Baird et al (2006) suggest that Autistic Spectrum Conditions (ASC) affect approximately 1 % of UK students. Nearly three-quarters of students with ASC attend mainstream school provision (DfE, 2012). The research explores perceptions of provision for ASC in mainstream schools. The research involved a 20% sample (36) of the total population of students who attended primary and secondary mainstream schools in the LA and who had a diagnosis of ASC. Students were placed at school action plus on the Special Educational Needs Code of Practice (DfES, 2001 ) or had a statement of special educational needs. This sample was drawn from both primary and secondary schools. This exploratory research is innovative in that attempts were made to secure both a geographical spread in the sample and a wide range of student needs. Semi-structured interviews allowed students, their parents and mainstream school staff to share perceptions of school. A mixed methods approach is adopted and both qualitative and quantitative data was collected and is discussed. Research findings indicated that students typically wanted a little more help in school. Those that wished for less help were often motivated by wishing to be seen as more independent. Students were often able to identify challenging areas of school life and frequently rated these areas as “very difficult” suggesting they caused anxiety. Typically, curriculum areas were rated as causing much more difficulty by students than social factors. Written recording was noted as a challenging feature of school. Parents appeared less concerned about curriculum difficulties compared to their children. The research identifies how some students do not always welcome help from peers and adults in school, preferring to be asked about whether they want help. Some students identified sensory issues, specifically noise, as causing difficulties. Noise made by other people was specified as challenging. The provision of a quiet area and the use of key visuals were identified as supportive by both students and staff. All staff using interventions to address emotions, for example, opportunities for students to discuss worries, reported that these were effective interventions. A high proportion of staff felt that ASC strategies are beneficial to students without ASC. Several parents valued Teacher Assistant support. They believed a good understanding of the individual was vital to including their child in school as was differentiation of response. They felt that lack of flexibility, poor communication with school or the approach adopted by certain staff could be a barrier. Parents were concerned about bullying, teasing and social issues, to a much greater degree than were their children. Some parents felt that research involving students with ASC at school should also consider the home environments. Staff and parents mentioned a good inclusive school ethos and flexible support as helpful. This research is original in considering the complexities of insider research as experienced by an Educational Psychologist researching school staff and parental views. The findings are discussed using conceptual frameworks of inclusion, child voice, Theory of Mind and a reconsideration of Maslow’s Hierarchy of Needs (1943). This research argues that safety needs are magnified as key motivators for those with ASC.

Fostering religious commitment in schools and considering children’s cultural diversity arguably enhances pupils’ tolerance and integration, which may have the potential to reduce racism and discrimination. Faith schools are religiously and culturally diverse institutions and typically appreciated for their core values, good behaviour and academic standards. However, their impact on school culture and ethos is under explored. Although, the role of faith has gained attention both in policy and practice, relatively little is known about its impact in the context of primary education. As such, this research explores the complex influence of faith on school culture and ethos. In addition, critical analysis is undertaken to investigate the impact of faith on pupils’ behaviour and understanding in school. The main research aims are to: explore the multiple ways in which faith is manifested in two schools, determine the influence of faith on school culture and ethos, and establish the impact of faith on pupils’ behaviours and understanding in school. This research takes an ethnographic approach to explore how faith is manifested in two primary schools in the North West of England. The ethnography enabled a deeper immersion in to the school culture as data were generated through observations, interviews, focus groups and documentary analysis in two schools: A denomination school, Church of England, and a community school with an Islamic ethos. The research was conducted in the North West of England which has many diverse faith-based schools. Critical Race and Feminist Theories were used as lenses of analysis to examine faith in school. Critical Race Theory is a framework employed to examine the role of race and power in education. This research provides rich ethnographic description and analysis of faith as understood, practiced and experienced in the two schools. The findings reveal two major themes, first, a mismatch between school policy/values and its practice. Second, a lack of integration of staff and children into the school. Despite schools’ efforts to embrace diversity and encourage integration, schools policies were found to be empty rhetoric with regards to fostering religious commitment and cultural diversity. Exploring the issue of recognising cultural diversity within schools, findings indicated that both schools did not acknowledge or teach other cultural traditions, therefore, impacting on issues of integration. Poor behaviour, bullying and racism amongst children were major issues at both schools. Data analysis suggests the source of misbehaviour was due to the lack of emphasis placed on teaching about different religions, insufficient knowledge of cultural traditions and lack of visits to places of worship. This research concludes that there is a need for schools to develop awareness of religions and cultural diversity; thereby, encouraging integration, community cohesion and respect for similarities and differences.

