Cantonese Tone Recognition Characteristics Of Aphasia In Native Speakers And The Influence Of Cantonese Tone Training On Language Function Based On Phonemic Contrast

BackgroundPost-stroke aphasia is a clinical symptom of oral or written communication disorder after brain injury,which affects the daily communication of patients.Cantonese,one of tonal language,plays a role in distinguishing semantics by changing the pitch of tones,which affects language functions.Therefore,to know the characteristics of Cantonese tone recognition in patients in native Cantonese with nonfluent aphasia,and to observe the effect of Cantonese tone recognition training on language dysfunction can provide references for the language rehabilitation.ObjectivesThe purpose of this study is to explore the characteristics of Cantonese tone recognition in different types of non-fluent aphasia and its relationship with language functions,and to observe the effect of Cantonese tone recognition training based on phonemic contrast on language functions of patients with aphasia.Methods1.A total of 52 patients with non-fluent aphasia after stroke in Cantonese native speakers were enrolled.They completed the assessment of the Hong Kong Cantonese Tone Recognition Test(Can TIT)and the Chinese Rehabilitation Research Center Aphasia Examination(CRRCAE).The characteristics of Cantonese tone recognition in patients with different types of non-fluent aphasia were compared,and their relationship with language functions was analyzed.2.Twenty patients with post-stroke aphasia were randomly divided into two groups: the experimental group and the control group,both received conventional speech therapy and medication.The patients in experimental group was given extra Cantonese tone recognition training that includes 30 pairs of tone in 30 minutes once a day and 10 times within 2 weeks.The Bilingual Aphasia Test(BAT)was used to evaluate the language functions in both two groups before and after language treatment.Results1.The accuracy of Cantonese tone recognitionIn the overall Cantonese tone recognition of patients in native Cantonese with nonfluent aphasia,T1/T2 has the highest correct rate and T3/T6 has the lowest correct rate.Except for T1/T2,the correct rate of tone identification is less than 85%,and the correct rate of T2/T5,T2/T6,T3/T6 and T5/T6 tones is less than 70%,which mainly focuses on the difficulty level of tone identification.The correct rate of T1/T5,T1/T6,T2/T4,T2/T5,T2/T6,T3/T5,T3/T6,T4/T5,T4/T6 and T5/T6 tone pairs in Broca Aphasia(BA),T2/T4,T2/T5,T2/T6 and T3/T6 tone pairs in Transcortical Motor Aphasia(TCMA),all tone pairs in Global Aphasia(GA),except T4/T6 tone pairs in Mixed Transcortical Aphasia(MTA),and T1/T2 and T1/T4 tone pairs in Basal Ganglion Aphasia(Ba A)are less than 85%.The accuracy of Cantonese tone recognition of GA is lower than that of BA(T1/T3,T1/T4,T1/T5,T2/T3,T2/T6,T3/T4,T4/T5,T5/T6),TCMA(T1/T3,T1/T4,T1/T5,T1/T6,T2/T3,T2/T6,T3/T4,T3/T5,T4/T5,T4/T6,T5/T6),MTA(T4/T6)and Ba A(T1/T4,T1/T5,T2/T6,T3/T4,T4/T6),which had statistically significant difference(P<0.05).The tone pairs with statistical differences are mainly focused on the easy level of different tone recognition.2.The influence of phonemic interference on Cantonese tone recognition abilityComparison of the effects of phonemic interference on the accuracy of tone recognition among different types of aphasia: the effect of phonemic interference of GA was more serious than that of BA,TCMA,and Ba A,and the effect of MTA was greater than that of TCMA(P<0.05).Comparison of the effects of different phoneme interference on the accuracy of tone recognition: in BA,TCMA,and Ba A,the influence on the accuracy of tone recognition of tone interference was more serious than that of consonant or vowel interference,and in GA,that of tone interference was more serious than that of vowel interference(P<0.05).There was no significant difference between the effects of consonant interference and vowel interference in aphasia in each group(P>0.05).3.The relationship between the characteristics of Cantonese tone recognition and language functionsThe accuracy of tone recognition of BA is positively correlated with reading(T1/T4,T3/T4,T3/T5 and T5/T6),that of TCMA is positively correlated with listening comprehension(T1/T2,T1/T4,T2/T4,T2/T5,T3/T6),retelling(T1/T3,T3/T4),speaking(T1/T4,T1/T5,T1/T6),reading aloud(T2/T3,T2/T6,T4/T6)and reading(T1/T2,T2/T4),that of GA is positively correlated with listening comprehension(T1/T3,T3/T4),reading(T2/T6),that of MTA is positively correlated with listening comprehension(T3/T6),retelling(T2/T4),speaking(T2/T5)and reading(T1/T2,T1/T4,T3/T4,T3/T5,T4/T6),and that of Ba A is positively correlated with listening comprehension(T1/T6,T2/T5,T2/T6),retelling(T3/T6),speaking(T1/T3,T1/T4,T2/T6)and reading aloud(T1/T6,T3/T6)(P<0.05).In BA,the influence of tone interference on the accuracy of tone recognition is negatively correlated with reading,and that of TCMA is negatively correlated with speaking(P<0.05).In GA,that of consonant interference is negatively correlated with listening comprehension,and that of tone or vowel interference is negatively correlated with speaking(P<0.05).In MTA,that of consonant or vowel interference is negatively correlated with reading(P<0.05).In Ba A,that of vowel interference is negatively correlated with listening comprehension and speaking(P<0.05).4.The influence of Cantonese tone recognition training on language functionsIn the experimental group,the ability of listening comprehension,retelling,oral expression,reading aloud,writing,reading and translation were improved after treatment(P<0.05).In the control group,the ability of listening comprehension,retelling,oral expression and reading were improved after treatment(P<0.05),but there was no significant difference in writing,reading and translation(P>0.05).There was no significant difference in language functions between the two groups before treatment(P>0.05).The improvement of the ability of translation,listening comprehension of negative sentences,sentences dictation and sentences reading subitems in the experimental group were significantly better than those in the control group(P<0.05).There was no significant difference in the ability of listening comprehension,retelling,oral expression,reading aloud,writing,reading and other subitems(P>0.05).Conclusion1.The patients in native Cantonese with non-fluent aphasia have different degrees of Cantonese tone recognition impairment.The smaller the tone difference,the lower the recognition accuracy.The interaction between Cantonese phonemes interferes with the process of tone identification.The influence of tone interference on Cantonese tone identification is more serious than that of vowels or consonants.2.The tone recognition ability of native Cantonese speakers with non-fluent aphasia is positively correlated with language functions,while phonemic interference is negatively correlated with language functions.3.Compared with conventional language training,Cantonese tone recognition training may better improve the language functions and Cantonese-Mandarin translation ability of patients with post-stroke aphasia.