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Objective The aim of this study was to describe coping strategies used by parents of children with cleft palate with or without a cleft (CP ± L) during the early development of their children in El Salvador.Design Qualitative interviews were completed with 16 parents of children born with CP ± L who were 6 months to 6 years old. Parents were questioned about their emotions and coping during eight time periods: prenatal, birth, social interaction before the first surgery, the beginning of surgeries, social interaction after the first surgery, early childhood education (ECE), speech–language therapy, and formal education. Thematic analysis (TA) was used to identify coping strategies as conceptualized by Lazarus and Folkman (1984).Results Four major themes emerged: (a) experienced emotions related to diagnosis, (b) interpretations related to the birth of a child with a cleft, (c) seeking and experiencing cleft treatment, and (d) social interaction of the children. During prenatal and birth stages, parents used emotion-focused strategies. A few hours to a week after birth, they used problem-focused strategies, which led them in search of treatment. Some parents used avoidance strategies during periods of social interaction before surgery, ECE, and formal education. Socioeconomic challenges impacted access to speech–language therapy. Sociocultural factors, such as discrimination, religion, and folk beliefs, appeared to influence some of the coping strategies used by parents.Conclusions Problem-focused strategies appear to be helpful in seeking surgical treatments. The emotion-focused strategy of avoidance seemed to have adverse effects in minimizing opportunities for social interaction prior to surgery and early education.

In this letter, the authors present archeological evidence of the presence of cleft lip and/or palate (CLP) in pre-Hispanic Mesoamerica. During years 2016 and 2017, the authors visited 5 anthropology museums in Mexico, Guatemala, and El Salvador, in search for pre-Hispanic archeological evidence of CLP, and 16 anthropomorphic figurines with evidence of CLP were identified; 9 at the Anahuacalli Museum, 6 at the National Anthropology Museum of Mexico, and 1 at the National Anthropology Museum of El Salvador. Fifteen of these ceramics originated from the shaft tombs (pre-Hispanic culture from western Mexico, Jalisco, Colima, and Nayarit; dating from 200 bc-600 ad), and 1 ceramic originated from the Cotzumalguapa (a pre-Hispanic culture from western El Salvador dating from 200 ad-900 ad).

In 1976, Paul Tessier provided a numerical classification system for rare facial clefts, numbered from 0 to 14. The Tessier 3 cleft is a rare facial cleft extending from the philtrum of the upper lip through the wing of the nostril, and reaches the medial canthus of the eye. The aim of this document was to describe a pre-Hispanic anthropomorphic figurine dating from the classic period (200 A.D.–900 A.D.), which has a Tessier 3 cleft. We also discuss the documented pre-Hispanic beliefs about facial clefts.