Despite reports that people with learning disabilities (PWLD) are more vulnerable to being bullied than the non-LD population, there is a paucity of research into bullying of PWLD. Semi-structured interviews were conducted with 20 adults with LD, using bullying vignettes, to explore how PWLD understand bullying; their knowledge of coping strategies for dealing with bullying; and what PWLD understand the consequences of bullying to be. Interview data was analysed using thematic analysis and categorised into four super-ordinate themes; Bullying is a bad thing; Reasons for the bullying; Coping strategies; and Consequences of own bullying experiences. The findings are discussed in relation to attribution theory (Heider, 1958) and socio-moral reasoning theory (Gibbs, 1979; 2003). Recommendations for clinicians working with PWLD involved in bullying are made; including considering the application of the concept of the “provocative-victim” (Sheard, Clegg, Standen, & Cromby, 2001); exploring how individual’s understanding of bullying experiences in terms of attributions made and socio-moral reasoning; exploring coping strategies and addressing aggressive or avoidance-based strategies, and consequences of bullying such as social and psychological problems. Recommendations are made for future research with larger, more representative samples.

Psychological research into bullying has highlighted the importance of considering the role of bystanders within this complex social interaction (see literature review). The aim of this paper was to apply this research to develop an anti-bullying intervention programme that increases pro-defending attitudes and behaviour, and consequently reduces bullying. The methodology was a design experiment; in this first iteration, the intervention programme was designed, implemented, and evaluated in collaboration with staff and students at a secondary school. Data were collected using a mixed methods approach via questionnaires, focus groups, an interview, and observation. The results showed that there was no significant difference in prevalence estimates of defending or bullying pre and post intervention. However, two thirds of participants reported that their attitudes and behaviour had become more supportive of defending victims since the intervention. Qualitative data revealed a diversity of perspectives regarding the effects and value of the programme. A model outlining factors that influence decisions to defend a victim of bullying was developed from the results and previous literature. The findings from this paper were used to inform modifications to the design of the intervention programme for implementation in the second iteration in paper 2.

This thesis examines the figure of the wandering adolescent, prominently visible in Japanese television anime and videogames produced from 1995 to the present. Japan in the 1990s and at the millennium experienced intense economic and social change, as the collapse of the ‘bubble’ economy of the 1980s resulted in a financial recession from which the country has yet to recover. At the close of the decade, the national experience was characterised in media descriptions of malaise and disenfranchisement, and the loss of perceived core traditional cultural values. Arguably in this period the figure of the adolescent changed qualitatively in Japanese culture, rising to prominence within youth panic discourses circulated by the Japanese news media. These concerned the perceived rise in antisocial and problematic teenage behaviour, including the otaku, the hikikomori shut-in, classroom disobedience, bullying, and prostitution, while multiple cases of brutal murder perpetrated by teenagers became the focus of extensive media coverage. Public discourse expressed alarm at the perceived breakdown of the traditional family and the growing commodification of childhood in Japanese culture. This thesis develops understanding of the shifting attitude in Japan towards adolescence within the context of these cultural anxieties, and through the analysis of anime and videogames suggests strategies that are at work within popular cultural texts that are the product of, contribute to and reorient debates about the position of the suddenly and inescapably visible teenager in Japanese society. Through analysis of discourses relating to the shifting representation of the wandering adolescent as it moves across cultural texts and media forms, the thesis forms an original contribution to knowledge and understanding of Japanese anime and videogames through illumination of a prominent motif that to date remains unexamined.

