How do children learn about facial disfigurement?

Jane Frances is the Policy Adviser in Education for Changing Faces. She is the author of Educating Children with Facial Disfigurement (London: Routledge/Falmer, 2004), and also has a chapter in the forthcoming Effaced publication, Approaches to Facial Difference: Past and Present (Bloomsbury: 2018): ‘Does researching disfigurement risk perpetuating stigma?’

Lucas was born with an unusual-looking face and head. At primary school the other children beat him up so much that he reached a point when he walked out and never went back. Adam Pearson, who now makes and sometimes hosts TV programmes about appearance and difference, also endured a great deal of horribleness from peers at school. Many children whose appearance is unusual have a similarly rough ride at school. Could it be that children actively dislike unusual — disfigured — faces?

During the 1970s and 80s when a team led by S.A. Richardson1 explored more than 3000 children’s responses to peers who had a range of visible differences and disabilities they included facial disfigurement. A preference ranking emerged which Richardson found to be “stable in the overwhelming majority of studies for children 6 to 16 years of age….” From most to least liked were: (a) nondisabled child, (b) child with a crutch or brace, (c) child in a wheelchair, (d) child with hand missing, (e) child with facial cleft disfigurement, and (f) child with obesity.

In their chapter2 on the development and maintenance of shame in disfigurement Gerry Kent and Andrew R. Thompson list several research findings to do with people’s general dislike and avoidance of persons with disfigured appearance. Interestingly there is a widespread tendency to attribute these reports from people with facial disfigurement to their oversensitivity. How often is a child who reports that they are being stared at or whispered about encouraged to “ignore it” or counselled that perhaps they are imagining it?

However, research in which “confederates have worn cosmetic creams to look as if they had some form of facial blemish, people [adults] were observed to offer less help and to try to avoid the confederate (Bull and Rumsey, 1988; Rumsey, Bull & Gahagan, 1982). Such reactions to disfigurement are often culturally sanctioned and can be seen in many children’s stories: ‘Out popped the troll’s ugly head. He was so ugly that the youngest billy-goat Gruff nearly fell down with fright’ (The Three Billy Goats Gruff).”3

Harper’s 1999 discussion of this and similar research, including his own, indicates a disquieting pattern in children’s attitudes and preferences when choosing playmates from among their peers. He finds that where success is associated with having enough to eat children view obesity positively. In communities which depend on people’s capacity for manual labour, children view physical incapacity very negatively. Among communities where these no longer hold true — broadly the West and Westernised cultures — children, as Richardson and his team found, most dislike facial scarring and obesity. Perhaps unsurprisingly, it emerges that children’s attitudes and preferences somehow come to reflect precisely those of the society in which they grow up, whatever those preferences or fashions may be. Apparently this alignment develops even though no-one teaches them to dislike and avoid a child with facial scars. Or do they?

In film, TV and computer games the disfigurement trope that we were probably first introduced to when, as small children, we encountered the Ugly Step-sisters in our first Christmas pantomime, continues to give the baddie facial scars while the goodie’s face is much more likely to be smooth-skinned and symmetrical. For several years until quite recently the “edutainment” Moshi Monsters’ community of mostly socially positive cartoon creatures engaged millions of very young children all over the world with its vignettes of social interactions, and its illustrated catalogues of moshlings. Among all the different Moshi Monsters and Moshlings are the Glumps who manifest that same old disfigurement trope. With names like Freakface and Fishlips it might look as if the makers of Moshi Monsters were actively teaching small children how to abuse any other child they might come across who had an unusual face. The Moshi Monster Character Encyclopaedia4 describes Bloopy, for example, as having “blue flabby skin” and asks, “Well wouldn’t you be monstrously depressed if your face looked like a squished blueberry?” Of Bruiser, this children’s reference book says, “Scarred skin makes for a scary sight.” Changing Faces ran a successful campaign against the face-ism (like racism) being promulgated by this erstwhile popular edutainment.

