You'll find hundreds of files on cleft lip, cleft palate here on

This one is about: Oh-Oh...Problems


(c) 1996 Wide Smiles
This Document is from WideSmiles Website -
Reprint in whole or in part, with out written permission from Wide Smiles
is prohibited. Email:

by Joanne Green

Some children harbor "sleepers". They go along in life, and for all intents and purposes, everything seems fine. They seem to be very well adjusted. They make friends, They do well in school. And they seem to be happy most of the time - and indeed, they are. But deep inside of them, growing and developing through a long and silent hibernation. And then all at once, the monster awakens. And our well-adjusted angel is tormented as though by demons!

There are many weather-worn parents who caution that the awakening of the monster is a normal (albeit difficult) part of growing up. It is the child's adult self reaching for independence. But when our kids are also dealing with cleft-related issues - combined with non-cleft-related issues - sometimes the monster stirs a little sooner or a little more formidably than usual.

One mother shares her experience:

The family had recently moved from one state to another. Shortly afterward her pre-teen son had an Abbey-Flap procedure done (a procedure in which tissue is moved from the lower lip to the upper lip in order to release tightness of the upper lip), and was "zooming into orthodontia". The move meant more changes for her son than simply a change of communities. The philosophy of the cleft team in the new setting was very different from that of the earlier team. The boy was at a stand still awaiting an upper jaw advancement and then a pharyngeal flap.

Worst of all, her son began to have problems controlling his temper as it related to his cleft and his adoption (the boy, who is ethnically different from his family, was adopted as an infant.) Evidently, after a seemingly well-adjusted early childhood, his monster had begun to stir. His mother sought out support and counseling for him, but the problems continued. Her son was going through a lot of changes in his life at a very difficult age. The move, the change of friends, the change in schools, the new neighborhood etc, each represented a new and oftentimes difficult adjustment.

The change in medical teams, and their differences in approach must must have had an unsettling effect. After all, he implicitly trusted the doctors that had provided his care throughout his life thus far, and now he must trust new doctors. But the new doctors do not agree with the opinions of the old doctors. In his mind he must have been confronting a very great confusion, and maybe a feeling of either having been mistreated by the first doctors or of being mistreated by the current ones.

The Abbey Flap procedure probably resulted in a slightly different look for him, which again, was an adjustment for him. He was not only adjusting to the new faces around him, but he saw a slightly new face in the mirror as well.

Our kids often cannot articulate what it is that makes them feel so angry, frustrated, confused or scared. They just feel it - and most do not have the obvious issues that that young man had. They try to make up an explanation for their feelings that fits for them, and so they lash out at all the wrong things for all the wrong reasons.

What can we do when the sleeping monster begins to stir? First, a child needs to feel safe to talk about the things that bother him. This can take place with a parent, a teacher, a counselor or anyone the child feels he can trust, and with whom he can speak openly and without fear of judgment. As he talks, he will discover that the things he says make him mad really aren't the things that cause his anger. They are only the most convenient targets.

He also has to find a constructive outlet for his anger. Can he build a play house, for instance? There's nothing like pounding a few nails to vent some unexpressed anger! Other things that work, depending on the child, are a trip to the batting cage, modeling clay, hand puppets, etc. Kids work their anger out in play. It works wonders.

Finally, he has to carve his niche. He needs to find an arena in which he feels comfortable and valued. For some it can be the Scouts. Or it could be a church youth program or intramural sports. Whatever it is, he needs to find something he can relate to where he can feel successful and participate as a valued member. Not everything that looks like a good choice is going to work for every child. Let the child discover his niche himself, out of his own interests.

Meeting and talking with other cleft-affected kids will help to strengthen him as well. It is most important for kids to feel "not different" among their peers. A support group of cleft-affected peers can do much to provide the troubled child with a forum for discussing feelings and problems that can only be understood by those with whom it is a shared experience.

It is important that we recognize the earliest stages of the awakening of the sleeping monster in our kids. Usually it takes the form of acting out, fighting, or sullenness. Early prevention is far preferable to later intervention. After all, when the monster is fully awakened in a confused and angry teen, the problems take on a whole new dimension that we would most rather avoid if possible - not only for our own sakes, but for the sake of our child as well.

-----------------Joanne Green is the mother of three cleft-affected children. She is also the Editor of WIDE SMILES Magazine.

Wide Smiles depends on donations to continue to provide this resource for you.
Please help keep us online!

Cleft Links | Wide Smiles | Photo Gallery