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Objective: To measure external ear resonant amplitude and frequency in children (3-7 years old) and to compare with adult measures.
Method and materials: The external ear resonance peak amplitude and frequency of 63 children 3-7 years old were recorded. All of the children had normal tympanogram and there was no cerumen in external auditory canal. 20 adult of 21-24 years old (10 male , 10 female) were selected in order to compare with children that had normal tympanogram. The tests included : 1-otoscopy 2- tympanometry 3-microphone probe tube test.
Results: The average of resonance peak frequency for children and adult is 4200 Hz and 3200 Hz , respectively. The resonance frequency of children had significantly diffrence with average of resonance frequency in adults. The average of resonance peak amplitude for children and adult is 17.70 dB and 17.17 dB , respectively.
Conclusion: Resonant frequency and amplitude affect the hearing aid prescription and fitting process and calculating insertion gain so, this measures seem should be considered in children hearing aid fitting.

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Objective: Genetic studies show that consanguineous marriage can increase the probability of incidence of genetic impairments such as hearing impairments. The target of this study is to identify the prevalence of consanguinity among the parents of hearing impaired students in primary schools.

Materials and Methods: We selected all of deaf students of Tehran (614 students). Their mothers answered to questionnaires. The questions were about Risk Factors of deafness in mother pregnancy or in neonatal period.
Results: from 614 students, 389 parents of them (64%) had consanguineous marriage and 223 person (36%) didn&apost have this factor. 2 person did not answer to this question. In this study we observed that there is 32.3% family history of hearing loss, 29.2%deaf sister and brother, 17% ear infection history. Other risk factors were studied too. Also there is significant correlation between consanguinity and more than one deaf children in the family (p<0.005).
Conclusion: According to high incidence of consanguinity (64%)that was observed in this study it may be one of most important causes of sensory neural hearing loss in children, so we should give enough information about this problem to the people.

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Background and Aim: One of the most significant complaints of children with learning disability (LD) is difficulty in understanding speech in the presence of background noise. Different studies have shown that the medial olivocochlear bundle(MOCB) may play a role in hearing in noise. The MOCB function can be evaluated by the contralateral suppression of tone burst evoked otoacoustic emissions (TBEOAEs).The aim of the present study was to evaluate frequency specifications of MOCB by the contralateral suppression of TBEOAEs at 1,2,3 and 4 KHz in response to contralateral white noise in LD students.
Materials and Methods: This case-control study was conducted on 34 LD students aged 7-11 years and 31 normal students matched for age.The contralateral suppression of TBEOAEs was evaluated by comparing TBEOAEs amplitudes with and without contralateral white noise.
Results: In the absence of noise there was no significant difference between TBEOAEs amplitudes of two groups. In the presence of noise significant decrease was seen in TBEOAEs amplitudes at 1,2,3 and 4 KHz in both groups. In LD students the amount of this decrement at 1,2 and 4 KHz was lower than in the normal students.
Conclusion: A significant diminished suppression effect at 1,2 and 4 KHz in LD students indicates that at these frequency regions MOCB function was reduced. Therefore its suggested that the assessment of MOCB by evaluating the suppression effect of TBEOAEs included in the test battery approach used in the diagnostic of LD students.

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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.

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Background and Aim: The voice of human being changes during lifetime with different patterns in males and females. In addition to assessment of changes due to aging, some studies examined the voice changes among various languages and ethnical groups. This study is performed to evaluate the fundamental frequency changes in normal 9-50 year-old Persian (Farsi) speaking individuals.
Methods: In this cross-sectional study, 320 voice samples in normal voiceless environment were recorded. The mean of fundamental frequency of vowels and counting is measured by Dr Speech software (real analysis program). Data analysis was performed by MANOVA test and the profiles of their changes were plotted.
Results: The profile of mean of fundamental frequency changes was different in males and females. The mean of fundamental frequency was equal in both genders until 13 years old and the samples of voice had low pitch (Mean: higher than 200 Hz). MFF after 13 years old significantly decreased in males specially in vowels (p<0.001). The changes in vowels and counting were similar. The mean of fundamental frequency in both genders, between 20-40 years old had  relative constancy.
Conclusion: The mean of fundamental frequency changes of vowels and counting in females and males result from diverse dimensions of larynx and other anatomical differences. Significant changes of mean of fundamental frequency in both genders after 13 years old result from puberty in males. The proportional consistence of mean of fundamental frequency between 20-40 years old is probably due to the uniformity of body in this age range.

