| 05 Novembre 2016
The Cleft Palate-Craniofacial Journal – It is natural for adults to focus their attention on a child who has a  chronic disease or disability, but what happens to the siblings of that  child? Research on chronic disease and disability has shown that  unaffected children often have poorer psychological functioning as a  result of their affected sibling’s condition. Children born with a cleft  lip and/or palate (CL/P) will experience surgeries, frequent doctor  visits, and therapy as a result of this condition; however, in  supporting these children through the process, their parents often  unintentionally overlook the siblings. To explore the effects of CL/P treatment on all family members, the authors of an article published in the The Cleft Palate-Craniofacial Journal detailed  their in-depth interviews with five siblings and eight parents of  children born with CL/P. Siblings had an average age of 17 years and the  parents 48 years. The authors found that unaffected siblings had a wide  range of reactions to dealing with their affected sibling’s condition.  Some children felt obligated to take on a protector role and often more  responsibility for the affected child, whereas others demonstrated an  attention-seeking behavior because they felt neglected. There were also  children who suffered from stress and anxiety about not knowing the  details of the condition and its treatment. During  these interviews, the authors were able to gain the perspective of how  the siblings coped with the stress of having an affected family member;  the parents were also able to realize and comment about their unaffected  child’s struggles. The interviews revealed that the more information  given to the unaffected child, the more help this provided to his or her  overall understanding. In addition, interviews revealed that having a  stronger support network for siblings within the CL/P community would  help to relieve some anxiety surrounding the situation. Author  Nicola Stock commented, “The study provided insight into a population  that is often overlooked in the context of cleft care, and highlighted a  number of practical solutions, both within the clinical setting and  within the cleft community. Above all, the study demonstrated that an  inclusive approach to health care, which is encompassing all members of  the family, is essential for optimal familial adjustment. As well as  ‘normalizing’ the process for siblings and reducing distress, being  involved in the treatment process may empower them to learn about cleft,  to feel included, and to report positive consequences of growing up in  an affected family.” Overall,  it was noted that sibling rivalry is very common among nearly all  children vying for adult attention, but it is greatly intensified when  one child has a condition that demands extra attention. However, with  proper knowledge and support, the family as a whole will have a more  positive experience that can potentially bring them closer together. Full text of the article, “The Psychosocial Impact of Cleft Lip and/or Palate on Unaffected Sibling,” The Cleft Palate–Craniofacial Journal, Vol. 53, No. 6, 2016, is available at http://www.cpcjournal.org/doi/full/10.1597/15-148.