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Background and Aim: Diabetes mellitus is a progressive metabolic disease. Studies about the relationship between diabetes mellitus and auditory impairment have shown variable results in supporting the fact that diabetes may have a complex repercussion on the auditory pathways. We aimed to evaluate hearing in patients with type II diabetes mellitus with behavioral and electrophysiological auditory tests.

Methods: In a cross-sectional study, we assessed 30 patients with type II diabetes mellitus with the mean age of 43.7 (SD: 1.3) years, ranging 40-45 years, and 30 matched healthy subjects with the mean age of 41.5 (SD: 1.5) years. Subjects were evaluated using auditory brainstem response (ABR) and pure tone audiometry. The results were compared between two groups.

Results: Pure tone audiometry was normal. There was a significant increased latency for waves I, III, and V, and also, interpeak latencies of I-III, III-V, and I-V waves (p<0.05).

Conclusion: ABR latency prolongation indicates abnormal nerve conduction velocity in patients with type II diabetes mellitus. ABR can be an important clinical tool for evaluating diabetes influence on cochlear nerve conduction velocity before hearing loss occurs in these patients.

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Background and Aim: Developing appropriate curriculum for the education of deaf children depends on identifying the needs of this group. We aimed to examine educational rehabilitating needs of hearing-impaired children from the point of view of their parents.

Methods: In this descriptive survey study, data gathering tool was a researcher-made questionnaire completed by 64 parents of deaf children.

Results: Parents expressed that fitness of training with the students in school, willingness to participate in the program, and the use of a uditory-verbal therapy as a good way were the main notification preferences to families of hearing-impaired children, exceptional centers, and advertisements. They emphesied that lack of appropriate facilities, children's pertinacity, and their lack of cooperation prevented the implementation of training programs and curriculum in educational centers and home. Good verbal communication and speech was as the parents' first priority expectation of their child at the end of course. There was a significant difference between parents' opinions about the educational needs and rehabilitation (p<0.05). No significant difference was seen between the parents' suggestions about educational problems of hearing-impaired children (p>0.05). Also, there was no significantly association between the gender of child or the educational level of parents with the parents' view.

Conclusion: It seems that parents should be supported by training workshops and consulting. Also, most of the children in this study were trained auditory-verbally and the results do not mean that other educational and rehabilitation methods have not the discussed characteristics.

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Background and Aim: Behavioral audiometry is the best method of hearing evaluation. Hearing thresholds are estimated with auditory evoked responses in patients who are not able to cooperate in behavioral audiometry. Because rehabilitative decisions are based on behavioral thresholds, it is essential to determine the amount of difference between behavioral and evoked response thresholds. The purpose of this study was to evaluate the difference between functional and auditory steady-state response (ASSR) gains.

Methods: Twenty six moderate to severe hearing impaired adolescents and adults (age range: 14 to 55 years) participated in this interventional-comparative study. Audiometery and ASSR testing was performed (without hearing aid and then with hearing aid). Finally, functional gain with ASSR gain, and behavioral thresholds with ASSR thresholds were compared using paired t-test and correlation statistical methods. All tests were performed in the sound field.

Results: The mean difference was 6.19 dB between unaided behavioral and ASSR thresholds, 4.33 dB between aided thresholds, and 2.43 dB between functional and ASSR gains. There was no significant difference between functional and ASSR gains (p>0.05).

Conclusion: The difference between functional and ASSR gains is less than the difference between behavioral and ASSR thresholds and it has less variability between different frequencies. So, it may be better to use ASSR gain instead of ASSR thresholds in hearing aid fitting in difficult-to-test population.

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Background and Aim: Staggered spondaic words (SSW) test examines central auditory nervous system . Some researches show stuttering causes hyperactivity in motor system of the right hemisphere and cerebellum and decreases activity in the left hemisphere. During stuttering also, central auditory processing is decreased . The aim of this study was to compare the Persian staggered spondaic word test results between persistent developmental stutterers and normal subjects.

Methods: Thirty people with persistent developmental stuttering were participants of this cross-sectional descriptive-analytic study, which were aged 11 to 40 years. The control group matched for gender and number with stutters. They were 8 females and 22 males, with the age of 11 to 40 years, without any stuttering history, neurological diseases and auditory disorders.

