of California, Berkeley, USA.
Insights
Infants with cleft palate (CP) showed less secure attachment at 12 months but improved by 24 months. Cleft lip and palate (CLP) did not adversely affect early mother-infant relationships.
Area of Science:
- Developmental Psychology
- Pediatric Health
- Attachment Theory
Background:
- Early life risk factors may impact attachment security in infants with clefts.
- Previous research has rarely explored this empirical link.
- Understanding early attachment is crucial for child development.
Purpose of the Study:
- To compare attachment classifications at 12 and 24 months.
- To investigate infants with cleft palate (CP) and cleft lip and palate (CLP).
- To compare with a group of unimpaired infants (COMP).
Main Methods:
- Assessed 22 CP, 24 CLP, and 61 COMP infants at 12 and 24 months.
- Utilized the Strange Situation procedure for mothers and infants.
- Coded videotaped interactions for attachment behavior patterns.
Main Results:
- CP infants had lower 12-month attachment security than CLP or COMP groups.
- No diagnostic group differences in attachment were found by 24 months.
- CP infants showed more instability but improved attachment security by 24 months.
Conclusions:
- Infant cleft lip and palate (CLP) appearance did not negatively affect early mother-infant relationships.
- Cleft palate (CP) infants experienced attachment instability in infancy.
- Most infants with clefts achieved secure maternal attachments by 24 months.
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, 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.