Children with SLD-R showed worse phonemic awareness than controls in Malayalam.

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medRxiv Published April 9, 2026 Medically reviewed April 25, 2026 Study authors: Soman, A.; Dev, S. S.; Ravindren, R. DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Note phonemic awareness deficits in SLD-R children in Malayalam, particularly for blending tasks.

This observational study assessed phonemic awareness deficits in children with Specific Learning Disorder-Reading (SLD-R) using an alphasyllabary language, Malayalam. The population included 30 children with SLD-R (mean age 11.4 years) and 29 age-matched typically developing children. No specific intervention was administered; the study measured performance on phonemic awareness tasks including phoneme blending, segmentation, and deletion.

Children with SLD-R performed significantly worse than controls across most phonemic awareness tasks. The largest deficits were observed in pseudoword blending and word blending, with smaller deficits noted in segmentation. Conversely, no significant difference was found for initial phoneme deletion between the two groups. Consonant clusters significantly affected performance in both groups, with the SLD-R group demonstrating more severe deficits.

In typically developing children, age showed strong positive correlations with phonemic performance across most tasks. In contrast, the SLD-R group exhibited weak or absent correlations, except for word blending and initial phoneme deletion. Safety data, adverse events, and discontinuations were not reported. The study did not report p-values, confidence intervals, or specific effect sizes for the outcomes.

Limitations include the observational design, which precludes causal inferences, and the lack of reported funding or conflicts of interest. Generalizability to other languages and clinical applicability are constrained by the specific linguistic context and sample size. These findings suggest an association between SLD-R and phonemic awareness deficits in Malayalam but require further investigation in diverse settings.

Study Details

EvidenceLevel 5

PublishedApr 2026

View Original Abstract ↓

Background Phonemic awareness deficits are a core feature of Specific Learning Disorder-Reading (SLD-R). How task- and language-specific factors influence these deficits in alphasyllabary languages may help clarify the cognitive mechanisms underlying reading impairment in SLD-R. Methods Thirty children with a DSM-5 diagnosis of SLD-R (mean age 11.4 years) and 29 age-matched typically developing children were given phoneme blending (words and pseudowords) and segmentation tasks in Malayalam. The effects of age and consonant clusters on task performance were evaluated. Results Children with SLD-R performed significantly worse than controls across most phonemic awareness tasks, with the largest deficits observed in pseudoword blending and word blending, and smaller deficits in segmentation. No significant difference was observed for initial phoneme deletion. In typically developing children, age showed strong positive correlations with phonemic performance across most tasks, whereas the SLD-R group showed weak or absent correlations, except in word blending and initial phoneme deletion. Consonant clusters significantly affected performance in both groups, with SLD-R showing more severe deficits. Conclusions Phonemic awareness deficits observed in SLD-R in alphasyllabary languages like Malayalam are more prominent in tasks where lexical support is absent, like pseudoword blending. These deficits vary across task types and linguistic complexity. Phonemic awareness improves with age in typically developing children, while improvement is uneven in children with SLD-R. The findings suggest that phonemic awareness deficits are a core feature of SLD-R across languages, but their manifestation is shaped by orthographic and linguistic characteristics of the writing system.