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Background and Aim: Learning disability is a term referes to a group of disorders manifesting listening, reading, writing, or mathematical problems. These children mostly have attention difficulties in classroom that leads to many learning problems. In this study we aimed to compare the auditory attention of 7 to 9 year old children with learning disability to non- learning disability age matched normal group.
Methods: Twenty seven male 7 to 9 year old students with learning disability and 27 age and sex matched normal conrols were selected with unprobable simple sampling. 27 In order to evaluate auditory selective and divided attention, Farsi versions of speech in noise and dichotic digit test were used respectively.
Results: Comparison of mean scores of Farsi versions of speech in noise in both ears of 7 and 8 year-old students in two groups indicated no significant difference (p>0.05) Mean scores of 9 year old controls was significant more than those of the cases only in the right ear (p=0.033). However, no significant difference was observed between mean scores of dichotic digit test assessing the right ear of 9 year-old learning disability and non learning disability students (p>0.05). Moreover, mean scores of 7 and 8 year- old students with learning disability was less than those of their normal peers in the left ear (p>0.05).
Conclusion: Selective auditory attention is not affected in the optimal signal to noise ratio, while divided attention seems to be affected by maturity delay of auditory system or central auditory system disorders.

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Background and Aim: Vocal cord nodule is one of the voice disorders causes hoarseness and breathy voice. Voice therapy is one of the treatment approaches. We aimed to find out the effects of voice therapy on vocal acoustic characteristics in these patients.
Methods: In this case series, five women with vocal nodule (14 to 45-year-old) participated in a 9-week voice therapy program developed by Boone. Vocal hygiene and voice practices were measured every day using a questionnaire. Moreover, structure and movements of vocal folds were examined using videolaryngostroboscope by a laryngologist before and after voice therapy to evaluate the effectiveness of program. For collecting voice samples we used sustained /æ/ in comfortable loudness for all patients and data were analyzed using Speech Studio.
Results: After voice therapy, fundamental frequency in four of five subjects were decreased but it was not significant (p=0.225). However, jitter in all of five subjects was significantly decreased (p=0.043). After voice therapy, shimmer in three of five subjects were decreased that was not significant (p=0.345).
Conclusion: Voice therapy can be used for the remedy of acoustic vocal characteristics and elimination or contraction of vocal cord nodule.

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Background and Aim: The words are the symbolic tools for communication. Nouns are the initial and the most frequent components of language that children acquire and use during the procedure of language development. Therefore, this study aimed to determine the noun perception and expression abilities in Persian-speaking children, as well as gathering the normative data for two picture-pointing and picture-naming tests.
Methods: In this cross-sectional study, 110 normal Persian-speaking children (54 girls and 56 boys), 2.5 to 4 year-old in four groups, were selected randomly throughout Arak kindergartens. Two pictorial perception and expression tests were performed in this study.
Results: Mean scores of perception and expression was statistically different between all age groups, except 3 and 3.5 year-old groups (p<0.05). There was no statistically difference between mean scores of girls and boys. In addition, a significant positive correlation between mean scores of perception and expression was shown (p=0.001, r=0.896).
Conclusion: The perception and expression abilities are different in 4 age groups. The two picture-pointing and picture-naming tests can show these differences. Regardless of rapid development of perception, perception and expression abilities develop in parallel, and the ability of girls and boys shows similar trends.

