Psychological Perspectives
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Published: June 20, 2007
Updated: June 20, 2007
Since treatment will occur over significant portions of your child's life, the cleft palate team is dealing with a growing, changing youngster. As a member of the cleft palate team, the psychologist stands ready to offer assistance and constructive advice to help your family get through the rough spots.
Most of us expect to give birth to a healthy, normal baby; so it is only natural to be unhappy or shocked at the birth of a child with cleft. Strong feelings are normal. These feelings may persist, but most parents are effective in dealing with their unhappiness. Parents pull themselves together, become involved in caring for the baby, and try to do what is best for the child.
Still, dealing with the decisions and problems involved in cleft palate treatment means a considerable amount of stress for most parents. Despite the efforts of medical professionals to be supportive, the hospital, where surgery and other aspects of treatment will take place, can be a stressful location in and of itself. If you are having difficulty adjusting, consult the psychologist on your cleft palate team; that is what he or she is there for.
Doubts and Fears
At first, you are confronted with the cleft each time you look at your baby. You may be concerned about your baby's future. You may be afraid about what will happen, whether everything will be okay, and what is in store for your child. Almost all parents have these same questions and doubts. Keep in mind that clefts are repairable. Your aim and the goals of team treatment are the same; your child should become as normal as possible in appearance, speech, and functioning.
The prospect of surgery may spark further concerns or fear in parents. They are concerned about having their baby operated on, and it makes them unhappy to put the baby through it. More questions arise: How dangerous is the surgery? How painful will it be for the baby? What can parents do to help?
While all surgery involves some risk, in our experience babies tolerate the operation well. Since they are put to sleep for the surgery, no pain is experienced until after the operation. Then the pain is relatively mild and is easily controlled. You baby might experience discomfort for two to three days. During this time your child needs a lot of love and holding. That is one way you can help.
After surgery you can expect the process and schedule of feeding your baby to be changed because of the need to protect the surgical site. To prevent your child from putting his or her hands into the mouth, restraints are usually used. You should know that babies will have no memory of this experience and at this point they will not be afraid of doctors or hospitals.
In order to keep the tension and anxiety of this temporary period in perspective, let's take a look on the positive side. After these operations are over, and the surgery sites have healed, the parents of our patients invariably say they like the changes in their baby's appearance. Although they worried, and had their lives disrupted, they would go through it again to achieve the same result.
Continuing Treatment
Cleft palate treatment takes a long time because there may be several operations, orthodontic treatment, and speech therapy. At times, further treatment must wait until additional growth takes place. It is important for you to know what is happening and why, so that you can help your child understand the treatment process, why it takes so long, and why waiting for growth to be completed is so important. You can turn to the team psychologist and other team members for answers to your questions.
In addition to providing information, your cleft palate team is a source for human support. You will see team members a number of times and have a chance to get to know them as they work with your child. Because treatment takes so long, they get to know your child at different stages of development. The team follows many children all the way through adolescence. Since this human support can be important to our families, the team psychologist sometimes puts parents in touch with other families who have formed parent support groups, helping each other outside of the context of the hospital setting.
In a sense, you become a part of the cleft palate team when it comes to psychological perspectives and emotional support. Nothing will be more important to your child's happiness than the support and care he or she gets at home. In addition, during your child's early years of development, you are the chief source of information for team members. As your child grows older, it is important for him or her to provide necessary information. You can help your child with this process with your explanations and your understanding.
The Family as a Source of Support
Your child's cleft will be a part of his or her life experience; but how your child grows up and what he or she becomes during adolescence and adulthood will depend more on your child's relationships with you, with other family members, and with friends and schoolmates. Equally important are your family attitudes, and how your child is raised. Finally, your child's performance in school and social situations will continue to have an impact through adolescence and adulthood. For the most part, persons with repaired clefts become productive adults, although they may have problems, as most of us do.
In the long run, there is no evidence of emotional disturbances specifically associated with cleft palate. Moreover, children with cleft palate tend to perform at normal levels in their school work; about 90 percent graduate from high school. Still, it is clear that giving birth to a child with cleft will involve certain psychological and emotional stresses, not only for that child, but for parents and other family members as well.
You may be uncertain or have questions about what is happening to your child as he or she grows older. Team members will be able to help you or, if needed, send you to an appropriate source of help in your local community. The psychologist can assist you if you have questions about your child's behavior, academic progress, teasing in school, or frightening experiences. You can deal more effectively with situations if you have appropriate information. The psychologist and other team members are there for that purpose.
