Background: hearing loss is a major health care problem that tends to retard the developmental milestones of children. It takes early detection and intervention to avoid a permanent loss in acquisition of speech and cognitive functions. Hence, the importance of hearing screening in all children especially in the developing world for accurate statistics and early intervention is clear. This work was aimed at predicting hearing in children by means of acoustic reflex measurements
Method: In this study which was performed in 1995, 146 ears(86 children aged between 5-10years old referring to audio logy clinic in Tehran university of medical sciences between august 1995 and February 1996) were evaluated (amongst 95 were normal and 51 ears with SNHL<84dB).the methods Niemeyer and Destrehan formula ,Lilly2 equation, un weighed Sensitivity prediction by acoustic reflex, weighed sensitivity prediction by acoustic reflex to establish their clinical viability.
Results: findings demonstrated that weighed sensitivity prediction by acoustic reflex(WASPAR) have a good correlation with conventional audiometric evaluation(K=.78) and also it has good sensitivity, Specificity , Negative predicted value(NPA) and positive predicted value (PPV).
Conclusion: In case that conventional audiometry is not applicable, WASPAR is a good objective choice in lieu of subjective tests.

Objectives: determining the frequency distribution of hearing disorders among the student of public elementary school by Otoscopy, Puretone Audiometry, Impedance Audiometiy and questionnaires.
Methods and Materials:This study was carried out in a cross - sectional descriptive survey - on 1200 students (600 girls and 600 boys) among the student of primary school of Neishabbor, academic year 1376-77
Results:1- Otoscopy examination abnormal conditions of external ear canal was found in 14.1% of cases mostly impacted ceruman (13.6%) Abnormal conditions of tympanic membrane (0.4%) and foreign body 0.16%. Abnormal conditions of external ear canal was statistically unmeaningful. (P V=0 .8)
2- Impedance Audiometiy: 5. 75% Abnormal tympanograms were observed, mostly type C (3.15%)
3- Pure Tone Audiometry: An overall 5.5% hearing loss was found in this population including 3% bilateral and 1.25% unilateral hearing loss. Only conductive hearing loss was found in this population (2.7% in right ear and 3.5% in left ear), PV=0.9.Hearing loss observed mostly in girls but the difference was slight.Family background showed no effects on the hearing disorders.9.8% of cases were in need of medical care and 0.3% were in need of rehabilitation services.Only 28.8% of parents, 36.3% of teachers and 40.9% of afflicted students were aware of the problem.

Method and Materials: This cross- sectional analytical survey is carried out in department of audiology, rehabilitation faculty, IUMS, 1997-1998 on 10 normal and 28 sensory damaged ears out of 27,8 to 40 years old male individuals were evaluated according to following critria:Hearing threshold up to 7OdBHL.Normal middle ear status.
Results: There is good correlation between kiessling&aposs procedure and R-N.A.L, P.O.G.O 11 and Lyharger procedures in determining gain of hearing aid in individuals with flat and raising audiogram. There is poor correlation between them in individuals with high frequency sensory hearing loss.
Conclusion: Kiessling&aposs procedure can he used instead of Lyharger, R-N.A.L, P.0.0.0 11 procedures in children, difficult to test and multihandicapped persons who are not able to cooperate in behavioral audiometry.

Objective: To determine SOAE,TEOAE, and DPOAE, characteristics in normal -hearing school boys.
Method and Material: This cross-sectional study was conducted on 7-11 year-old normal -hearing boys (n = 100) living in 12th zone of Tehran. OAEs also performed and investigated if otoscopy, pure tone and immittance audiometry were normal. Both handedness and ear effects was also considered.
Results : 31% had SOAEs. No significant differrence between the right and lefe ear SOAEs frequency and amplitude means. 1,3 kHz and total response TEOAEs amplitude was significantly different between two ears. There was no significant difference between both ear DPOAEs amplitudes, whereas the letf-handed boys&apos DPOAE amplitude is greater than the right -handed ones&apos amplitudes.
Conclusion : As some results including equal SOAEs of both ears , no difference between both ears SPOAEs amplitude , and handedness effect on the amplitude do not agree with other studies , these finding should be considered in testing OAEs of school boys.