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Background and Aim: Contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) test evaluates the efferent auditory system. In this test, acoustic reflex is an important confounding variable. In recent years, application of this test is growing especially in children suspect to central auditory processing disorder. Therefore, the magnitude of influence of this confounding variable on the suppression of TEOAEs should be made clear. The aim of this study was to investigate the impact of acoustic reflex on contralateral suppression of TEOAEs.
Methods: This research was performed on 39 normal-hearing adults of both sexes and of 18-26 years of age. Tests were used for the determination of interaural attenuation (IA), acoustic reflex, TEOAEs and contralateral suppression of TEOAEs.
Results: TEOAEs amplitudes and their contralateral suppression were significantly higher in females and males respectively (p=0.01). The amount of TEOAEs suppression before reflex activity ranged between 2000 to 3000 Hz. Activation of acoustic reflex significantly increased the magnitude of suppression in all frequency bands (p≤0.01) and maximum suppression occurred in 500 to 1000 Hz.
Conclusion: For achieving accuracy of clinical findings, clinicians should always use suppressant levels lower than the acoustic reflex threshold. It is recommended that different norms for males and females be used in contralateral suppression of TEOAEs.

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Background and Aim: American Academy of Pediatrics (AAP) established standards for neonatal hearing screening programs in 1999. The main purpose of this study was to achieve exact statistical data of this program in Ahvaz, Iran, and to compare these results with the standards of American Academy of Pediatrics.

Methods: In this cross-sectional descriptive study, the data of neonatal hearing program in Ahvaz west health center from 2008 to 2011 were reviewed. Data were analysed by descriptive statistics.

Results: From 25073 neonates, 25 had hearing loss. The false positive and referral ratio to the diagnosis stage were 2.6 and 0.48 percent, respectively. 92 percent of hard of hearing infants were diagnosed before three months of life.

Conclusion: In comparison with the standards of American Academy of Pediatrics, all of the items, except two, were included completely or relatively complete. But, more efforts must be done to achieve the whole standards which are available.

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Background and Aim: Auditory-perceptual assessment of voice a main approach in the diagnosis and therapy improvement of voice disorders. Despite, there are few Iranian studies about auditory-perceptual assessment of voice. The aim of present study was development and determination of validity and rater reliability of Persian version of the Consensus Auditory Perceptual Evaluation of Voice (CAPE -V).

Methods: The qualitative content validity was detected by collecting 10 questionnaires from 9 experienced speech and language pathologists and a linguist. For reliability purposes, the voice samples of 40 dysphonic (neurogenic, functional with and without laryngeal lesions) adults (20-45 years of age) and 10 normal healthy speakers were recorded. The samples included sustain of vowels and reading the 6 sentences of Persian version of the consensus auditory perceptual evaluation of voice called the ATSHA.

Results: The qualitative content validity was proved for developed Persian version of the consensus auditory perceptual evaluation of voice. Cronbach’s alpha was high (0.95). Intra-rater reliability coefficients ranged from 0.86 for overall severity to 0.42 for pitch inter-rater reliability ranged from 0.85 for overall severity to 0.32 for pitch (p<0.05).

Conclusion: The ATSHA can be used as a valid and reliable Persian scale for auditory perceptual assessment of voice in adults.

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Background and Aim: During speech development in normal children, cluster reduction is one of the natural phonological processes. Children begin to produce some consonant clusters from the age of 2 years but ability to produce all consonant clusters continues up to 9. The main objective of this investigation was assessing the ability of Persian-speaking children in production of consonant clusters in mono-syllable CVCC words.

Methods: In this cross-sectional and comparative study, production of 19 clusters with stop, fricative, affricate, nasal, and glide consonants in 38 words were tested in 200 Persian-speaking children at the age of 3 to 6 years in kindergartens of Tehran, Iran. Content validity indexes of 38 words were above 0.80 and Cronbach’s alpha of split half was 0.91.

Results: More than 75% of 3-years-old children were able to produce /xl/, /bz/, /rs/, and /xm/ clusters. Age was positively correlated with correct production scores of words (p=0.001) and was negatively correlated with cluster reduction scores (p=0.001).

Conclusion: Three-years-old normal Persian-speaking children may use cluster reduction in words with consonant clusters but this phonological process decreased by increasing of age so, most of the 6-years-old children could produce consonant clusters correctly. Place of articulation more than manner of articulation affect on correct production of consonant clusters.