Background and Aim: A negative deflection with a 3-4 ms latency period has been reported to exist within the auditory brainstem response of some patients with profound hearing loss following a strong acoustic stimulus. This deflection, namingly the n3 or the acoustically evoked short latency negative response is assumed to be a vestibular-evoked potential, especially of saccular origin. Since the myogenic potential is also saccular in origin, the purpose of the present study was to investigate the relationship between these two tests in adults with profound hearing loss.
Methods: The present cross sectional study was performed on 20 profoundly deaf volunteers(39 ears) who aged between 18-40 years old, randomly selected from available deaf adults in Tehran. The auditory brainstem response of all subjects was recorded following a 1000 Hz tone burst in 70-100dB nHL. Subjects were also tested for vestibular evoked myogenic potential.
Results: Only 34 of 39 ears recorded myogenic potential that negative response was recorded in 27 of 34 ears with normal p13 and n23. In seven ears with normal p13 and n23, the negative response was absent. In 3 ears with no p13 and n23, the negative response was observed, and two none.
Conclusion: In view of the high prevalance of the negative response in profoundly deaf ears with normal p13 and n23, it could be concluded that the negative response can be used when for any reason, it is not possible to record myogenic potential and be considered as a new test in vestibular test battery.

Background and Aim: A system that could make speech visible to deaf people has been dreamt of for long time. Several systems have been developed during recent decades with the most popular being cued speech invented 50 years ago by Cornett (1967). The aim of this article is to review researches about cued speech and its efficacy on different language skills of hearing impaired children.
Methods: In this article we reviewed researches on cued peech and its impacts on speech and literacy of hearing impaired children. We searched Medline, Proquest and Scopus search engines with the "cued speech" keyword and read all textbooks and thesis published between 1972 and 2011. Cued speech is an oral system which makes the sounds visible and accessible. It makes speech perception much simpler and improves lip-reading skills and ability of using residual hearing in hearing impaired children.
Conclusion: Cued speech enhances children's communication and speech perception and discrimination from early ages. It improves speech and ability to benefit from cochlear implantation. The original impetus behind cued speech was to improve literacy levels of hearing impaired children and it has been found to be uniquely successful.

Background and Aim: Hearing impairment can effect many educational abilities and will lead in a dealy in his growth. The objective of this research was to study the effect of hearing impairment on mathematical skill of hearing-impaired students of 4^th grade of elementary in contrast with normal-hearing students.
Methods: The project was cross-sectional and the tool used was the international standard booklet of mathematical questions. There has been 35 hearing-impaired students with range of moderately sever-profound hearing loss selected from the 4^th grade of elementary from exceptional schools in Ray, Pakdasht and Varamina, Iran, and 35 normal-hearing students were randomly selected from ordinary schools next to exceptional schools.
Results: By analyzing the outcomes, the normal-hearing students showed a better result in knowing, application, argument in aspects of cognitive in contrast with hearing-impaired students and there has been a meaningful difference (p<0.05). There was not a meaningful difference in mathematical skill between Ray, Pakdasht and Varamina, Iran in hearing-impaired and normal-hearing groups.
Conclusion: The hearing impairment effects learing of mathematical skill. It is important for hearing-impaired students to presentation various methods in instruction in progress deductive thought and cognitive structure and also development in concepts understand in mathematical domain in rehabilitation services.

Background and Aim: Children with severe and profound hearing loss have difficulties in communicating with others and educating at school. Effects of learning environment on children&aposs language skills have been recently focused and educating those students in ordinary schools has been proposed. According to this view, we compared perception of antonyms and synonyms as a semantic aspect of language in students of ordinary, integrated and special schools.
Methods: It was an analytic cross-sectional study. Three groups of students were enrolled: normal-hearing students of ordinary schools and hearing-loss students of integrated and specials schools. Each group consisted of 25 students in fifth grade of elementary schools in Tehran city. Two written tests were used. Subjects wrote synonyms and antonyms for each word in the tests.
Results: Results denoted significant differences between scores of normal-hearing and hearing-loss students and also between hearing-loss students of integrated schools and hearing-loss students of special schools (p<0.05). In all three groups of the students, perception of antonyms was better than antonyms (p<0.001). Speech processing rate in normal-hearing students were higher than both groups of hearing-loss students (p<0.001).
Conclusion: The differences between normal-hearing and hearing-loss students shows that similar to other language skills, perception of synonyms and antonyms as a semantic aspect of speech is related to the hearing conditions and type of education. Moreover, the differences between two groups of hearing-loss students represent that speech stimulants and interaction with normal-hearing children could improve semantic aspect of speech in hearing-loss students.

