Foundations of phonological awareness in pre-school children with cerebral palsy: the impact of intellectual disability.
For preschoolers with CP, low non-verbal IQ plus poor speech clarity signals weak phonological awareness, so screen early and start sound-play interventions.
01Research in Context
What this study did
The team looked at preschoolers with cerebral palsy. They wanted to know why some kids struggle to hear and play with speech sounds.
Each child took a short non-verbal IQ test and said some words so staff could score speech clarity. Then kids tapped out syllables, matched rhymes, and blended sounds.
The study used a quasi-experimental design. This means kids were not randomly placed in groups; the researchers just watched and recorded.
What they found
Children with CP scored lower on phonological awareness than same-age peers. Lower IQ and slurred speech explained most of that gap.
In plain words, if a child with CP also had intellectual disability or hard-to-understand speech, sound games were tougher.
How this fits with other research
Moreira et al. (2012) saw the same pattern in dental health: kids with CP plus ID got more cavities, and IQ was the key driver, not motor severity. Together the papers show IQ acts like a common risk flag across learning and health domains.
Chien-Hu et al. (2013) tracked preschoolers with CP for six months. Higher motor severity and older age predicted slower gains in every developmental area. Geurts et al. (2008) add that low IQ and poor articulation specifically slow early literacy, giving you a clearer target to probe.
Tassé et al. (2013) seems to clash: they showed children with ID can self-teach new words by sounding them out. The difference is timing. M et al. measured preschoolers who had not yet received reading instruction; J et al. worked with older kids who already had some phonics skills. Early screening still matters because it points you to the kids who will need extra practice before self-teaching can kick in.
Why it matters
You can screen for future reading risk in under five minutes. Give a non-verbal IQ item like block patterns, ask the child to repeat a short word list, and try one rhyme matching game. If scores are low, start phonological awareness games now while speech therapy ramps up. Pairing these quick probes beats waiting for later reading failure and gives you data to share with the school team.
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02At a glance
03Original abstract
BACKGROUND: Children with cerebral palsy (CP) and accompanying disabilities are prone to reading difficulties. The aim of the present study was to examine the foundations of phonological awareness in pre-school children with CP in comparison with a normally developing control group. Rhyme perception was regarded as an early indicator of phonological awareness, whereas non-verbal reasoning, speech ability, auditory perception, auditory short-term memory and vocabulary were regarded as foundation measures. METHODS: A number of tasks were administrated to examine group differences in rhyme perception and its foundation measures. Correlations between the tasks were analysed for both groups followed by multiple regression analyses wherein rhyme perception was predicted by its foundation measures. RESULTS: Children with CP scored below their normally developing peers on emergent phonological awareness and its foundation measures. Regarding the prediction of phonological awareness, non-verbal reasoning followed by pseudoword articulation, were found to predict phonological awareness, i.e. rhyme perception, in the group of children with CP. In the control group, auditory perception was a significant predictor of emergent phonological awareness. The CP group was further split up into two groups according to the children's non-verbal reasoning skills, i.e. general IQ. The below-average IQ group scored below the average IQ group on phonological awareness and on most foundation measures. In addition, the average IQ group of the children with CP scored lower than the control group. CONCLUSION: The results of this study indicate that general intelligence and speech ability (i.e. pseudoword articulation) can be seen as important facilitators of emergent phonological awareness in children with CP. These findings support the role of intelligence in the emergence of phonological awareness in children with CP. Children with CP with intellectual disabilities seem to have a disadvantage in acquiring phonological awareness, especially when their speech abilities are also impaired. However, general intelligence is not enough to predict phonological awareness as other foundation measures are also important for phonological awareness independent of general intelligence.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2007.00986.x