Social Interactions of School-Aged Children With CFA: Mothers' Perspectives and Advice

Objective: To learn about (1) mothers' perspectives on their children's social experiences and (2) how mothers interpret social situations and provide guidance to their children in challenging situations. Design: This was a qualitative study analyzing narratives. Mothers participated in a semistructured interview; mothers and their children participated in a social coaching task involving responses to hypothetical situations. Transcripts of audio recordings were used to create thematic coding categories, and transcripts were reviewed and coded. Setting: Children were patients at a reconstructive plastic surgery center in an urban hospital and medical school; families were recruited from a regional support group associated with the hospital. Participants: Mothers of nine children with congenital craniofacial anomalies, aged 9 to 14 years. Main Outcome Measures: Thematic narrative coding categories, focusing on mothers' perspectives on children's actual social experiences (from the interview) and mothers' advice and interpretations regarding challenging hypothetical social tasks (from the coaching task). Results: In the interviews, mothers reported positive and negative social experiences for their children. Multiple approaches were used by mothers to interpret social interactions experienced by children (interview) and hypothetical social situations (coaching task). These included consideration of situational factors, motivations of others, and factors within own child. Mothers' hypothetical advice was often prosocial, including concrete strategies to resolve conflict, to plan ways to avoid problems, to foster self-reliance, and to avoid hurtful situations. Conclusions: Mothers showed active interest and concern in their children's peer relationships and were thoughtful in devising strategies to successfully manage potential social challenges.