Facial attractiveness and facial impairment ratings in children with craniofacial malformations

Objective: This study examined (1) the effects of type of malformation, sex of ratee, and sex of rater on facial attractiveness and facial impairment ratings, and (2) the reliability of judgments on facial attractiveness and facial impairment and the association between these two constructs. Setting: A university hospital for children. Participants: Raters were eight volunteers from the student population in a university, four men and four women. Main Outcome Measures: Raters judged frontal and lateral view slides of chi ldren with various types of craniofacial malformations both on a 5-point fa cial attractiveness scale and on a 5-point facial impairment scale. Results: Main effects were found for type of malformation, sex of ratee, an d sex of rater. No interaction effects were found among type of malformatio n, sex of ratee, and sex of rater. Interrater reliability was moderate to h igh, both for attractiveness ratings and for impairment ratings. The correl ation between facial attractiveness and facial impairment was also moderate to high. Conclusions: Both condition parameters (type of malformation) as well as so cial parameters (sex of rater and sex of ratee) seem to influence judgments on attractiveness and impairment. Facial attractiveness and facial impairm ent can be rated reliably in children with (cerebro)craniofacial dysplasias . Raters consider these concepts to be very similar but not identical.