{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:58:42Z","timestamp":1791593922768,"version":"4.3.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T00:00:00Z","timestamp":1446336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine family functioning related to sociodemographic and clinical characteristics in youth with cleft lip and\/or palate (CL\/P)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional, multi-site investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Six U.S. cleft centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients\/Participants<\/jats:title>\n                    <jats:p>A diverse sample of 1200 children with CL\/P and their parents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure<\/jats:title>\n                    <jats:p>Parents completed the Family Environment Scale (FES), which assesses three domains of family functioning: cohesion (or closeness), expressiveness (open expression of feelings), and conflict. Demographic and clinical characteristics were also assessed including race, ethnicity, type of insurance, and surgical recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The FES scores for families seeking team evaluations for their youth with CL\/P (mean age = 11.6 years) fall within the average range compared with normative samples. Families receiving surgical recommendations for their youth also had FES scores in the average range, yet families of children recommended for functional surgery reported greater cohesion, expressiveness, and less conflict compared with those recommended for aesthetic surgery ( P &lt; .05). For cohesion and expressiveness, significant main effects for race ( P = .012, P &lt; .0001, respectively) and ethnicity ( P = .004, P &lt; .0001, respectively) were found but not for their interaction. No significant differences were found on the conflict domain. Families with private insurance reported significantly greater cohesion ( P &lt; .001) and expressiveness ( P &lt; .001) than did families with public insurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Family functioning across domains was in the average range. However, observed differences by race, ethnicity, type of insurance, and surgical recommendation may warrant consideration in clinical management for patients and families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1597\/14-050","type":"journal-article","created":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T15:22:38Z","timestamp":1416324158000},"page":"651-659","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":30,"title":["Parent-Reported Family Functioning among Children with Cleft Lip\/Palate"],"prefix":"10.1177","volume":"52","author":[{"given":"Canice E.","family":"Crerand","sequence":"first","affiliation":[{"name":"Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital and Departments of Pediatrics and Plastic Surgery, The Ohio State University College of Medicine, Columbus, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Craniofacial Center, Departments of Surgery and Psychiatry, University of Illinois Medical Center at Chicago, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leanne","family":"Magee","sequence":"additional","affiliation":[{"name":"Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot B.","family":"Stein","sequence":"additional","affiliation":[{"name":"University of North Carolina Craniofacial Center & Department of Dental Ecology, Chapel Hill, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Wilson-Genderson","sequence":"additional","affiliation":[{"name":"Department of Public Health, Temple University, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary L.","family":"Broder","sequence":"additional","affiliation":[{"name":"Department of Cariology and Comprehensive Care, New York University College of Dentistry, New York, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,1,3]]},"reference":[{"key":"bibr1-14-050","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.10.002"},{"key":"bibr2-14-050","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsm083"},{"key":"bibr3-14-050","unstructured":"American Cleft Palate Craniofacial Association. 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