Objective: Survery and comparison between the physical characteristics of Distortion-Product Otoacoustic Emissions of 1-59 day-old normal-hearing newborns refered to TUMS, Rehabilitation School , Audiology department , 2002
Method & Material : This analytical-descriptive study was conducted on the ears of 102 easy method selected newborns. The tests included: otoscopy , BOA, Immittance audiometry , DPOAEs, and ABR if necessary. The amplitude and frequency of 2f1-f2 emissions of DPOAEs evoked by two pure tones (L1=65 dBSPL , L2=50 dBSPL and f2/f1=1.2) were also calculated.
Results: 1-All normal hearing newborns have normal DPOAEs. No significant difference was observed in test-retest. 2- The amplitude of the DPOAEs to the right ear is significantly greater than the amplitude of the left ear (P<00.05). 3- No significant difference was observed between newborn&aposs DPOAEs in terms of their gender.
Conclusion: DPOAEs could be measured quickly and noninvasively and are excellent tools for the screening of newborn hearing loss. The results are valid only within the Context of this research.

Background and Aim: Central auditory processing disorders (CAPD) may have a variety of etiologies therefore, performing CAPD tests seem inevitable. Behavioral tests such as synthetic sentence identification (SSI) has gained considerable popularity because of high sensitivity to brainstem and cortical lesions, high diagnostic ability,  cost-benefiting, and also limitations of electrophysiologic tests. The purpose of this study was to prepare a Farsi-language version of SSI and to perform a primary evaluation. 
Materials and Method: Farsi SSI test was made and recorded on CD. Then sixty 20-to 35- year old normal-hearing participants were evaluated in audiology clinic, Faculty of Rehabilitation Sciences Iran University of Medical Sciences in three months.
Results: There is no significant difference between scores of Farsi and original versions of SSI. Gender has no significant effect on the scores.
Conclusion: According to this results, Farsi SSI is comparable to the original one. It can, therefore, be used in CAPD test battery.

Background and Aim: Mismatch negativity (MMN) is one of auditory evoked potentials that occurs about 100-250 ms after stimulus onset. The MMN waveform is elicited by a discriminateable change in a sequence of repetitive homogenous stimuli. This change can be in intensity level, frequency, or duration of auditory stimuli. The purpose of this study was to obtain MMN waveform using tonal stimuli and to investigate its changes during changes in age.
Materials and Methods: The study was prescriptive-analytic cross-sectional. The participants were sixty children aged 4 to 9 year.The Stimuli were at 80 dB pe SPL. A 1000Hz tone and a 1500 Hz tone were used as standard and deviant stimuli, respectively. Probability of deviant stimuli was 20%. Trials were recorded using surface electrode placed at four locations on the head.
Results: The MMN waveform does not exist in 22.5% of the children. Also, determining of MMN peak in 22.5% was not exactly possible. In other subjects, a significant negative correlation was observed between latency of MMN and age, but not for age and amplitude for this negativity.
Conclusion: This study confirms that the MMN may not be seen in normal people. Also there are maturational changes in MMN waveform.

Background and Aim: Vestibular evoked myogenic potential (VEMPs) is one of the clinical tools to evaluate vestibular function. The VEMPs can be recorded from sternocleidomastoid muscle by auditory stimulation with various sound stimuli and are thought to have saccular origin. The aim of this study was to compare the VEMP responses evoked by short (500 Hz) tone burst (STB) with those evoked by click stimuli in healthy young individuals.          

Materials and Methods: Thirty healthy volunteers (15 males, 15 females) with ages of 18 to 30 years were enrolled in this study. Subjects were instructed to sit on a chair and rotate their head to the opposite side of the recording muscle. The VEMPs was recorded using 500 Hz STB and then click sound stimuli to each ear. The p13 and n23 latencies, p13-n23 peak-to-peak amplitude and VEMPs thresholds were obtained for further analysis.       

Results: The VEMP responses were present in all subjects for STB and ware not recorded in one subject for click. The latencies of p13 and n23 of STB-VEMP were significantly longer, and the p13- n23 amplitudes were significantly greater for STB-VEMP (p<0.05), and thresholds were higher for clicks (p < 0.05). No significant difference was obtained between both ears and genders. (p > 0.05).