Background and Aim: In different language approaches, reading is considered as a major skill. Language skills comprising listening, speaking, reading and writing are completely interlinked with each other. Thus, providing active application of listening and speaking skills, children will learn reading and writing skills easily. The aim of this research was to compare reading skills of hearing-loss students studying at exceptional schools with normal students of different degrees.
Methods: The research was conducted post-traumatically using standardized 2006 PIRLS test. 80 students in fifth grade of exceptional primary schools, and first and fourth grade of exceptional high schools in Tehran City who had severe and or profound hearing loss were randomly selected along with 80 normal students in ordinary schools who were selected using available sampling method.
Results: There were significant differences between reading comprehension of hearing-loss and normal students of all three grades (p<0.001). Reading comprehension in female students was significantly higher than the male ones (p<0.001). There were not any significant differences in mean reading comprehension scores of hearing-loss students in different grades which demonstrate that their reading skills had not developed in tandem with their age and school educations.
Conclusion: This study shows that one of the significant concerns regarding hearing-loss students is their reading comprehension ability. Considering reading ability as one of the most important acquisitive abilities which students learn at school, evaluation of reading skills of hearing loss students as well as recognition of their strengths and weaknesses in this field is indispensable.

Background and Aim: Early diagnosis of hearing loss lead to early intervention and improvement of developmental skills of children with hearing loss. The present study aimed to determine the mean age of hearing loss diagnosis and cochlear implantation (CI) in hearing impaired children and to compare the age of performing cochlear implantation in children who were identified by newborn hearing screening with those who were not.
Methods: This cross-sectional study was conducted on 96 children with severe to profound sensorineural hearing loss who received cochlear implantation in Amir-e-Alam cochlear implantation center between the years 2008 and 2010. For data gathering, we assessed subjects&apos medical archives, interviewed with their parents and took medical history including demographic information, birth history and hearing loss history.
Results: Mean age of hearing loss suspicion, diagnosis, hearing aids administration, Initiation of rehabilitation program, performing cochlear implantation and mean age when cochlear implantation was utilized were 6.73 (SD=5.79), 9.35 (SD=5.79), 13.41 (SD=6.10), 16 (SD=6.36), 41.25 (SD=11.12), and 42.15 (SD=11.00) months, respectively. There was statistically significant difference between them (p<0.05). 43.8% of hearing impaired children had been identified by newborn hearing screening. There was statistically significant difference between cochlear implantation operation age of children who were identified by newborn hearing screening with those who were not (p<0.0001).
Conclusion: In spite of notable reduction in the age of hearing loss diagnosis and intervention during recent years, compared to international indices it is still tardy. Conducting newborn hearing screening can significantly reduce these ages.

Background and Aim: Sound conditioning is exposure to a non-traumatic, moderate level of sound which increases inner ear resistance against further severe noise. In this study, we aimed to survey the effect of sound conditioning on auditory brainstem response (ABR) threshold shifts using click stimulus, and the effect of the frequency of conditioning on hearing protection.
Methods: Fifteen guinea pigs were randomly divided into 3 groups. Two conditioned groups were exposed to 1 kHz, and 4 kHz octave band noise at 85 dB SPL, 6 hours per day for 5 days, respectively. On the sixth day, the animals were exposed to 4 kHz octave band noise at 105 dB SPL, for 4 hours. The control group was exposed to intense noise, 4 kHz at 105 Db SPL for 4 hours (without conditioning). After exposure, ABR thresholds using click were recorded an hour, and 7 days after noise exposure.
Results: The results of the ABR with click stimulus showed less thresold shifts in conditioned groups than control (p≤0.001). Comparison of the results of conditioned groups, showed less threshold shift by 4 kHz conditioning, however, this difference was not statistically significant (p>0.05).
Conclusion: Electrophysiological data of our study showed that sound conditioning has a protective effect against subsequent intensive noise exposure, and the frequency of conditioning does not have significant effect on ABR threshold shifts when using click stimulus.