Inclusive education in the UK calls upon most children to rub along together regardless of their wide-ranging physical, cognitive and appearance differences. Their teachers may try to facilitate this with the help of lessons about difference and respect, alongside optimistic advice such as “Don’t judge a book by its cover” and “It’s the inside that counts”.

Regarding the acquisition in childhood of socially conforming aesthetic responses, John Rickman5 includes in his reflections upon ugliness and the creative impulse, a summary of research by Dr Erno Peto in 1935, into infants’ and children’s responses not to faces, unfortunately, but to smells and tastes. Peto found that the response of disgust increased and standardised with age, from under five to over six years, becoming more in line with general adult judgements regarding what smells or tastes are experienced as horrible. Earl Hopper6 shows how these kind of aesthetic responses might be ‘learned’ through non-verbal social molding that cannot but occur as the infant is continually exposed to adult’s responses to smells and tastes — and faces.

We can see how such early non-verbal learning will lead to visceral responses that can seem completely natural. And the children of parents whose facial appearance is disfigured in some way grow up with entirely different non-verbal social molding that leaves them puzzled and upset, when they start school, by their classmates’ questions, comments and seeming dislike of their unusual-looking parent. “Yes— Imagine having to grow up with a father who looks like that.”7 “Yes. My youngest son… had a fight with the boy who commented in an unkind way. The boy had said ‘At least my mum has two eyes.’”8 “Yes…. Comments like ‘Ugh’.”9

It’s so hard to reverse non-verbal social molding in infancy and early childhood that we eagerly await the first ‘Becoming a Parent’ book or website that includes activities that will encourage children to respond positively to unusual faces. This will range from the ubiquitous response of adoration to conventional new babies that leaves us covered in discomfort and lost for words when we see a baby with a large facial birthmark. And not forgetting the task of countering the hissing, etc, that arises in the theatre when the ugly sisters come on stage (whose attitudes and behaviour are the thing, not their appearance). Meanwhile, books for children about a classmate whose face is disfigured10 are inevitably set in social contexts where everyone spends a lot of time getting it all wrong.

That dreadful Moshi encyclopaedia is out of print now and the press are beginning to refer to facial injuries as ‘life-changing’ where previously they would have used ‘horrific’. Many people live good lives that include the challenge of living with an unusual facial appearance from birth or following injury or cancer treatment etc. So let’s keep chipping away at the old face-ist mindset to re-shape it into something much more varied and human.


Richardson, S. A. (1983) ‘Children’s values in regard to disabilities: A reply to Yuker’, Rehabilitation Psychology, 28, pp. 131–140. Cited in Harper, D.C. (1999) ‘Social psychology of difference: stigma, spread and stereotypes’, Childhood, Rehabilitation Psychology, 44/2, pp. (131–144). Accessed online 6 August 2017.

Kent, G. and Thompson, A.R., (2002) ‘The development and maintenance of shame in disfigurement’, in P. Gilbert and J. Miles (Eds) Body Shame: Conceptualisation, Research and Treatment (Hove: Routledge, 2004): pp. 103–116.

Ibid., p. 104.

Published by Dorling Kindersley in 2013.

Rickman, J. (1957). ‘X. On The Nature Of Ugliness And The Creative Impulse’ (Marginalia Psychoanalytica. II) 1 (1940). Int. Psycho-Anal. Lib., 52: pp. 68–89.

Hopper, E. (1996) ‘The social unconscious in clinical work’. In Hopper, E. (2003) The Social Unconscious: Selected Papers (London: Jessica Kingsley), p. 126–161.

Free text answers from the Changing Faces Survey behind Disfigurement in the UK – Q107 asked if people discourage you from having children.

As above. Q113 asked if your children have ever faced questions or comments about your condition or appearance.

As above. Q 113 again.

10 Fire Girl by Tony Abbott and R.J. Palacio’s Wonder.

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