Audiology

Difficulties in parenting hearing-impaired children

Gita Movallali

Background and Aim: Despite the abundance of literature about deaf children, few works specifically address the concept and practice of difficulties in parenting hearing-impaired children. The first interactions of the child are with his parents, and parents have the most important role in child improvements during early intervention programs. The main purpose of this paper was to investigate different aspects of parenting hearing-impaired children.

Methods: In this article, we reviewed all aspects of parenting hearing-impaired children in papers from 1984-2009 in Medline, Scopus and Proquest and relative textbooks. The semi-professional role of parents of hearing-impaired children make them feel under excessive stress and this usually affects their other roles as fathers and mothers. Many factors including child age, type of hearing loss and parents' individual characteristics may influence the impact of child's hearing loss on parents.

Conclusion: Parenting a hearing-impaired child is both similar and different to parenting any other child. Where there are differences, there are usually challenges too. Taking support and advice from professionals and other parents are necessary and invaluable for parents of hearing-impaired children.

Investigation of Persian speech interaural attenuation in adults

Fahimeh Hajiabolhassan

Background and Aim: As clinical audiometry assessment of each ear needs to know interaural attenuation (IA), the aim of this study was to investigate Persian speech IA in adults.

Methods: This cross-sectional, analytic study was performed on 50 normal hearing students (25 males, 25 females), aged 18-25 years old in Faculty of Rehabilitation, Tehran University of Medical Sciences. Speech reception threshold (SRT) was determined with descending method with and without noise. Then speech IA for Persian spondaic words was caculated with TDH-39 earphones.

Results: Mean speech IA was 53.06±3.25 dB. There was no significant difference between mean IA in males (53.88±2.93 dB) and females (52.24±3.40 dB)(p>0.05). The lowest IA was in females (45 dB) and the highest IA was in males (60 dB). Mother's language has no significant effect on speech IA.

Conclusion: We may consider 45 dB as the lowest IA for Persian speech assessment, however generalization needs more study on a larger sample.

Relationship between phonological awareness, rapid automatized naming and reading in first grade students in Tehran, Iran

Zahra Soleymani

Background and Aim: Reading is one of the human's communicative skills. Phonological awareness and rapid automatized naming are parts of the person's linguistic knowledge. Research in different languages and communities suggest that there is a relation between phonological awareness, rapid automatized naming and reading. To survey these relations in Persian language is the aim of this study.

Methods: In this study 130 male students from the first grade were selected at random. They were normal in IQ, visual and hearing status. Language development was also normal in these children. This study was a cross-sectional one. Pearson correlation coefficient and linear regression test were used to analyze data.

Results: The relation between phonological awareness and automatized rapid naming was significant (p<0.0001). Pearson correlation coefficient between phonological awareness and reading was direct (0.86). Pearson correlation coefficient between rapid automatized naming and reading was indirect that equals -0.87. In investigating the relation of two variables simultaneously with reading we concluded that the relation between phonological awareness, rapid automatized naming and reading is statistically significant (p<0.0001).

Conclusion: The results of this research revealed that in Persian language like other languages there is a relation between phonological awareness, rapid automatized naming, and reading. Reading skills of children could be improved with this exercises.

Comparison of voice perceptual charactheristics between speech - language pathologists', dysphonic and normal voiced adult's view

Seyyedeh Maryam khoddami

Background and Aim: In recent years, several tools for assessment of quality of patient life have been designed especially for dysphonics. Nowadays, we have useful assessments in health system that are refered for numerous clinical decisions. In this way, this investigation compares clinician and patient perception in dysphonic and normal voiced for first time.

Methods: This study was carried out on 30 dysphonic and 30 subjects with normal voice. Their age, sex and job were same. In two groups, Consensus Auditory - Perceptual Evaluation of Voice (CAPE-V) was used for evaluation of clinician perception and Voice Handicap Index - 30 (VHI-30) for assessment of patient perception. After collecting data, they were analyzed by Mann- witney and Wilcoxon tests.

Results: The research revealed that mean of total and each section score of VHI-30 have significant difference between dysphonic and control group (p<0.01). Comparison of total and every parameter score of CAPE-V and speed also indicated significant difference between two groups (p<0.01). Study of reliability shows weak reliability (r=0.34) between clinician and patient perception of voice in dysphonics.

Conclusion: Dysphonic patients percept their voice problem different and severe rather than clinicians that shows physical, psychological and social affects of dysphonia. This research confirms that patient - based assessment of voice is necessary to be part of common assessments of dysphonia.

Comparison of the prevalence and latency of vestibular evoked myogenic potentials in normal participants and symptomatic and asymptomatic Meniere's disease patients

Mansoureh Adel Ghahraman

Background and Aim: Vestibular evoked myogenic potentials (VEMP) originate from the saccule and the inferior vestibular nerve. In this study, the prevalence of VEMP and latency of the p13 and n23 were compared between three groups of individuals, including symptomatic and asymptomatic Meniere's disease cases and normal participants.