Background and Aim: Hearing impaired individuals, who have undergone cochlear implantation, do not have satisfactory relationships with their peers and cannot be fully integrated into the hearing communities. The main purpose of this study was to examine the effect of a family-oriented social skills training program on cochlear implant users.
Methods: In this experimental study, 16 volunteer families consisting of mothers and their 12-19 year old children, who had undergone cochlear implantation at least two years in advance, were chosen from 328 families, members of the Hearing Rehabilitation Association of Iran. They responded to social skills rating scale as pre-test after they were randomly assigned to control and experimental groups. The experimental group underwent a 12-session social skills training. The social skills rating scale was then administered as a post-test in the two groups.
Results: The results showed the effectiveness of the family-oriented social skills training program on assertion (p<0.01), self-controlling (p<0.01), and general social skills (p<0.01) however, they showed no significant effect on cooperation (p>0.05).
Conclusion: The study revealed that family-oriented social skills training program is effective in improving the social skills of individuals with cochlear implantation. Therefore, this training program can be employed to improve these skills as an integral part of the rehabilitation program.

Background and Aim: Oral stereognosis is the ability to recognize the objects placed in the mouth this plays a significant role in speech sounds production. Since the children with hearing loss have articulation disorders, this study aimed to clear the relation of hearing loss degrees and oral stereognosis in 5-year-old children.
Methods: In this cross-sectional non-invasive study, 40 children of 5-year-old (30 children with different degrees of hearing loss and 10 normal children) were involved. Oral steriognostic test was done for all of them and the Mann-Whitney U was used for statistical analysis.
Results: There were significant differences between the mean of oral stereognostic ability between the normal children and the children with severe (p<0.01) or profound hearing loss (p=0.05). There was no significant difference between the mean of oral stereognostic ability among the children with moderate, severe and profound hearing loss compared with together. Besides, there was no significant difference between the mean of the time of diagnosis among all of hearing loss and normal children.
Conclusion: The study shows that the children with moderate, severe and profound hearing loss have inefficient oral stereognosis in comparison with the normal children.

Background and Aim: Reading skills, a complicated process, should be learnt and solely is not depend on sounds conforming with the written symbols on a page. Readers will be able to understand and perceive the deeper meaning of the text based on their experiences and knowledge obtained through reading. This research aimed to compare hearing-impaired students&apos reading literacy in exceptional and ordinary schools in Iran.
Methods: This cross-sectional study was done on 28 hearing-impaired students of the 4^th year of primary exceptional and ordinary schools of Shahr-e-Ray and Shahryar cities, Iran, using the Progress in International Reading Literacy Study (PIRLS 2006) booklets. Comparative statistical analysis was performed using Student&aposs t-test.
Results: The hearing-impaired students in ordinary schools had significantly (p<0.05) higher scores [mean (SD)] in reading literacy [3.67 (1.74)], comprehension of informational contents [4.21 (2.48)], and comprehension of literary contents [3.14(1.23)] than hearing-impaired students in exceptional schools [1.78 (1.06), 1.92 (1.49), and 1.64 (1.62), respectively].
Conclusion: Hearing-impaired students in ordinary schools meaningfully had higher performance of reading skills in comparison with hearing-impaired students in exceptional schools. It seems that an appropriate cultural bed should be provided in order to conduct these students and accept them in ordinary schools.

Background and Aim: There is a relation between language skills and science learning in educational approach. Hearing-impairment and delay in learning of language skills influence the progress of learning. The aim of this research was to study the effect of educational level elevation on growth of mathematical skill. Therefore, third grade hearing-impaired students of secondary school, and forth grade hearing-impaired and normal-hearing students of elementary school were compared in terms of mathematical skill.
Methods: The research was cross-sectional and the internationally standardized mathematics questions (2007) were selected as the tools of the test. The sample included 31 students of 4^th grade elementary and third grade of secondary school with sever hearing loss from exceptional schools, and 17 normal-hearing students were randomly selected from ordinary schools next to the exceptional schools in Robatkarim, Karaj, and Shahriyar cities, Iran.
Results: According to data analysis there was a meaningful difference between hearing-impaired students of forth and third grades and normal-hearing students in the three fields of knowledge, application and argument (p<0.05). There was a significant difference between the two hearing-impaired groups in knowledge (p<0.05), but they had no meaningful differences in the fields of application and argument (p>0.05).
Conclusion: No significant improvement was seen in the mathematical skill of hearing-impaired students by educational level elevation. Writing mathematical books for the pre-elementary courses, revision of teaching methods, and increasing teaching hours are necessary in mathematics.