This thesis addressed the bystander intervention gap in the workplace bullying literature. Bystanders are employees, other than the bully or target, who are present when bullying occurs. They are well placed to intervene but often they do not. Previous research suggested that increased bystander intervention may lead to a reduction in workplace bullying. Although suggestions for bystander intervention in workplace bullying were found in the literature none had been implemented or measured. As field research this thesis addressed a real-world problem. The participating employees were from a large, mainland UK organisation where workplace verbal bullying had been identified as a problem. Therefore a strategy for bystander intervention in workplace verbal bullying was designed, implemented and measured. The new Responsible Intervention Decision Strategy (RIDS)model combined existing theories on the bystanders’ decision process and responsibility to support bystander intervention. This quantitative study developed and validated a new 15 item Responsible Bystander Intervention in Verbal Bullying (RBI-VB) metric. The concise metric was incorporated into a practical, single-page survey to test the RIDS model in the field. Shop-floor employees participated in pre and post-intervention surveys (N = 1501) and one of four conditions. The RBI-VB metric demonstrated that responsible bystander intervention was positively correlated to bystander willingness to intervene in workplace verbal bullying. This could be increased with RIDS-based training or the in-house campaign; and was positively correlated to self-reported bystander intervention. The study is limited as it took place within a single UK organisation. However, the findings demonstrated the efficacy of the RIDS model and the practical application of the RBI-VB metric for baseline measurements, monitoring and to assess bystander intervention programmes. Willingness to intervene can be increased and this relates to actual intervention but most bystander intervention was carried out by previous targets of workplace verbal bullying. The implications are discussed.

Positioning itself within policy debates on the best way to deal with disputes in UK workplaces and the (potential) resultant increased interest in mediation, this thesis draws on literature from law, philosophy, psychology and management to add to the growing, but largely theoretically-underdeveloped research on workplace mediation. In this research, mediation refers to a voluntary and confidential process where parties to dispute seek a mutually agreed outcome. This process is facilitated by an impartial third-party mediator. The research offers an empirically-informed theoretical framework exploring the extent to which the use of mediation to deal with bullying and harassment is appropriate. In asking whether mediation is appropriate, it argues that it is necessary to consider whether its use is not only feasible but also fair. Using Rawls’s (2001) theory of justice as fairness to structure the discussion and focusing on cases involving sex, race and sexual orientation it constructs an argument for the use of fairness as a guiding concern for an understanding of mediation grounded in an appreciation of public values and notions of social cooperation. It explores tensions between the nature of mediation and of bullying and harassment to question the extent to which an emphasis on cost/efficiency and empowerment in mediation rhetoric may obscure questions of the privatisation and individualisation of systemic and structural problems. Within this discussion theoretical and practical questions are identified and are then explored through the use of a mixed method research design comprised of a small-scale questionnaire (N=108), interviews (N=20) and focus groups (Four groups, N=16). Samples were purposively recruited and consisted of those over 18 years old with six month’s work experience in a UK workplace (questionnaire/focus groups) and external workplace mediators (interviews). Answers to the questions are offered in the form of a framework comprised of a theoretical model and a practically-orientated schematic. It is argued that the reconciliation of potential conflicts between mediation and bullying and harassment are found in a greater understanding of the way mediation operates in practice. This understanding is guided by an appreciation that different standards of reasonableness apply to different behaviours and that individuals, organisations and the courts have differing levels of responsibility for setting and upholding these standards. In meeting this responsibility it is important an organisation is seen as a party to the mediation process since a threat to fairness arises not from privatisation per se but from a personalisation of problems of organisational and/or societal significance. Rather than reject the use of mediation in such situations it suggests the notion of ‘tailored privatisation’ offering a compromise between the concerns of privatisation and the purported benefits of mediation.

This thesis considers how sexual and romantic relationships between academic faculty and students in higher education are governed. Using analytic techniques drawn from Foucault and discursive psychology to interpret a corpus of texts, which includes policy documents, interview transcripts, fictional accounts, newspaper articles, and computer mediated discourse, I explore how five discourses are mobilized to frame faculty student relationships. I find that harassment discourse, which emerges as the dominant frame of reference in scholarly accounts, is taken up less readily in the accounts studied here. Rather, discourses foregrounding four alternative, but often imbricated, themes are more extensively mobilized: infantilization; religiosity; health, safety, and hygiene; and professionalism. These discourses reinforce elements of the truth claims propounded by harassment discourses; notably, their gendered and heterosexist assumptions, and their insertion of a gap between academic and student, albeit one configured along subtly different lines. However, they also challenge them, positing alternative claims to truth, recasting the subject positions of academic and student, and re-orienting relations between the two. For example, infantilization discourses construct faculty-student relationships as a horrific relation between adult or parent and child which must be monitored, whereas religious discourses construct a pastor-flock relation, articulating relationships as a temptation to be resisted or atoned for. The thesis offers contributions to research on faculty-student relationships per se, and is also understood as opening up analysis of organizational sexuality and the university more generally by arguing for the usefulness of a government approach to these phenomena.