Methods: This study was conducted on 42 cases with the mean age of 40.48 years thirty were Meniere's disease patients, of which 19 were symptomatic and 11 were asymptomatic twelve were normal participants. The VEMP were recorded with 500 Hz tone bursts at 120 dBpeSPL. Then the prevalence and latency of the waves were analyzed and compared in the three above mentioned groups.

Results: The prevalence of VEMP in symptomatic Meniere's disease patients (52.6%) was significantly less than asymptomatic individuals (90.9%) and also normal subjects (100%)(p<0.05). There was no significant difference between latencies of the waves in these three groups (p>0.05). The latency of p13 for symptomatic, asymptomatic and normal participants was 16.41, 15.20 and 14.14 ms, respectively and the latency of n23 for these groups was 20.25, 18.77 and 18.50 ms, respectively.

Conclusion: In Meniere's disease, after medical management, the succule probably regains normal function resulting in re-existence of VEMP. It seems that there is no change in the latency of the waves, most likely due to involvement of the inner ear and intactness of the nerve. VEMP may be a useful test for diagnosis of Meniere's disease and additionally for monitoring the trend of medical management.

Correlation between serum aldosterone level and hearing condition of elderly patients referred to Otolaryngology services of Hamadan, Western Iran

Farhad Farahani

Background and Aim: Recently, more attention was paid to the direct protective effect of aldosterone against hearing impairment in elderly patients. The aim of this study was determination of possible correlation between serum aldosterone level and hearing condition of elderly patients that referred to the Otolaryngology services of Hamadan in 2005-2006.

Methods: In this case control study 54 (27 males,27 females) persons above 60 years old were evaluated. They contained twenty eight cases with normal hearing and 26 cases with presbycusis. Persons with any abnormal biochemical finding or history of conditions that predispose them to the sensorineural hearing loss (SNHL) were excluded. In both groups serum level of sodium, potassium and aldosterone were measured and hearing condition evaluated by puretone, speech and immitance audiometry.

Results: Statistical relationship between serum aldostrone level and hearing condition, sex, configuration of audiogram and speech discrimination score (SDS) were not significant. In addition, no significant relationship between sodium and potassium levels with hearing condition was found (p>0.05). Conclusion: This study could not confirm protective effect of aldostrone against presbycusis. This discrepancy may originate from epidemiologic differences, laboratory errors or small sample size.

Syllabic elision ability in 5 to 6 year-old normal Persian-speaking children of Tehran kindergartens, Iran

Seyyede Zohreh Ziatabar Ahmadi

Background and Aim: phonological awareness skill is an integrated ability that is manifested in 4 skills including syllable, rhyme, and phoneme awareness and alliteration. The aim of the present study is to explore development of syllabic elision skill as an aspect of syllabic awareness.

Methods: It was a descriptive-analytic cross-sectional study. Thirty normal Persian-speaking children, 15 girls and 15 boys, were randomly selected throughout Tehran kindergartens. The participants were monolingual. Children should eliminate a syllable from any word presented, and to state the remaining section of the word. The responses were analyzed using SPSS software.

Results: Ability of 5 to 6 year-old children in eliminating a syllable in two syllabic words was significantly higher than those of three and four syllabic words and syllabic elision of three and four syllable words was significantly different (p=0.000). Two, three and four syllabic task correlations were statistically significant and the correlation between syllabic elision ability and the syllabic construct and the positioning of elision syllable was significant (p<0.05).

Conclusion: Syllabic elision skill blossoms in 5 to 6 year-old Persian-speaking children. The maximum ability of syllabic elision evolves after phonological recoding and after learning reading and writing skills. Syllabic elision ability is also influenced by the syllabic construct and the positioning of elision syllable.

A comparative study of diadochokinesis and the rate of reading and speech in second grade primary school students of Tehran, Iran

urieh Ahadi

Background and Aim: Children with speech and language disorders can have reduced diadochokinesis (DDK) rates. Although a relationship has been proposed between DDK and the rate of speech, there is no consensus among the experts and its credibility remains questioned. The purpose of this study was to compare oral DKK with the rate of speech and reading in normal students.

Methods: One hundred second grade female students participated in this descriptive-comparative study. The subjects were asked to read a text of their book, tell a story, and perform some oral DDK tasks. The elapsed time was measured by Cool Edit software. Descriptive statistics were used to describe the data. Data analysis was performed using Student t-test.

Results: Time history durations of DDK tasks /tâ/, /pâ/ and /kâ/ were 4.10, 4.15 and 4.74 ms, respectively. The rate of reading was 3.1 syllables per second and rate of talking was 2.8 syllables per second. No relationship between the rate of speech and DDK was found, still, we found a significant association between the reading rate and DDK in /kâ/ (p=0.03) and /pâtâkâ/ (P<0.01).

Conclusion: Relevant DDK tasks can be utilized in order to improve the reading rate. Reading rate was higher than speech rate and the rate of bilabial diadochokinesis in mono syllables is the highest rate that may be expected during the treatments.

