Abstract
This study aimed to identify awareness about cleft lip and/or palate （CLP） in elementary school teachers, and to examine the difficulties they experience when working with such students. We conducted a cross-sectional study from September 2017 to January 2018 using self-administered anonymous questionnaires. The questionnaires and accompanying letters requesting participation were mailed to 6,000 elementary school teachers across 1,000 public elementary schools. Descriptive statistics were computed, and qualitative data were examined using the content analysis method suggested by Berelson. This study was approved by the ethics committee of our university. Responses were obtained from 412 teachers, of which 405 were used in the analysis after excluding incomplete or invalid responses. The average age of the teachers was 47.2 （SD＝8.9） years and the average number of years of experience was 23.3 （SD＝9.7） years. Participants correctly recognized that CLP was caused by complex interactions between co-occurring hereditary and environmental factors. Further, while they were aware that the prognosis of CLP was good, they regarded it as a disorder that caused problems related to appearance. With reference to concerns of students with CLP regarding school life, the teachers perceived that such students were concerned about their appearance, friendships, and pronunciation aspects. The difficulties experienced while teaching students with CLP were: Problems arising from unclear pronunciation; difficulties in responding to teasing/bullying; problems in the development of self-esteem; difficulties in explaining the disorder to other children; difficulties in responding to parents of students with CLP; need for consideration when swimming; need for mental-health follow-ups for students with CLP; difficulties in confirming the extent to which students with CLP understand their disorder; need for common understanding among faculty and staff; and being confused about CLP. These findings suggest the importance of shared understanding among parents and teachers regarding not only CLP-related educational needs, but also the status of children’s understanding of their disorder and measures to control teasing/bullying regarding CLP by other children.
