This study compared the self-concept of primary-school-age children (5 years to 9 years) with clefts to a control group on nonaffected peers. The children with clefts reported a significantly lower global self-concept. They perceived themselves as less socially adept and more frequently sad and angry than their peers. It is postulated that poor self-concept in primary-school-age children with clefts may be related to concerns with speech, appearance, differential parental expectations, or a combination of these variables.