Comparison of vestibular evoked myogenic potential and caloric tests findings in noise induced hearing loss-affected and healthy individuals

Abdolreza Sheibanizadeh

Background and Aim: Balance disturbance is one of the non-auditory effects of noisy industrial environments that is usually neglected. The aim of the current study was to investigate the effect of occupational noise on vestibular system among workers with noise-induced hearing loss (NIHL), based on both vestibular evoked myogenic potentials (VEMP) and caloric tests.

Methods: Thirty male workers with noise-induced hearing loss and thirty male matched controls were examined by VEMP and caloric tests. Study parameters included unilateral weakness, p13 and n23 latencies, and p13-n23 amplitude. Caloric test was performed only for 20 patients.

Results: No significant difference was observed in unilateral weakness between the two groups. On the other hand, the difference in mean latencies of p13 in the right ear (p=0.003) and left ear (p=0.01) was significant between the two groups. However, the difference in n23 latency was significant only in the right ear (p=0.03). There was no significant difference between groups in p13-n23 amplitude.

Conclusion: It seems that pars inferior of vestibule is the susceptible part in individuals with NIHL. In general, abnormal findings in both VEMP and caloric tests were more common compared to functional symptoms such as vertigo, which may be due to central compensation and the symmetry of the disorder.

Comparison of auditory event-related potential P300 in sighted and early blind individuals

Saeed Farahani

Background and Aim: Following an early visual deprivation, the neural network involved in processing auditory spatial information undergoes a profound reorganization. In order to investigate this process, event-related potentials provide accurate information about time course neural activation as well as perception and cognitive processes. In this study, the latency and amplitude of auditory P300 were compared in sighted and early blind individuals in age range of 18-25 years old.

Methods: In this cross-sectional study, auditory P300 potential was measured in conventional oddball paradigm by using two tone burst stimuli (1000 and 2000 Hz) on 40 sighted subjects and 19 early blind subjects with mean age 20.94 years old.

Results: The mean latency of P300 in early blind subjects was significantly smaller than sighted subjects (p=0.00.( There was no significant difference in amplitude between two groups (p>0.05).

Conclusion: Reduced latency of P300 in early blind subjects in comparison to sighted subjects probably indicates the rate of automatic processing and information categorization is faster in early blind subjects because of sensory compensation. It seems that neural plasticity increases the rate of auditory processing and attention in early blind subjects.

Language characteristics of preschool children with hearing loss in Tehran, Iran

Saeideh Mehrkian

Background and Aim: Hearing impairment affects all aspect of individual life, specially language and communication skills. When hearing impairment is congenital or occurs early in life, the child's ability to learn optimally through audition, will be affected. The aim of this study was to evaluate linguistic skills of preschool hearing impaired children and compare these skills with normal peers.

Methods: This descriptive cross-sectional study was performed on 38 preschool hearing impaired children that the main handicap was severe to profound hearing loss with ability to communicate orally and 28 normal children with the same cultural and social context. Twenty four non linguistic variables including age, gender, the age of entrance of preschool center, number of hearing aids, etc. were obtained by filling a questionnaire and fifteen linguistics variables including number of utterance, morphemes, correct utterance, noun phrase, ambiguous utterance, correct sentences, compound sentences, etc. were collected by some part of TOLD-P-3 test and three complementary questions. Then we compared the data from two groups.

Results: There were significant differences between number of utterance, number of correct mean length utterance, number of well-formed sentences in normal and hearing impaired group (p<0.000). There were no significant difference between unintelligible utterances, repetitive utterances and bad-formed sentences between two groups(p>0.05).

Conclusion: This study showed a severe deficit in linguistic skills in preschool hearing impaired children.

Effect of vestibulo-proprioceptive stimulations in a child with agenesis of the corpus callosum

Leila Dehghan

Background and Aim: The purpose of the present study was to investigate the effect of vestibulo-proprioceptive stimulations of sensory integration theory on the development of gross and fine motor, language and personal-social functions in a child with agenesis of the corpus callosum.

Case: We report a 10.5 month old boy with agenesis of the corpus callosum. The intervention was administered based on sensory integration theory an hour a week for 20 weeks. The exercise intervention consisted of proprioceptive and linear, sustained and low frequency vestibular stimulations on suspension device and physio roll. A Denver Developmental Screening- II and milestones skill testing was completed pre-intervention and monthly. Post-intervention, age of gross motor, fine motor adaptive, language, and personal-social functions significantly improved. Based on milestones skills, maintenance of gross motor functions (e.g. sitting and quadruped position) improved. The child could roll from side to side and released objects voluntarily. The reaction time to auditory stimulations became less than 2 seconds.

Conclusion: vestibulo-proprioceptive stimulations using the neuroplasticity ability of the central nervous system is effective for development of gross and fine motor, language, and personal-social functions. These exercises can be administered for a child with agenesis of the corpus callosum.