Over the past forty years the topic of bullying has generated considerable research interest. Schools spend a large amount of their budgets on interventions designed to reduce the incidence of bullying and to promote prosocial behaviours (Viding, McCrory, Blakemore and Frederickson, 2011). Nationwide initiatives such as the Social and Emotional Aspects of Learning (SEAL) curriculum (DfE, 2005) have been widely implemented across schools in the United Kingdom with a view to increasing social and emotional competence and reducing bullying. Despite this, bullying remains a prominent concern and anti-bullying interventions do not always seem to lead to a significant decrease in bullying behaviour (Salmivalli, Kaukiainen & Voeten, 2005). Although much of the bullying research has focused primarily on bullies and victims it seems more widely accepted now that bullying is a group process which happens within a social context. More recent studies have looked at the other roles that children can adopt in a bullying situation such as defender, reinforcer, assistant and outsider (Salmivalli, 1996), however research in this areas is relatively limited to date. Existing research is largely quantitative in design and is considerably reliant on fixed response questionnaires. The current study looks at defending in particular and explores the factors associated with children’s expressed intentions to defend. Due to complexities involved in operationalising bullying as a construct, the focus of this study is on unkind behaviour rather than bullying. A mixed methods approach is used incorporating both qualitative and quantitative methodologies. 113 upper Key Stage 2 children (66 boys and 47 girls) from two schools in the south east of England completed questionnaires designed to assess behavioural tendencies in relation to unkindness, friendship quality, social group structure and attitudes towards unkind behaviour. Paired interviews were conducted with 32 children (17 girls and 15 boys). Correlation, regression and thematic analyses were used to explore factors seemingly associated with defending. Results are discussed in light of existing literature on defending along with implications for the professional practice of Educational Psychologists (EPs).

Co-location involves the physical placement of two schools onto one site. By some it is seen as a ‘compromise policy’ which prevents inclusion, whilst other authors argue that it offers ‘the best of both worlds’ in allowing pupils with special needs to access both mainstream and special school environments. The teacher-research presented here focused on the co-location of a special school with a mainstream secondary school. It used formal interviews and questionnaires to explore the attitudes of staff and parents towards the co-location and a ‘mosaic’ (Clark and Moss, 2001, p.1) of child-friendly methods to access the opinions of pupils from both schools. The research also included case studies of two co-located special schools which further explored the concept of co-location and considered the relationship of co-location to broader literature relating to the educational placement and inclusion of children with special needs. The research discovered that participants from the mainstream school were generally less concerned about the co-location than the special school participants. Participants from the special school were concerned about bullying, inequality and educational failure as a result of the co-location. Participants from all groups spoke with enthusiasm about the potential of the co-location to deconstruct prejudices and offer staff and pupils opportunities to learn together. The research concludes that co-located schools can be ‘autonomous’ and joined only by their physical placement on the same site, or that the schools can become ‘collaborative’ and work together to offer a unique inclusive learning environment.

Research exploring the psychological consequences of workplace bullying has demonstrated that exposure to bullying may have devastating effects on the health and well-being of those who experience it. However, the nature of this relationship remains virtually unknown and there is an increasing call for researchers to undertake a more interpretive and individualised orientation to the bullying phenomenon. There is little research into workplace bullying from a counselling psychology perspective and yet research developing therapeutic guidelines for models of intervention with targets of workplace bullying is essential given the impact of bullying upon psychological health. The current study therefore aims to consider the therapeutic needs’ of targets of workplace bullying by exploring how targets make sense of and give meaning to their experiences. It is hoped that this will provide insights into the ways in which workplace bullying can have detrimental psychological effects and point to potential interventions that may be utilised when working therapeutically with targets of workplace bullying. Using interpretative phenomenological analysis, the current study explores in-depth the experiences of eight self-labelled targets of workplace bullying. Semi-structured interviews were undertaken to explore: how participants have experienced workplace bullying, how they have made sense of their experience, how they perceive effects on their psychological health, how they might explain such effects, and how they have coped with their experience. The findings comprise of four superordinate themes: ‘Bullying as a Powerful Experience’, ‘Psychological Consequences of Workplace Bullying’, ‘Impact of Workplace Bullying on Identity’ and ‘Coping with the Experience of Being Bullied’. These support the conceptualisation of workplace bullying as a traumatic experience with devastating impacts upon targets ‘ sense of self. A rich description of the participants’ experiences of psychological distress following being bullied at work is presented and discussed. Implications and applications for the clinical practice of counselling psychology are subsequently highlighted.

