Children with craniofacial disorders have increased incidence of anxiety, withdrawal and social competence problems, but they tend to rate their own appearance more positivity than it is rated by others. Some may learn to cope with facial impairment by minimizing it an developing compensatory behavior. Direct observations of these children reveal social interactions that differ significantly from peers. Other data suggest they have impaired ability to communicate emotion through facial expressions. This study will employ: (1) microanalytic direct observation methods, and (2) computer-automated recognition of facial expressions to quantify the social and facial behavior of 8 to 16 year-old subjects videotaped during: (1) an analogue social interaction with a confederate peer, and (2) a structured facial encoding task. Results will be compared across matched Craniofacial (oral cleft and craniosynostosis). Non-facial (short stature), and Normal Control groups. Within-group comparisons will examine ow subjects with positive self-perceptions differ from those with comparable physical impairments and average or negative self-perceptions. Differences in self ratings of appearance and self-concept are expected to be significantly correlated with observable differences in social behavior. Craniofacial subjects (particularly those with oral clefts) are expected to evidence impaired ability to encode emotion through facial expressions. Some differences in social and facial behavior may reflect compensatory behavior developed by those who are better-adjusted and more socially competent, which could be taught those who are less competent. If differences in ability to generate facial expression are found in subjects with craniofacial disorders, and associated with impaired social competence, the results may lead to assessment techniques for detecting subtle but clinically significant facial dysfunction. Some may be amenable to surgical correction, others to behavioral intervention (e.g. response shaping with reinforcement contingencies or biofeedback training of facial muscles). Such intervention could be tested by subsequent demonstration projects. The combined results will provide an empirical basis for selecting specific skills to be taught in future prospective interventions for children with craniofacial disorders.
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