Phonological Awareness Of Mandarin In Preschool Children With Non-Syndromic Cleft Palate:A Preliminary Study

BackgroundNon-syndromic cleft palate(NSCP)is the most common type of facial congenital malformations.It refers to cleft palate without other systemic abnormalities but only manifested as oral and maxillofacial malformations.NSCP children are usually accompanied by hearing and speech disorders.In early years,speech disorders lead to the difficulty of NSCP children to achieve good communication with others,and it is difficult for listeners to understand the meaning of the words speaking by NSCP children,which makes children with NSCP afraid to speak and communicate.At the age of 3,nearly half of NSCP children show speech related problems,which may affect the effective social interaction of them.The causes of speech disorders in NSCP children are complex.Early studies revealed that the speech disorders of NSCP children were related to a series of factors such as maxillofacial anatomical structure abnormalities,hearing impairment and compensatory speech.Recent studies showed that NSCP children may have brain structure abnormalities,brain function disorders,and insufficient ability in auditory task,which indicates that there may be abnormalities in the auditory central nervous system of NSCP children and the auditory speech mechanism may be impaired at the same time.In the whole chain of auditory speech mechanism,the individual perception of sound information and phonological awareness are particularly important,which are the main pathological mechanism causing speech disorders.However,it is unclear whether speech perception and phonological awareness of NSCP children affect their speech disorders.ObjectiveTo explore the characteristics of phonological awareness of Mandarin in preschool NSCP children compared with the normal children.To explore the influence of age and gender on the phonological awareness of Mandarin in NSCP children.Materials and methodsFrom November 2021 to August 2022,37 NSCP children(19 males and 18 females)with the age range of 48-84 months were collected from Shenzhen Second People’s Hospital,and 30 NSCP children(16 males and 14 females)were finally enrolled according to the inclusion criteria.At the same time,we recruited 30 normal children who matched the sex and age of children in NSCP group as the control group.The data were imported into SPSS software,and independent sample t-test was used to compare the results of two groups of Mandarin phonological awareness tests to analyze whether phonological perception ability of NSCP children was different from that of normal children of the same age.Pearson correlation coefficient was used to analyze the correlation between the age of each group and phonological awareness test scores.We also conducted independent sample t-test for the phonological awareness test scores and the gender of the subjects to analyze the impact of gender on the test results.Results:1.NSCP children’s Mandarin phonological awareness test compared with normal children of the same age:NSCP children got lower scores in the consonant and vowel discrimination test(MCDT,MVDT)than normal children at the same age(P<0.01).They also got lower scores in the tone identification test(MTIT)than normal children at the same age(P<0.05).In MCDT,NSCP children failed to achieve 100% accuracy for all consonant minimal pairs.There were 7 consonant minimal pairs(/d/-/t/,/j/-/q,/f/-/s/,/sh/-/x/,/zh/-/j/,/ch/-/q/,/sh/-/r/)that were one standard deviation(SD)higher than the average score for NSCP group,and there was no statistical difference compared with the scores obtained in control group(P>0.5).However,7consonant minimal pairs(/n/-/l/,/g/-/h/,/k/-/h/,/p/-/t/,/s/-/sh/,/z/-/zh/,/c/-/ch/)were one SD lower than the average score for NSCP group and significantly different from that of the control group(P<0.01).In MVDT,NSCP children also failed to achieve 100% accuracy for all vowel minimal pairs.6 vowel minimal pairs(/a/-/o/,/i/-/u/,/ang/-/eng/,/u/-/v/,/in/-/ing/,/ie/-/ue/,/ang/-/un/)were lower than the average score for NSCP group and significantly different from that of the control group(P<0.01).Among them,there were 2 vowel minimal pairs(/in/-/ing/,/ie/-/ue/)that were one SD lower than the average score for NSCP group.Only one vowel minimal pair(/ai/-/ou/)exhibited one SD higher than the average score of NSCP group,which was not significantly different from the scores of the control group(P>0.5).In MTIT,the accuracy of NSCP children in testing the four tones was lower than that of normal children at the same age.There were statistically significant differences between two groups in the accuracy of Tone 2(t=2.922,P<0.05),although Tone 1,Tone 3,and Tone 4 did not(P>0.5).2.Correlation between phonological awareness test of NSCP children and gender and age:The age of NSCP children was positively correlated with the accuracy of MCDT and MVDT,with correlation coefficients of 0.438 and 0.469 respectively(P<0.01).There had no correlation with the accuracy of MTIT(P>0.5).The gender of NSCP children had no significant effect on the accuracy of MCDT,MVDT and MTIT(P>0.5).ConclusionsThe results show that the phonological perception ability of pre-school NSCP children(including the ability to identify initial consonants,vowels and tones)lags behind that of normal children of the same age,with the most prominent difference in consonant perception ability.NSCP children have poor discrimination ability on the consonant minimal pairs including /n/-/l/,/g/-/h/,/k/-/h/,/p/-/t/,/s/-/sh/,/z/-/zh/,/c/-/ch/.The ability to distinguish some vowel minimal pairs is poor,such as /a/-/o/,/i/-/u/,/ang/-/eng/,/u/-/v/,/in/-/ing/,/ie/-/ue/,/ang/-/un/.The identification of Tone 2 is the lowest contrast in NSCP children.Age development was positively correlated with the ability to discriminate consonants and vowels.However,there is no significant correlation between age development and tone identification.Gender has no significant effect on children’s phonological perception ability.