Results: Stutterers were in normal category in corrected staggered spondaic words test. The mean scores of errors of right compete, right ear, left compete, left ear and total in corrected s taggered spondaic words between control and stuttering group showed significant differences. There was a significant relationship between stuttering and effect, too (p<0.05).

Conclusion: Based on the obtained results of this study, stutterers may have different cortical and sub - cortical brain activity than people who have not stutter . Central auditory processing abilities of stutterers are weaker than normal people.

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Background and Aim: Omega-3 fatty acid have structural and biological roles in the body 's various systems . Numerous studies have tried to research about it. Auditory system is affected a s well. The aim of this article was to review the researches about the effect of omega-3 on auditory system.

Methods: We searched Medline , Google Scholar, PubMed, Cochrane Library and SID search engines with the "auditory" and "omega-3" keywords and read textbooks about this subject between 19 70 and 20 13.

Conclusion: Both excess and deficient amounts of dietary omega-3 fatty acid can cause harmful effects on fetal and infant growth and development of brain and central nervous system esspesially auditory system. It is important to determine the adequate dosage of omega-3.

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Background and Aim: Concerning the important role of parents of hearing-impaired children in auditory-verbal therapy, this study mainly focused on preparing a Persian version of the “Parental needs questionnaire” and analyzing its validity and reliability.

Methods: First, the original English version of the questionnaire “the needs of hearing-impaired Children’s Parents in Auditory-Verbal Therapy” translated to Persian, based on the approved translation protocol of International Quality of Life Assessment by world health organization. Then, the Persian version presented to seven experts for validating the content and their feedbacks were applied into the questionnaire. Finally, the questionnaire presented to parents of 51 hearing-impaired children who attend in auditory-verbal therapy, and the collected results were analyzed statistically.

Results: The overall mean of content validity index in 32 items of the questionnaire was 0.87. The overall Cronbach’s alpha of this questionnaire was 0.86 in the test and 0.99 in the re-test phases.

Conclusion: Based on the obtained results, the Persian version of the questionnaire has a satisfactory content validity and reliability and could be used in clinics and medical centers for analysis of parental needs.

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Background and Aim: The auditory steady state response is a modern test for estimating hearing thresholds, especially in difficult to test individuals . However, there are few bone conduction auditory steady state response data, particularly for individuals with hearing loss. The objective of this study was to investigate bone conduction auditory steady state response thresholds in individuals with sensorineural hearing loss and normal hearing.

Methods: In a cross-sectional study, 10 individuals with normal hearing and 10 with sensorineural hearing loss at the age of 15-30 years were selected by non-probability sampling. Auditory steady state response and pure tone audiometry to bone conduction stimuli in 500 and 2000 Hz were recorded in two groups. Paired and independent t-test were used to compare data between the groups.

Results: There was low correlation between bone conduction auditory steady state response and pure tone audiometry in both groups (p>0.05 for both). The difference of behavioral thresholds and auditory steady state response in 500 Hz was higher than 2000 Hz in both groups (p=0.033 for normal hearing and p=0.017 for sensorineural hearing loss groups). Comparison of these results showed significant differences between the two groups (p<0.001).

Conclusion: In both groups, there was low correlation between bone conduction auditory steady state response and pure tone audiometry thresholds. In individuals with sensorineural hearing loss and in higher frequencies , bone conduction auditory steady state response thresholds was closer to pure tone audiometery thresholds.

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Background and Aim: Studies have shown that long-term use of monaural hearing aid in symmetrical hearing losses may lead to physiological changes. In this research, the possibility of plasticity occurrence in bilaterally hearing impaired listeners fitted with only one hearing aid was investigated.

Methods: Our study was carried out on 12 elderly listeners with a mean age of 61.92 years who had symmetrical moderate to severe sensory neural hearing loss in both ears. All of the participants had minimum monaural hearing aid experience of 2 years. We used auditory brainstem response (ABR) testing in order to compare absolute latency and amplitude of wave V between the two ears of cases. Air conduction click stimuli were presented monaurally at 80, 90 and 100 dB nHL.

Results: Despite the shorter absolute latency of wave V in the fitted ear, no significant difference was found between the two ears (p>0.389). The difference between wave V amplitude of both ears was greater in 90 dB nHL level (p=0.043). Women showed shorter mean latency than men and the mean amplitude of women was greater than men. Significant gender difference was observed in absolute latency of wave V (p<0.037).

