Discrepancies in Parent Perceptions and Patient-Reported Psychosocial Function in Children with Craniofacial Anomalies.

Abstract

Understanding and optimizing psychosocial functioning in children with craniofacial anomalies are essential components of their reconstructive care. This work compared parental perceptions to pediatric self-reported psychosocial functioning in children with craniofacial anomalies. Two hundred twenty-one children with craniofacial anomalies (aged 8 to 17 years) and their parents were prospectively evaluated at two institutions using the parent-proxy and pediatric Patient-Reported Outcomes Measurement Information System to assess anger, anxiety, depression, and peer relationships. Children were stratified into three age groups: group A, 8 to 10 years; group B, 11 to 13 years; and group C, 14 to 17 years. Pearson correlations, analyses of variance with post hoc comparisons under the Tukey criterion, and paired samples t tests were performed. When stratified by age, no correlations between parent and child reports were found in anxiety for group A and anger, anxiety, and peer relationships for group C. Whereas group A reported the worst psychosocial functioning, group C parents perceived their children to have the worst psychosocial functioning. Group A parents perceived lower depression and better peer relationships, whereas group C parents perceived higher anxiety and depression compared to self-reports. Parents perceived an inverse relationship between age and psychosocial functioning compared to self-reports by children with craniofacial anomalies. These discrepancies in the current work highlight the importance of child self-report and suggest incorporating longitudinal patient-reported and parent-proxy-reported outcomes measures for psychosocial functioning as part of standard clinical care for patients with craniofacial anomalies.