Children with language impairment (LI) can experience a wide range of social and emotional difficulties in addition to linguistic difficulties, but there is limited understanding about how LI impacts on these broader, psychosocial aspects of children’s lives. Furthermore, psychosocial outcomes for children are not assessed routinely in speech and language therapy research and practice. Studies of experiences of disability and impairment in other areas have highlighted the importance of addressing the psychosocial beyond the medical. This study draws on interpretive phenomenological analysis (IPA) to explore children’s, parents’, peers’ and professionals’ experiences of children’s LI. Using a phenomenological methodology to explore LI from multiple-perspectives, the study sought to uncover psychosocial features of LI and identify goals for support. Four children, aged 8-10 yrs with a diagnosis of LI, were interviewed about their experiences using arts-based methods. Children’s parents, teachers, learning support assistants, speech and language therapists and siblings and/or friends were also interviewed. Analysis of the 22 interviews is presented as four case studies that include each perspective around the child. Themes were identified through coding and analysing within and across cases. A second stage literature review was undertaken to understand, theorise and discuss emerging themes. Analysis revealed three themes: Agency, Understandings and Misunderstandings, and Making Sense of Difference. Children’s experiences of agency were associated with their emotions and their engagement in classroom and social activities, and not always dependent on their communication abilities. Children with LI often had different understandings of others’ intentions, situations and instructions to that of their peers, professionals and parents. Mismatches in understandings were associated with children being considered unusual, immature, egocentric or rude by others, impacting on their risk for bullying and social exclusion. There were divergent experiences and understanding of LI. Interpretations included impaired speech, language and social communication; social and emotional immaturity; parental neglect; and other people’s attitudes and behaviours. For children, LI was predominantly relational, that is, it was mainly experienced in relationship with others. Psychosocial goals for intervention include addressing attitudes, understandings and behaviours of professionals and peers towards children, in addition to children’s understanding and use of language; promoting children’s experience of agency; and addressing children’s emotional wellbeing and risk for bullying. Good communication and understanding between children, families and professionals is essential for intervention.

The aetiology and impact of inappropriate behaviour in Malaysia is not well understood. This study was designed to explore inappropriate behaviour at work in Malaysia among health care employees. In this research, inappropriate behaviour was defined as harassment, bullying or mobbing, according to the definitions from the Equality Commission for Northern Ireland and Labour Relations Agency (2006). The research was conducted in three stages: an explanatory study; a large-scale quantitative survey; and an interview-based qualitative study. Results indicated that 42.6% of employees experience inappropriate behaviour in the.workplace. The inappropriate behaviour perpetrators are both superiors and co-workers, but the pattern of findings suggests that there is no association between demographics and the reports of inappropriate behaviour. This suggests that inappropriate behaviour occurs throughout the workforce. However, there was little variation in ethnicity in the sample, so conclusions about this variable are tenuous. When compared to participants who had not experienced harassment, those who did were less satisfied with the support provided by the organisation in this situation and were less satisfied at work, according to scores on the Job Satisfaction Scale (JSS). Additionally, the research suggests that the factor structure of the JSS may not be appropriate in a Malaysian sample and an alternative factor structure is proposed. In the final qualitative study, participants from different professions expressed feelings of frustration at their experiences of inappropriate behaviour and a sense of helplessness/hopelessness that anything could be done to remedy this situation. Consequently, participants found themselves in a situation where they felt forced to tolerate the inappropriate behaviour because they feared the adverse consequences of making a complaint about their experiences. Overall, these findings contribute to an awareness of inappropriate behaviour at work, its enablers and its consequences in a culturally diverse, non-Western society.