Conclusion: Our findings indicate that the use of monaural hearing aid in symmetrical hearing losses can induce neural plasticity within auditory brainstem pathways which can be displayed by auditory brainstem response test.

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Background and Aim: Dyslexia is the most common learning disability. One of the main factors have role in this disability is auditory perception imperfection that cause a lot of problems in education. We aimed to study the effect of auditory perception training on reading performance of female students with dyslexia at the third grade of elementary school.

Methods: Thirty-eight female students at the third grade of elementary schools of Khomeinishahr City, Iran, were selected by multistage cluster random sampling of them, 20 students which were diagnosed dyslexic by Reading test and Wechsler test, devided randomly to two equal groups of experimental and control. For experimental group, during ten 45-minute sessions, auditory perception training were conducted, but no intervention was done for control group. An participants were re-assessed by Reading test after the intervention (pre- and post- test method). Data were analyed by covariance test.

Results: The effect of auditory perception training on reading performance (81%) was significant (p<0.0001) for all subtests execpt the separate compound word test.

Conclusion: Findings of our study confirm the hypothesis that auditory perception training effects on students' functional reading. So, auditory perception training seems to be necessary for the students with dyslexia.

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Background and Aim: Cerebrovascular accident is a neurological disorder involves central nervous system. Studies have shown that it affects the outputs of behavioral auditory tests such as dichotic auditory verbal memory test. The purpose of this study was to compare this memory test results between patients with cerebrovascular accident and normal subjects.

Methods: This cross-sectional study was conducted on 20 patients with cerebrovascular accident aged 50-70 years and 20 controls matched for age and gender in Emam Khomeini Hospital, Tehran, Iran. Dichotic auditory verbal memory test was performed on each subject.

Results: The mean score in the two groups was significantly different (p<0.0001). The results indicated that the right-ear score was significantly greater than the left-ear score in normal subjects (p<0.0001) and in patients with right hemisphere lesion (p<0.0001). The right-ear and left-ear scores were not significantly different in patients with left hemisphere lesion (p=0.0860).

Conclusion: Among other methods, Dichotic auditory verbal memory test is a beneficial test in assessing the central auditory nervous system of patients with cerebrovascular accident. It seems that it is sensitive to the damages occur following temporal lobe strokes.

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Background and Aim: Memory is one of the aspects of cognitive function which is widely affected among aged people. Since aging has different effects on different memorial systems and little studies have investigated auditory-verbal memory function in older adults using dichotic listening techniques, the purpose of this study was to evaluate the auditory-verbal memory function among old people using Persian version of dichotic auditory-verbal memory test. Methods: The Persian version of dichotic auditory-verbal memory test was administered to 23 old people ranging 60-80 years and 30 young people aging 20-30 years, with normal and symmetric hearing in both ears. The performance of the two groups was compared. Results: The mean score of young (6.36±0.43) and old (4.58±0.74) adults on dichotic auditory-verbal memory test were significantly difference (p=0.001). The correlation test showed a negative correlation between age and the memory scores in aged people (r=0.36). A significant difference in recall of early (p=0.034), middle (p=0.037), and final (p=0.041) words was seen between aged and young people. Conclusion: Based on the obtained results, significant reduction in auditory memory was seen in aged group and the Persian version of dichotic auditory-verbal memory test, like many other auditory verbal memory tests, showed the aging effects on auditory verbal memory performance.

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Background and Aim: While most of the people with tinnitus have some degrees of hearing impairment, a small percent of patients admitted to ear, nose and throat clinics or hearing evaluation centers are those who complain of tinnitus despite having normal hearing thresholds. This study was performed to better understanding of the reasons of probable causes of tinnitus and to investigate possible changes in the auditory brainstem function in normal-hearing patients with chronic tinnitus.

Methods: In this comparative cross-sectional, descriptive and analytic study, 52 ears (26 with and 26 without tinnitus) were examined. Components of the auditory brainstem response (ABR) including wave latencies and wave amplitudes were determined in the two groups and analyzed using appropriate statistical methods.

