Face-to-face interaction between infants with orofacial clefts and their mothers.

Compared mother-infant face-to-face (en face) interaction among 3-month-old infants with cleft lip and palate (CLP), infants with isolated cleft palate (CP), or nonimpaired infants (NI). The Monadic Phase system (Tronick, Als, & Brazelton, 1980) was used to describe patterns of laboratory en face interaction in 116 mother-infant dyads. Diagnostic group comparisons of percentages of monadic phases and infant-mother monadic phase sequences revealed more similarities than differences. However, CP group mothers appeared less involved in en face interaction than mothers in the CLP group. Low maternal involvement in the combined cleft groups was predicted by concurrent measures of infant characteristics including infant negative reactivity, whereas low maternal involvement in the comparison group was predicted by maternal characteristics including low psychological distress. There was little evidence to suggest that anomalous facial appearance is a significant factor influencing the quality of early mother-infant interaction. Assessing other characteristics of the infant and the broader social context is also important.