Articulation Characteristics And Speech Training Of Consonants In Preschool Patients With Repaired Cleft Palate

Objective1.To discuss the articulation characteristics of consonants in preschool patients with velopharyneal competence and mild velopharyneal insufficiency after cleft palate surgery.2.To explore the specific training methods according to different misarticulation and analyze influence factors of the effect,thus providing the reference for training.Methods1.Study one:214 preschool patients with repaired cleft palate were selected as research objectives,who came from speech therapeutic room in a first-class tertiary hospital in Zhengzhou during January 2016 to December 2017.They were given objective velopharyneal function assessment and speech assessment by using CSL accordering to speech intelligibility test table of West China College of Stomatology,and then mild VPI children were given lateral skull radiography film for a subjective velopharyneal function assessment.We analyzed articulation characterstics of consonants in children with different velopharyneal function respectively.2.Study two:56 children were selected as research objectives,who received speech training in speech therapeutic room in a first-class tertiary hospital in Zhengzhou during January 2017 to December 2017.They were recorded according to the Chinese speech intelligibility test table before and after training.We used the specific training methods according to different misarticulation,then calculated phonetic intelligibility to evaluation the effect and analyzed influence factors of the effect.3.The mean((?)~x),standard deviation(s),percentages(%)and absolute(n)frequencies were presented in study one.Paired t-test was performed for the effect.Two independent samples t test was used for PI and lessons needed to correct the error consonants among groups,?=0.05.Binary logistic regression analysis was performed for analyzing influence factors of the effect.Results1.There were 104 cases with VPC and 110 cases with mild VPI among 214 preschool patients with repaired cleft palate,the proportion was 48.6% and 51.4% respectively.The misarticulation might lie in all consonants and the types of misarticulation were complex,the error types were mainly omission and(or)weakness,palatalization,and glottal stop.Among VPC children,omission and(or)weakness lay in labial,dental,lingual-palatal and velar mainly,the ratio was 53.8%(56/104),67.3%(70/104),52.9%(55/104)and 55.8%(58/104)respectively,palatalization lay in blade-alveolar and blade-palatal mainly,the ratio was 47.1%(49/104)and 45.7%(48/104)respectively.Among mild VPI children,labial showed mainly omission and(or)weakness,the ratio was 62.7%(69/110),blade-alveolar,dental,blade-palatal,lingual-palataland velar showed mainly glottal stop,the ratio was 55.5%(61/110),56.4%(62/110),56.4%(62/110),52.7%(58/110)and 50.0%(55/ 110)respectively.The form of misarticulation with the highest error ratio was omission and(or)weakness of /g/ and omission and(or)weakness of /b/ among two groups,the proportion of which was 52.0%(54/104)and 60.9%(67/110)respectively.2.The PI of 56 children was improved to(89.36�1.51)after training from(38.04�3.46)before training was established,which was improved by(51.32�2.47)averagely,the difference was statistically significant(t=21.907,P<0.001).The PI of two groups was dramatically improved after training(t=12.061,20.914,P<0.001),the difference both two groups was not statistically significant(t=-1.940,P=0.058),the difference of lessons was statistically significant(t=-19.041,P<0.001).The operative age was a risk factor of the effect(P<0.001,odds ration=1.610,95%CI of odds ration=1.005 to 2.611).The home consolidation time weekly and the parents' educational level were protective factors of the effect(P<0.001,odds ration=0.377,95%CI of odds ration=0.240 to 0.652,P=0.013,odds ration= 0.635,95%CI of odds ration=0.467 to 0.802,respectively).Conclusion1.The articulation characteristics of consonants in preschool patients with repaired cleft palate are complex,the types of misarticulation are mainly omission and(or)weakness,palatalization,and glottal stop.VPC children show mainly omission and(or)weakness and palatalization.Mild VPI children show mainly omission and(or)weakness and glottal stop.2.The specific training methods according to misarticulation are effective.The operative age before 1.5 years old,the home consolidation time weekly is more than 420 min,the higher the parents' educational level is,the better the effect.