Conclusion: The VEMP responses were significantly different between the stimuli of STB and click, and the norms of different stimuli should be established for clinical interpretations. According to these data, we recommend STB stimuli in comparison with clicks for clinical diagnosis.

Background and Aim:  Among all auditory assessment tools, auditory steady state response (ASSR) is a modern test. Modulation frequency for this test is usually 80 Hz. The purpose of this study, was to examined adult subjects with 40 Hz and 80 Hz ASSR and compare the results.
Materials and Methods: Thirty adult (60 ears) were evaluated by ASSR and PTA test, Results were divided into three groups: normal hearing, mild and moderate sensorineural hearing loss.
Results: In all groups, forty hertz ASSR thresholds were relatively closer to behavioral threshold than those of 80 Hz ASSR(p<0.05). Besides, the more severe hearing loss, the lower the difference between those two thresholds. Correlation coefficients were also higher in 40 Hz ASSR(p<0.05).
Conclusion: Frequency modulation thresholds with 40 Hz are more likely to be closer to the behavioral thresholds. Moreover, it has better results than the thresholds with 80 Hz.

Background and Aim: Patients with Parkinson&aposs disease manifest oculomotor abnormalities. This is the consequence of basal ganglia impairment.  The most common abnormalities include increased saccade latency, hypometric saccades  and decreased saccade velocity. The purpose of this study was comparison of saccadic parameters using videonystagmography in patients with idiopathic Parkinson&aposs disease and normal subjects.
Materials and Methods: In this cross sectional study, saccadic movements were investigated in thirty patients with idiopathic Parkinson&aposs disease and thirty age matched subjects were 35-70 years old. Saccade latency, velocity and accuracy were quantitatively analyzed.
Results: Results of this study indicated increased saccade latency, reduction of saccade velocity and accuracy in patients with Parkinson&aposs disease(P<0.001).
Conclusion: This study showed that patients with Parkinson&aposs disease manifest saccadic deficits. This suggests dopaminergic control of these ocular movements.

Background and Aim: Regions in the cochlea with no (or very few) functioning inner hair cells and/or neurons are called dead regions. The aim of this study was to identify the cochlear dead regions in moderate to profound sensory neural hearing impaired children through the Threshold equalizing noise (TEN_HL) test.
Materials and Methods: In this cross-sectional study, the TEN(HL) was performed for the all frequencies available on test CD, on 30 children with ages ranging from five to forteen years (mean age, 8.5 ±2.8 years old).
Results: In this study, 58.3% of ears were found to have a dead region for at least one frequency. Classifying by test frequencies, 20% were found to have a dead region, 24% to be inconclusive and 56% to have no dead regions. The difference between mean SNR(T) in ears with and without dead regions was statistically significant. The difference between mean absolute thresholds in two groups was statistically significant at 1000 Hz and below (p <0.05).
Conclusion: The results indicated a relatively high prevalence of dead regions in children with sensory neural hearing impairment, especially for frequencies at which the hearing loss exceeds 70 dB HL.

Background and Aim: Nowadays, auditory perception is not a complete method to assess vowels quality and we need to use more objective instruments.In this study we want to determine and compare the persian vowels formants in normal and hearing Impaired students in 7ـ9 year old children of Isfahan.
Materials and Methods: This cross sectional study was performed on 64 normal and hearing impaired students. Background information was by interview and then, vowel production test was performed. First three formants of each vowel were obtained and recorded by speech studio soft ware and Dr. Speech device Data were compared between groups.
Results: Mean F₁ and F₂, and F₂/F₁ and F₃/F₁ ratio of Persian vowels between these three studied groups were different significantly. Mean F₃ of /o/, /e/ and /a/ in all groups was different significantly. Although we could not find such a significant differences for /u/, /i/ and /æ/ between these groups(p<0.05).
Conclusion: The most important difference between normal and hearing impaired children is their vowel Space, and we found that, the more sever the hearing impairment is, the closer vowel space will be seen. The hearing impaired children rely mostly on their proprioceptive sense because of their hearing deficiency and it causes less movement of the tongue, so they usually substitute vowels which have similar F₁ and F₂.

