Articulation Characteristics And Speech Training Of Postoperative Patients On Cleft Palate With Apical Consonant Articulation Disorders

Although operation established normal velopharygeal structure for patients with cleft palate, the founction of soft palate is still very poor if they don't receive speech training. Bad habits of pronunciation still exist, thus they cannot obtain normal speech function. Communication disorders of patients bring negtive effects to their study, life, work and even mentality; and it's more difficult for them to integrate into the social life.Apical articulation characteristics of patients with velopharyngeal competence and mild velopharyngeal insufficiency show significant difference, so do the speech training methods. In this study, apical articulation characteristics of the two kinds of patients were analyzed and new methods were explored for speech training, providing reference for clinical speech training for postoperative patients with cleft palate.Objective To discuss the apical articulation characteristics and speech rehabilitation training of postoperative patients with cleft palate who perform velopharyngeal competence and mild velopharyngeal insufficiency and provide reference for clinical speech training.Methods220 postoperative patients with apical articulation disorders were selected as research objectives.They all came from speech therapeutic room in the First Affiliated Hospital of Zhengzhou University during July 2012 to December 2014,male 117 cases, female 103 cases, aging from 4 to 25. The ratio of male to female was 1.1:1. The apical articulation characteristics of 220 patients were given speech evaluation by using CSL according to speech intelligibility test table of Huaxi oral hospital and analyze the apical articulation characteristics. 42 patients who met the criteriawere recorded in according to the Chinese speech intelligibility test table respectively before and after speech training of apical and the number of wrong apical was calculated.Statistical analysis was performed by SPSS17.0 statistical software. The type of experimental design of this study was self- paired design and paired t-test was performed for the speech training effect of apical, ?=0.05.ResultsThe number of patients with velopharyngeal competence and mild velopharyngeal insufficiency was respectively 108 and 112. 82.4% of patients with velopharyngeal competence had problem of syllable replacement; 48.1% of patients showed consonant deletion; 17.6% of patients performed pronunciation with root of tongue and 11.1% of patients remained speech lateralization. 40.2% of patients with mild velopharyngeal insufficiency had problem of syllable deletion of/d/; 25% of patients showed syllable deletion of /t/; 59.8% of patients performed soft compensatory of /zh/ /ch/ /sh/ /z/ /c/ /s/ /l/; 50.0% of patients remained soft compensatory of /l/; 19.6% of patients manifested speech lateralization of /zh/ /ch//sh/ /r/ /z/ /c/ /s/ and 59.8% of patients demonstrated nasalization of /i/ /u/. The number of wrong apical of patients with velopharyngeal competence and mild velopharyngeal insufficiency both decreased after speech training. Numbers of wrong apical of the two kinds of patients reduced respectively by(22.19±8.98)and( 22.24 ± 5.95),the differences were statistically significant(t=? 11.330,P <0.001 and t=? 17.130,P<0.001).ConclusionThe apical articulation characteristics of patients with velopharyngeal competence are remarkable for syllable replacement and syllable deletion;the apical articulation characteristics of patients with mild velopharyngeal insufficiency show. nasalization,soft compensatory and syllable deletion instead. The articulation characteristics of the two kinds of patients are widely different. Formulating specific speech training programs for patients according to their different articulation characteristics is helpful to improve the effect of speech training. The training methods of this research established for patients are effective.