This study analyses ‘Gifted and Talented’ (‘G&T’) identities in post-16 education, exploring ‘G&T’ identity construction processes and how students manage ‘G&T’ identities once labelled as such. Bourdieu’s work, social constructionism and identity theorising are used to analyse how ‘G&T’ labelling processes, arising from government policies, located within family, peer and school institutional cultures impact on students’ identities, and their responses to identification. Constructionist critical-realist epistemology is used, with data drawn from semi-structured interviews conducted with 16 post-16 students; 16 e-mailed questionnaires with their parents; and three e-mailed questionnaires with GATCOs (‘G&T’ Co-ordinators), from three schools in Eastern England. Eight follow-up informal couple-interviews were conducted with students and their parents. My data analysis of ‘G&T’-students’ subjectivities shows ‘G&T’ identification has repercussions affecting self-esteem, confidence levels, and other aspects of identity constructions. I identify varied ways in which ‘G&T’ post-16 students actively construct ‘G&T’ identities in family and school cultural contexts, using peer-subcultures to manage ‘G&T’ roles, and show how school institutions differ in ‘G&T’ emphasis. Students display agency in ‘choosing’ routes through their ‘G&T’-journeys, on a continuum ranging from ‘conformity’ through to ‘resistance’. Through my analysis of rich qualitative data, some consequences for students of ‘G&T’-identity construction are revealed to be: fear-of-failure, perfectionism, bullying, eating disorders, stress; as well as confidence, pride, motivation and satisfaction. I argue that what is constructed and identified as ‘G&T’ is the result of social class based cultural capital, as the middle-classes access ‘G&T’ provision disproportionately. I conclude that ‘G&T’ policies function as neoliberal educational differentiators, in further separating the advantaged from the disadvantaged, entrenching class divisions. Recommendations include inclusive, personalised provision for all students. Students, parents and teachers revealed how differentiation within classrooms is as necessary as provision allowing for meeting the ‘like-minded’ e.g. through vertical tutoring, leadership programmes and establishing ‘learning communities’ within schools. I argue that school and family cultures need to ‘scaffold’ developing identities of post-16 students ensuring their potential is reached in academic, confidence and identity domains. The label of ‘G&T’ is not needed in order to achieve these aims of ‘gifted’ education for all students to at least sometimes feel like they are ‘fish in water’.

There is limited research into the impact of non-specific factors on the outcome of Cognitive Behaviour Therapy (CBT). This current study aimed to investigate the relationship between client and therapist attachment styles and client interpersonal problems to the therapeutic relationship and symptom reduction over eight sessions of CBT. Seventeen therapist-client dyads were asked to complete measures of interpersonal problems, attachment style and report on the therapeutic relationship. Results showed that in this small sample there was a relationship between core alliance, as rated by clients, to reduction in symptoms of depression over the course of eight sessions of CBT (TB=0.423, p<0.05) but not anxiety. Client level of confidence in relationships was negatively correlated with the reduction in anxiety symptoms over time (TB =-.320; p<0.05). The level of difference in scores on a measure of ‘confidence in relationships’ between therapists and clients was found to be positively correlated to the level of reduction in anxiety scores over eight sessions (TB = .0428; p<0.05) and negatively correlated to the therapist rated core alliance (TB=-.428, p<0.05). These results indicate that the role of attachment styles in CBT warrants further investigation and both clinical and theoretical implications of these findings are discussed. Key words: Cognitive Behaviour Therapy, therapeutic relationship, treatment outcomes, attachment, interpersonal problems Service Improvement Project Title: What is helpful about attending an Alzheimer’s café: does it do what it says on the tin? Abstract: Alzheimer’s Cafes were developed in 1997 in the Netherlands and have since been set up all over the world. They are a post-diagnostic support group for people with dementia and their families with an aim to reduce stigma around having dementia. As yet there have been very few evaluations of these cafes. This project aimed to find out what family carers of people with dementia found helpful about attending one of two Alzheimer’s cafes. Seven carers took part in a focus group and two were interviewed individually about what they found helpful about attending an Alzheimer’s Café and what they thought could be improved on in the future. Results showed that people found the opportunities to socialise with others ‘in the same boat’ the most helpful aspect as well as meeting professionals outside of the clinic. The results of this study will enable the development of a questionnaire that can be used to continue to evaluate the café and the feedback provided used to guide future service development. Key words: Alzheimer’s Café, social support, dementia, service evaluation Critical Literature Review Title: Risk and protective factors for psychological adjustment of children born with a cleft lip and/or palate and their families: A review of the literature Abstract: Research suggests that around 30-40% of children born with a cleft lip and /or palate will develop psychological difficulties. Services supporting these individuals need to be able to identify those that might be vulnerable as early as possible so that preventative support can be offered. This review summarises findings from research studies looking at within-group differences in samples of children with a cleft and their families. Risk factors found included being male, experiencing bullying or having additional difficulties. Protective factors included satisfaction with appearance and social support. The methodological strengths and weaknesses of these studies are discussed along with implications of the findings for theory and clinical practice.