AASCIT Journal of Psychology 2015; 1(2): 14-32 Published online February 15, 2016 (http://www.aascit.org/journal/psychology) Keywords Cleft Lip and Palate, Psychosocial, Literature Review Received: November 18, 2015 Revised: December 31, 2015 Accepted: January 2, 2016 Psychosocial Impacts of Cleft: A Review of the Literature Wendy Nicholls 1 , Martin Persson 2 , Suzanne Robinson 3 , Linda A. Selvey 3 1 Dental Department/Cleft Lip and Palate Unit, Princess Margaret Hospital for Children, Perth, Australia 2 Centre for Appearance Research, University of West England, Frenchay Campus, Bristol, United Kingdom 3 School of Public Health, Curtin University, Perth, Australia Email address wendy.nicholls@health.wa.gov.au (W. Nicholls) Citation Wendy Nicholls, Martin Persson, Suzanne Robinson, Linda A. Selvey. Psychosocial Impacts of Cleft: A Review of the Literature. AASCIT Journal of Psychology. Vol. 1, No. 2, 2015, pp. 14-32. Abstract Background: A cleft of the lip and / or palate (CLP) is one of the most commonly occurring congenital conditions, with a global estimated incidence of 1 in 700 births. The long term care of patients with a cleft condition involves many years of multi- disciplinary therapy, treatment and surgical interventions at both fixed and varying time points. As well as the physical component of this complex condition, consideration must also be given to the emotional and psychosocial implications that may arise from this long term treatment commitment. Objectives: This review investigated the psychosocial impacts of cleft and recommended actions reported in the literature across three physical and psychologically significant developmental age cohorts. It sought to address questions of whether people with a cleft are at increased risk of developing psychosocial problems, what psychosocial problems are developed within each age group, and what recommendations and trialled interventions were indicated to address these problems. Results: Overall, the literature reports that the majority of children, adolescents and adults with CLP do not appear to experience major psychological disorders, however, they are at a higher risk of developing specific psychosocial problems in four key areas: self-esteem and self-worth; social inhibition and isolation; depression and anxiety, and appearance dissatisfaction. Conclusion: Results indicated an abundance of tools for attempting measurement of psychosocial problems with equally abundant recommendations for further verification study but very few definitive recommendations for intervention strategies or outcomes from trialled intervention strategies. 1. Introduction A cleft of the lip and / or palate (CLP) is one of the most commonly occurring congenital conditions, with a global estimated incidence of 1 in 700 births (Olasoji, Ukiri, & Yahaya, 2005). The long term care of patients with CLP involves many years of multi- disciplinary therapy, treatment and surgical interventions at both fixed and varying time points through the lifespan. The range of treatment issues include facial and palatal defects requiring reconstructive and revision plastic surgery; neonatal feeding problems requiring alternate practices of feeding, specialised equipment and pre-surgical appliances; speech and hearing abnormalities requiring ongoing therapy practices and surgery; tooth and jaw abnormalities and subsequent malocclusion requiring dental, orthodontic and oral surgery treatment and surgical interventions. As well as the physical component of this complex condition, consideration must also