Observed social interaction patterns in adolescents with and without craniofacial conditions.

OBJECTIVE: This study examined social interactions of adolescents in a natural environment (school lunch room) to determine if there were identifiable differences in social behavior between children with and without craniofacial conditions (CFC).
DESIGN: This was an observational study comparing social interaction skills of children with CFC to peers without craniofacial conditions.
SETTING: The observations were conducted in the respective school lunch rooms of the adolescents with CFC. PARTICIPANTS: Clinical subjects were 13 adolescents (4 male) with various craniofacial conditions (5 cleft lip and palate) and 12 (4 male) peers without CFC present in the same lunch room. MAIN OUTCOME MEASURES: An unknown observer obtained 45 minutes of structured observational data on subject initiations, responses, nondirected comments, and extended conversations over two to three lunch room periods. Data was coded on the Epson HX-20 for type, frequency, and duration of social contact. Specific measures included: subject initiations and responses, peer initiations and responses, conversations events, and nondirected comments.
RESULTS: Statistically significant differences were found between CFC and comparison subjects (CS) on each social interaction variable measured. CS initiated more contacts, received positive responses more frequently, and engaged in longer conversations than CFC subjects ([F (1,24) = 14.1, p < .01; F (1,24) = 67.2, p < .001; F (1,24) = 5.50, p < .05]. CS were approached by and responded appropriately to peers more often [F (1,24) = 28.1, p < .001; F (1,24) = 43.2, p < .001]. Subjects with CFC were more likely to produce nondirected comments (N = 7, x = 0, p < .01).
CONCLUSIONS: A significant number of children with CFC behaved differently than their peers in a natural, daily occurring situation. They were often at the periphery of the group, observers rather than participants in conversation.