Background and Aim: The correlation of stuttering and different linguistic factors is assessed in many studies. The obtained results can pave the way to reach a better understanding of stuttering, as well as finding more appropriate treatments. This study investigates the effect of utterance length on speech dysfluency comparing stuttering Persian(Farsi) -speaking children and nonstuttering ones.
Methods: Ten stuttering and ten nonstuttering Persian-speaking children between 4 and 6 years of age, matched by age and gender where included in this cross-sectional study. All individuals were investigated by ten sets of simple and complex sentences. Morphemes were added one by one to sentences in each set in order to assess the impact of utterance length on dysfluency. Data analysis was performed using SPSS software.
Results: In practicing ten sets of sentences, the speech dysfluency shows significant enhance with increase of utterance length in both stuttering and nonstuttering children (p=0.001). Furthermore, while comparing two groups of simple and complex sentences, significant increase of speech dysfluency was observed by length enhance of utterance, in both stuttering and nonstuttering children (p<0.05). The comparison of stuttering and nonstuttering children showed significant difference between the two groups as well (p=0.001).
Conclusions: The results of this study show that increase in utterance length in both simple and complex sentences lead to increase in dysfluency in stuttering and nonstuttering children. Stuttering children indicated more dysfluency than nonstuttering ones.

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.

Background and Aim: valid identification, prevention, and treatment of language disorders are a high priority for the speech and language professionals. One method for studying language development is sentence repetition that is faster to implement and analysis than other procedures. The aim of this project was constructing sentence repetition test as a quick measure of grammatical potency in 2.5 to 4 year old children.
Methods: Sentences appropriate for 2.5 to 4 year old children were selected during several stages by speech and language pathologist and linguists. The validity of sentences was assessed by professional masters in this theme. Subsequently, 41 sentences including those with 80% high validity were selected as the test sentences. Appropriate pictures were also provided with sentences. The test was administrated to 72 children in 3 groups (2.5-3, 3-3.5, and 3.5-4 year olds, gender matched). The reliability was administered with a test-retest design across a 2 weeks interval.
Results: Content validity Index for this test was 80%. "Test-retest reliability" was used for reliability of this test. The Interclass correlation coefficient for this test was 0.95 and standard error measurement was 7.45. The average of scores for sentence repetition, between groups was significant (p<0.001, p<0.001, p= 0.014).
Conclusion: This sentence repetition test has the appropriate validity and reliability as well as the capability of proper and quick assessment (screening) of grammatical development in 2.5 to 4 year old Persian speaking children.

Background and Aim: Hearing-impaired children make a lot of stress for the parents. Providing the parents of these children with suitable consultation and rehabilitation services results in increased satisfaction and reduced anxiety level. In this study we investigated the relationship between audiology service satisfaction and level of anxiety in parents of hearing-impaired children.
Methods: Seventy-five parents of hearing-impaired children, whose problem was diagnosed during the last year, participated in the study. The mothers were interviewed using satisfaction and anxiety questionnaires.
Results: There was no association between level of service satisfaction and parental state and trait anxiety level however, the group with a higher level of satisfaction (score 64-90) recorded a lower anxiety score (0-20). There was also a significant association between parental state and trait anxiety level (p<0.001). Considering the demographic data, only the living place (Tehran compared with other provinces) showed a significant association with satisfaction and anxiety levels people living in small provinces had a significantly less satisfaction level (p=0.002) and a more anxiety score (p=0.017).
Conclusion: Lack of durability of services was the concern of people living in small provinces which resulted in being more anxious and less satisfied.

Background and Aim: High incidence of speech disorders in children with cerebral palsy could be related to a deficiency in processing of auditory stimuli. So it is vital to check out any peripheral or central disorders in auditory system using behavioral and electrophysiological auditory tests.
Methods: In a cross-sectional study, 15 children with spastic diplegia, mean age 5.77, SD 2.26 years, and 15 normal children, mean age 5.33, SD 1.80 years, were tested using pure tone audiometry, immittance and auditory brainstem responses. The results were compared between the two groups.
Results: Hearing thresholds and middle ear status were in normal range in all participants however, contralateral acoustic reflex thresholds were mostly elevated. Comparing absolute latency and interpeak latency intervals of auditory brainstem responses between the two groups, absolute latency interval of later waves, and in specific the V wave, was significantly longer in diplegic children (p=0.04) resulting in a longer III-V interpeak latency intervals (p=0.02).
Conclusion: Neurological disorders in ponto-reticulo-spinal pathway, pontine reticular nuclei and upper pons which are adjacent to auditory nuclei of lateral leminiscus and inferior colliculus result in auditory dys-synchrony and increased latency intervals in latter waves of auditory brainstem responses. This could also attributed to functional disorders in wave-generating sites in these patients.

