Journal of Plastic, Reconstructive & Aesthetic Surgery
Self- and parent-perceived stigmatisation in children and adolescents with congenital or acquired facial differences☆
Section snippets
Participants
Participants were recruited at University Children's Hospital in Zurich, Switzerland (n = 63) and at University Children's Hospital in Freiburg, Germany (n = 24). Inclusion criteria were as follows: (1) a visible facial burn scar, infantile haemangioma, port-wine stain or congenital melanocytic nevus, with a current size of at least 1 cm2; (2) age between 9 months and 16 years; (3) at least 6 months post-trauma for burn patients; (4) no wearing of a facial compression mask by day at the time of
Sample characteristics
Overall, data from 87 patients were collected (Mage = 6.17, SD = 4.66). In two of the 31 cases involving a child aged 7 years or more, only the child participated, whereas in three of those cases, only the parent participated. Therefore, the final tally was 85 parent reports; 29 self-reports from patients; and 29 self-reports from controls. Sample characteristics are summarised in Table 1, for preschool and school-age patients separately. In preschool patients, the majority of cases had a
Discussion
Overall, our results confirm our principal hypothesis that children with facial differences are at high risk for experiencing stigmatising behaviours, such as staring, startled reactions, teasing and expressions of pity. This is in-line with previous reports.9, 16 Even though teasing and making fun of are common experiences in school-age children, the comparison with matched controls demonstrates that individuals with facial differences experience more negative social behaviours than peers
Conclusions
Children and adolescents with a facial difference experience a variety of stigmatising behaviours, such as staring and teasing. Their risk of stigmatisation is greater than among non-disabled children and increases, the larger the facial difference and the older the child. Provision of care for children and adolescents with facial differences ideally includes psychosocial assistance.
Conflicts of interest statement
None of the authors has any interests to disclose. No outside funding were received.
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Meetings at which parts of this research has previously been presented:
1. Appearance Matters 4 Conference, Bristol, 23–26 June, 2010.
2. International Expert Meeting for Large CMN and Neurocutaneous Melanocytosis, Tubingen, 6–8 May, 2011.
3. 19. Jahrestagung des Arbeitskreises “Das schwer-brandverletzte Kind”, Stuttgart, 20–21 May, 2011.
4. 6th Word Congress on Paediatric Burns, Zurich, 20–23 August, 2011.