Results: The mean differences between the absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that was not statistically significant. Also, the interpeak latency values of waves I-III, III-V and I-V in both groups had no significant difference. Only, the V/I amplitude ratio in the tinnitus group was significantly higher (p=0.04).

Conclusion: The changes observed in amplitude of waves, especially in the latter ones, can be considered as an indication of plastic changes in neuronal activity and its possible role in generation of tinnitus in normal-hearing patients.

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Background and Aim: Speech-evoked auditory brainstem responses were used in the assessment of subcortical encoding of the speech stimuli in the English language. These processes are affected by language background and experiences. Considering the language specific acoustic differences, the aim of current study was establishing the response norms in adult Persian-speakers and comparing the encoding of the speech syllable /da/ between Persian and English languages.

Methods: Auditory brainstem responses to speech syllable /da/ in the right ear, gained from 48 normal adults (25 women and 23 men) with the mean age of 22.70 with SD 2.05 years were recorded. After characterizing the onset elements, transition from consonant to vowel, the periodic portion and offset of response, the Persian dataset were compared with 95% confidence interval norms in the age range of 18-28 years.

Results: The response to speech syllable /da/ was successfully recorded in all of the subjects and main features of response were highly overlapped with published English norms.

Conclusion: Normative values for speech-evoked auditory brainstem responses in adult Persian speakers are presented in the current survey. Our findings suggest that the recommended procedure and more importantly, the scoring method based on English norms can be used in Persian speakers without replacing the original synthetic vowel /da/.

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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: CE-Chirp stimulus has been developed for stimulating more apical regions of the cochlea. Inadequacy of clinical information on the latency and amplitude characteristics of ABR evoked by CE-chirp at different levels in addition to discrepancy in identifying earlier ABR waveforms using CE-chirp stimulus are the reasons of this study.

Methods: This study was done by recoding ABR to click and broad-band CE-chirp stimuli in the right ear of 15 non-randomly selected normal-hearing individuals with age range of 20-30 years old. Frequency of recordable waves I and III, as well as threshold, amplitude, and latency of wave V were compared in response to click and CE-Chirp at 20-80 dB nHL.

Results: At 80 dB nHL, click stimulus evokes waves I and III more frequently than chirp stimulus (p=0.012 and p=0.016 respectively). At 20 and 40 dB nHL, wave V latency evoked by CE-Chirp is significantly longer than wave V latency evoked by click (p=0.012 and p=0.0001 respectively) however, at 80 dB nHL wave V latency evoked by CE-Chirp is shorter than click (p=0.0001). Wave V amplitude for CE-Chirp is significantly larger than for click at levels of 20, 40 and 60 dB nHL (p=0.0001, p=0.0001 and p=0.013 respectively). Wave V threshold is approximately 5 dB lower with CE-chirp compared to click (p=0.014).

Conclusion: Except at high levels, CE-Chirp evokes wave V with larger amplitude and lower threshold than click. Possibility of recording earlier ABR waves is reduced with CE-chirp stimulus.

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Background and Aim: Music exists in all cultures many scientists are seeking to understand how music effects cognitive development such as comprehension, memory, and reading skills. More recently, a considerable number of neuroscience studies on music have been developed. This study aimed to investigate the effects of null and positive background music in comparison with silence on auditory-verbal memory performance.

Methods: Forty young adults (male and female) with normal hearing, aged between 18 and 26, participated in this comparative-analysis study. An auditory and speech evaluation was conducted in order to investigate the effects of background music on working memory. Subsequently, the Rey auditory-verbal learning test was performed for three conditions: silence, positive, and null music.

Results: The mean score of the Rey auditory-verbal learning test in silence condition was higher than the positive music condition (p=0.003) and the null music condition (p=0.01). The tests results did not reveal any gender differences.

Conclusion: It seems that the presence of competitive music (positive and null music) and the orientation of auditory attention have negative effects on the performance of verbal working memory. It is possibly owing to the intervention of music with verbal information processing in the brain.

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Background and Aim: Although double dichotic digit test is a useful tool for assessing the central auditory system in adults, it is more useful for evaluating younger children. The present study aimed to develop the Persian version of the single dichotic digit test and to obtain initial normative data.

