Cleft lip and palate: Relationship between phonological awareness and audiological characteristics in children

Context: Cleft lip and palate (CLP) stands out due to its esthetic-functional impact and its high incidence. Phonological awareness involves skills related to the structure of language, and children with CLP may experience impairment in these skills due to auditory impairment resulting from otitis media and fluctuating hearing loss. Aim: The aim of this study was to correlate phonological awareness with audiological characteristics in children with CLP. Materials and Methods: Thirty children, 13 (43%) with cleft palate (CP) and 17 (57%) with CLP from 6 to 9 years old, were evaluated at a specialized center in Brazil to determine their phonological awareness skills and were classified into low, medium, and high skills categories. Phonological awareness was related to the speech reception threshold (SRT) at two time points: at 3 years old and at the time of data collection. Results: The study population was homogeneous in terms of age, sex, and socioeconomic status. In terms of phonological awareness skills, 8 children (26.7%) were classified as having low skills, 9 (30%) were classified as medium, and 13 (43.3%) were classified as high. Low phonological awareness skills were associated with worse mean SRT at 3 years old (mean = 34.4 dB, standard deviation [SD] = 11.2, P = 0.046) and at the time of data collection (mean = 22.2 dB, SD = 17.2). Conclusion: The association of phonological awareness with SRT suggests that prolonged or transient hearing loss can lead to changes in phonological skills and auditory processing.