Facial Impairment Scales for Clefts

The purpose of this paper is to present the Facial Impairment Scales for Clefts. The Facial Impairment Scales for Clefts consist of four, 24-photograph, empirically derived scales of severity of cleft impairment. They were developed (1) to serve as research tools in single and multicenter studies of the surgical, psychosocial, and integrated treatment outcomes of facial clefts and (2) to assist in clinical assessment staging of the aesthetic severity of cleft impairment. Study 1 was conducted to extend the generalizability of the Facial Impairment Scales for Clefts to other groups of raters, including plastic surgeons. Reliability of scale ratings between children (n = 54) and plastic surgeons (n = 23) was examined. Rank orders of photographic subjects by severity of cleft impairment by children were highly correlated with ranks given by plastic surgeons. Study 2 in this series was conducted to assess if new photographs could be reliably fitted to scales. One-hundred and thirty-four medical student raters were able to scale new photographs reliably to the standard measures. These findings suggest that the Facial Impairment Scales for Clefts have sufficient reliability and validity for use in studies of severity of facial impairment.