Methods: The Persian version of the present test consisted of three different sets of 25 single digit pairs for testing in the free recall, directed recall to right, and directed recall to left conditions. The digits in each list were recorded dichotically on a compact disc. The sectional study was performed on 126 male students, aged between 7 and 9. The test-retest reliability was assessed in 29 subjects two to four weeks after the first test session.

Results: In seven year olds, the mean right and left ear scores increased from around 95.79% and 89.69%, respectively. In eight year olds, the mean right and left ear scores increased from around 98.59% and 96.29%, respectively. The mean right ear advantage decreased from around 6.13% in 7 year olds to around 2% in 8 year olds (p=0.001). No significant difference was found in scores between the free recall and directed recall conditions (p>0.05). The test had a high test-retest reliability (p>0.05).

Conclusion: The Persian version of the test has a high test-retest reliability for evaluating male children aged between 7 and 9 it can be used for assessing binaural integration in male children of this age group.

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Background and Aim: Specific language impairment (SLI), one variety of developmental language disorder, has attracted much interest in recent decades. Much research has been conducted to discover why some children have a specific language impairment. So far, research has failed to identify a reason for this linguistic deficiency. Some researchers believe language disorder causes defects in phonological working memory and affects auditory processing speed. Therefore, this study reviews the results of research investigating these two factors in children with specific language impairment.

Recent Findings: Studies have shown that children with specific language impairment face constraints in phonological working memory capacity. Memory deficit is one possible cause of linguistic disorder in children with specific language impairment. However, in these children, disorder in information processing speed is observed, especially regarding the auditory aspect.

Conclusion: Much more research is required to adequately explain the relationship between phonological working memory and auditory processing speed with language. However, given the role of phonological working memory and auditory processing speed in language acquisition, a focus should be placed on phonological working memory capacity and auditory processing speed in the assessment and treatment of children with a specific language impairment.

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Background and Aim: Creatine plays an important role in the regulation of cellular energy in high energy demand organs such as the inner ear. It is also believed to play a protective role. This article reviewed the mechanisms and effects of creatine on the auditory and vestibular systems.

Recent Findings: Creatine transporters and creatine kinase enzymes are involved in converting creatine to creatine phosphate. Phosphate is a fuel cell available in the cochlear and vestibular hair cells and the protective cells, striavascularis, peripheral and central neural pathways to the auditory cortex. It provides essential ATP for auditory and vestibular system performance. Creatine kinase prevents cochlear damage by regulating the metabolism of energy in marginal layers of the striavascularis and preventing free radical production in stressful situations. It also plays an important role in vestibular compensation. Creatine kinase dysfunction leads to an increase in the threshold of auditory brainstem potentials and a reduction in vestibular performance. The use of creatine improves vestibular evoked myogenic potentials and neurologic symptoms.

Conclusion: Creatine and creatine kinase protein is essential for normal hearing and balance function and sensitivity. Creatine kinase deficiency impairs the functioning of these two systems however, creatine consumption may boost the sensitivity of the vestibular system and neurological performance. Effects of the creatine consumption on the auditory system have not yet been examined.

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Background and Aim: Clinicians and researchers always need standard measures for the evaluation of auditory perception and speech production in deaf children, particularly those with cochlear implants. This study addresses the reliability and validity of the Persian version of categorization of auditory performance (CAP) scale and speech intelligibility rating (SIR) in cochlear-implanted prelingual deaf children.

Methods: A total of 92 cochlear-implanted deaf children aged 1.3-15.7 years participated in the study. Test-retest reliability, inter-rater reliability, and criterion and construct validity of the scales were investigated.

Results: The obtained test-retest reliability for categorization of the auditory performance scale and speech intelligibility rating was 0.82 and 0.99 (p<0.01), respectively, whereas the suggested inter-rater reliability based on average Cohen’s kappa coefficient was 0.73 and 0.70 for the two scales (p<0.01), which appear acceptable. The concurrent validity of the scales was 0.64 and 0.69 (p<0.01). The construct validity for categorization of the auditory performance scale ranged between 0.58 and 0.74 (p<0.01), whereas the same feature for the speech intelligibility rating indicated a range between 0.66 and 0.69 (p<0.01).

Conclusion: The findings of this investigation indicated that both CAPII and SIR scales are reliable and valid instruments for the assessment of auditory perception and speech production of cochlear-implant deaf children.