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Early predictors of attachment in infants with cleft lip and/or palate
M L Speltz1, M C Endriga, P A Fisher
1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98105, USA. mspeltz@u.washington.edu
Insights
Infants with cleft lip and palate (CLP) and cleft palate (CP) do not show increased insecure attachment. Early stressors did not negatively impact infant-caregiver attachment quality in these children.
Area of Science:
- Developmental Psychology
- Pediatric Health
- Attachment Theory
Background:
- Children with cleft lip and palate (CLP) and isolated cleft palate (CP) face risks for psychosocial issues.
- The origins of these psychosocial problems, particularly concerning infant attachment, remain unclear.
- Early life stressors like feeding difficulties and facial disfigurement are hypothesized to negatively affect attachment.
Purpose of the Study:
- To investigate attachment classifications in infants with CLP, CP, and a comparison group at 12 months.
- To identify predictors of insecure attachment at 3 months, considering infant, maternal, and family factors.
- To examine the influence of facial appearance on maternal attachment in infants with CLP.
Main Methods:
- Attachment classifications were assessed at 12 months for infants with CLP, CP, and controls.
- Infant, maternal, and social/family characteristics were analyzed as predictors of attachment at 3 months.
- Statistical analyses explored interactions between diagnostic status and predictor variables.
Main Results:
- No significant differences in attachment status were found between the cleft and comparison groups.
- For infants with clefts, infant and maternal factors predicted insecure attachment, not family factors.
- For the comparison group, maternal and family factors predicted insecure attachment, not infant factors.
- Facial appearance in CLP infants did not adversely affect maternal attachment quality.
Conclusions:
- Infants with clefts do not exhibit an elevated risk for insecure attachments by 12 months of age.
- Despite challenges, early medical and environmental stressors do not appear to compromise infant-caregiver attachment.
- Findings challenge social-psychological theories suggesting facial disfigurement negatively impacts maternal attachment in infants with CLP.
Abstract:
Previous studies have found that children with cleft lip and palate (CLP) and isolated cleft palate (CP) have elevated risk for a variety of psychosocial problems, but the origins of such problems are unclear. We expected that early medical and other stressors during infancy--including feeding problems and facial disfigurement--would have adverse effects on the infant, his or her caregivers, and the family environment, leading to a higher than expected rate of insecure attachments among infants with clefts. Twelve-month attachment classifications of CLP, CP, and comparison group infants were examined. No significant group differences in attachment status were found. When 3-month infant, maternal, and social/family characteristics were examined as potential predictors of insecure attachment, predictors interacted with diagnostic status. For the cleft group, infant and maternal characteristics, but not family characteristics, significantly predicted insecure attachment. For the comparison group, maternal and family characteristics, but not factors associated with the infant, were predictive. Infants with clefts, despite their special needs and caregiving requirements, seem not to have elevated risk for insecure attachments at the end of their first year. Contrary to social-psychological formulations, the facial appearance of infants with CLP had no adverse effect on the quality of their maternal attachment.