Background and Aim: To date, the function of auditory efferent system remains unclear. There is evidence that medial olivocochlear bundle receives descending input from the cortex. In this study, the effect of auditory selective attention on stimulus-frequency otoacoustic emissions (SFOAE) was analyzed to investigate the modification of peripheral auditory system by auditory cortex activity in frequency specific mode.
Methods: Thirty-six normal hearing adult subjects with their age ranging from 18 to 30 years (mean age: 21.9 years) participated in this cross-sectional study. Contralateral suppression of stimulus-frequency otoacoustic emissions was recorded in the right ear at 2 KHz. In order to eliminate the auditory attention, subjects were instructed to read a text. Besides, in order to evaluate the effect of auditory attention on contralateral suppression, subjects were instructed to detect target tones in background noise at 1000, 2000, and 4000 KHz.
Results: A significant increase at contralateral suppression of stimulus-frequency otoacoustic emissions was observed in auditory selective attention conditions (p≤0.001). The largest magnitude of stimulus-frequency otoacoustic emissions suppression was seen at 2 KHz.
Conclusion: The results of this study indicated that the activities of medial olivocochlear bundle enhanced by contralateral auditory selective attention increase the magnitude of stimulus-frequency otoacoustic emissions suppression. In fact, these results provided evidence for influence of auditory cortex on the peripheral auditory system via corticofugal pathways in a frequency specific way.

Background and Aim: It is well established that adult sensory systems can reorganize following environmental changes hearing aid stimulates a deprived auditory system resulting in changes in received stimuli and may be capable of inducing changes within the auditory system abilities such as difference limen for intensity. Hearing aid fitting induces perceptual and physiological modifications. The present study was conducted to evaluate the effects of hearing aid use on the intensity discrimination performance.
Methods: The study group consisted of 30 monaural users of hearing aid with symmetrical moderate or moderately severe sensorineural hearing loss in both ears (15 males, 15 females), aged 45-65 years old with the mean of 57.73 and SD of 8.12 years. difference limen for intensity was measured at two frequencies, 500 Hz, 2000 Hz, and two intensity levels (10 dB SL, 40 dB SL). The results of fitted ears were compared with not-fitted ones.
Results: The results of the study showed better difference limen for intensity scores at high frequency and high intensity levels. A significant lower difference limen for intensity in fitted ears was observed compared with not-fitted ears (p<0.05), while there was no significant difference between the difference limen for intensity in the two groups at 500 Hz with 10 dB SL intensity (p=0.132).
Conclusion: Hearing aid use affects intensity discrimination performance. Besides, perceptual modification following use of hearing aid is confirmed by our study which suggests a possible functional plasticity due to hearing aid use. However, further

Background and Aim: The communication process includes both verbal and nonverbal elements. Nonverbal behavior or body language includes facial expression, eye contact, posture and prosody. Prosody conveys semantic or affective information to a listener. Nonetheless, so far in Iran no report on assessment of speech prosody comprehension in patients has ever been published. The aim of this study was to measure the validity and reliability of the prosody comprehension test specifically designed for the Persian language and culture.
Methods: This study is a type of test development. 73 sentences were orated by 22 professional vocalists in eight different prosodies. A total of 6582 voices were prepared which were listened by 200, 18-30 year-old students and a voice specialist. Having the content validity calculated for all voices, 1473 voices were found to be unanimously agreed upon by all participants in terms of emotional status which were analyzed by a voice specialist. Eventually, 169 voices were selected for developing the prosody comprehension test including the following four subtests: none motional prosody discrimination, emotional discrimination, naming of prosody and naming conflicts. Reliability of the test was determined by performing the test on 32, 18-60 year-old normal people.
Results: The designed test of comprehension prosody had 100% content validity ratio and 94% reliability and the correlation of test of prosody was 89% (p=0.001).
Conclusion: This test in Persian language has appropriate validity and reliability and is appropriate for assessment of prosody comprehension.