We wish to address the comments by Anderson et al on our paper entitled 'Strabismus-related prejudice in 5-6-year-old children' In our paper, we discussed that the absence of an effect of strabismus on participants' playmate choice in Anderson et al's study could be due to differential age-related cognitive and language capacities. In our study, the age range of the participants was much narrower (ie, 5-6 years) than that of the participants in Anderson et al's study, which ranged from 3 to 8 years. Since Anderson et al did not specify the number of participants in each age group, we could not ascertain whether age was sufficiently accounted for in their data analysis. Given that children between 3 and 8 years old may be at various stages of developmental maturity, we believe that age may be a factor that needs to be controlled for when examining children's responses to images of peers with strabismus. To qualify this further, a recent study3 demonstrated that age is an important factor that might influence perception and response to strabismus. The study clearly showed that children exhibited negative social reactions to peers with obvious exotropia. However, older children's reactions were less marked than the reactions of their younger peers.
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