Highlights

What are the main findings?

Both non-cleft and cleft participants could distinguish facial differences in 3D images of children with and without cleft lip and palate (CLP).
While non-cleft participants rated non-cleft images more positively for appearance, no significant difference was found in social interaction ratings between the two groups.

What are the implications of the main findings?

This study suggests that for early adolescents in Taiwan, appearance alone may not be a major factor affecting social interactions for children who have undergone CLP reconstructive surgery.
The findings imply that other factors, such as pronunciation difficulties or low self-confidence, may be more significant contributors to social difficulties experienced by children with CLP.

Abstract
Background: This study explored how Taiwanese schoolchildren perceive the appearance of their peers with and without cleft lip and palate (CLP) and whether this perception affects social interactions. We specifically focused on early adolescents with surgically repaired CLP to assess the impact of residual craniofacial deformities. Methods: A cross-sectional design was used, analyzing three-dimensional (3D) surface images of twenty patients with repaired CLP and five without. A total of 91 schoolchildren (40 with CLP, 51 without) served as raters. Participants used a Likert scale to rate images on facial appearance and perceived social acceptance. The study also measured the reliability of its questionnaires using Cronbach’s alpha. Results: All participants successfully differentiated between images of children with and without CLP, though non-cleft participants had significantly better distinguishing abilities. Non-cleft raters consistently gave more positive appearance ratings to non-cleft images, a pattern less evident among cleft raters. While differences in awareness and acceptance between the two groups were not statistically significant, over half of all responses regarding social interaction were neutral. The questionnaires demonstrated high reliability, with Cronbach’s alpha values greater than 0.85. Conclusions: Despite the ability to perceive residual craniofacial differences, appearance alone did not significantly affect social interactions for early adolescent children with surgically repaired CLP in Taiwan. This suggests that other factors may play a larger role in social dynamics within this population.