Management of patients with non-syndromic clefts of the lip and/or palate part 3: from age 10 until adulthood

Just as at age 5, a series of audit records are undertaken at age 10 (Table 3, Part 1) including an assessment of speech, hearing and psychology, with parent and patient satisfaction and the outcome of alveolar bone grafting being recorded on the audit database.

The psychological health of children (and indeed their family) is crucial to overall health. As children begin early adolescence, they become more interested in their appearance. Body image concerns resulting from lip scars, abnormal dentofacial relationships and negative self-perception, in addition to speech problems and difficulties with hearing, can affect self-confidence and relationship building.1 Where there are any concerns about psychological well-being, psychological support and intervention may be necessary during childhood and adolescence and, on occasion, in adulthood as well to help the patient and family develop coping strategies. The transitions between these stages are often the times at which input from a clinical psychologist is most desirable as transitioning involves establishing new relationships, among other challenges. Unfortunately, in some geographic areas of the UK, clinical psychology services for cleft lip and palate care are poorly resourced. However, other members of the multidisciplinary team offer help and advice where possible.