Low Self Esteem:
Society can sometimes have lower expectations, socially and intellectually, of someone who looks different. A pupil may have a low expectation of him/herself if he believes his peers or teachers have low expectations.
Teasing and Bullying:
A child born with a cleft may be subject to teasing and bullying because he or she looks or sounds different. He/she may find it harder to make friends and be a reluctant speaker in class or the playground, which may lead to withdrawal. Some children might be aggressive or disruptive to assert themselves. ^
Cleft children may need to be regularly absent from school to attend medical appointments or have surgery. This disrupts school life and creates pressures to keep up-to-date with work. Anxiety about being forgotten and left out by friends, and worries about what effect a change in appearance or speech due to surgery will have on how peers accept them, are common among cleft children.