Background and Aim: Stress is the source of many problems in human-kind lives and threatens people&aposs life constantly. Having hearing-impaired child, not only causes stress in parents, but also affects their marital satisfaction. The purpose of this study was comparing the stress and marital satisfaction status between the normal and hearing-impaired children&aposs parents.
Methods: This was a causal-comparative study. Eighty parents of normal children and 80 parents of hearing-impaired children were chosen from rehabilitation centers and kindergartens in city of Tabriz, Iran by available and clustering sampling method. All parents were asked to complete the Friedrich&aposs source of stress and Enrich marital satisfaction questionnaires.
Results: Parents of hearing-impaired children endure more stress than the normal hearing ones (p<0.001). The marital satisfaction of hearing-impaired children&aposs parents was lower than the parents of normal hearing children, too (p<0.001).
Conclusion: Having a hearing-impaired child causes stress and threatens the levels of marital satisfaction. This requires much more attention and a distinct planning for parents of handicap children to reduce their stress.

Background and Aim: Hearing-impairment leads to problems in language perception which in turn results in difficulties in language production. The present study investigated hearing-impaired children&aposs ability to discriminate Persian vowels. It aimed to describe the extent to which children have difficulty comprehending and discriminating phonetic features of vowels.
Methods: To fulfill this aim, a researcher-made test, which was based on the Auditory Perception Test 2001, investigated the phonetic discrimination of vowels in Persian-speaking and hearing-impaired children aged five to eight years. The test has two sections, auditory-visual and just auditory discrimination of vowels, which included five subtests assessing discrimination of front and back vowels. Through this test, the phonetic discrimination ability of 22 hearing-impaired children was evaluated. The gathered data were analyzed using matched t-test and repeated measures ANOVA.
Results: The findings showed that there is a significant difference between correct responses to the sections on front and back vowels (p<0.05). The audio-visual test showed that the /â/ vowel is easier to discriminate than other back vowels. Moreover, in the auditory test the /â/ vowel had the highest mean. The audio-visual test showed that the /i/ vowel is easier to discriminate than the other front vowels (/e/ /æ/). However, the discrimination of front vowels in the auditory test was the same.
Conclusion: The results revealed that back vowels were more easily discriminated than front vowels by hearing-impaired children.

Background and Aim: The majority of people experience problems and stressors, such as job layoffs and illnesses during their lives. However, the way people cope with stress varies. According to previous research, use of effective coping strategies can significantly reduce stress and tension. The aim of the present study was to investigate the effectiveness of stress coping strategies on hearing-impaired students.
Methods: This is a quasi-experimental study with pre-test, post-test, and control group. The sample consisted of 40 hearing-impaired male students of guidance and high schools of the city of Sari, Iran, in the years 2010 and 2011. They were randomly selected and assigned to two experimental and control groups (n=20). The data collection tool was the General Health Questionnaire-28. The experimental group was administered eight sessions of stress coping strategies based on cognitive-behavioral techniques two hours weekly. Data were analyzed using statistical indices including mean, standard deviation, and two-way analysis of variance.
Results: There was a significant difference between the pre-test and post-test scores in the subscales of somatic symptoms, anxiety and insomnia, depression, and social function (p<0.05). Moreover, after the eight sessions the rate of general health of the experimental group was higher than the control group.
Conclusion: Stress coping strategies based on cognitive-behavioral techniques increased the general health of hearing-impaired people. Therefore, stress management training should be developed and expanded as an appropriate intervention.

Background and Aim: Reading is the most important human need for learning. In normal-hearing people working memory is a predictor of reading comprehension. In this study the relationship between working memory and reading comprehension skills was studied in hearing-impaired children, and then compared with the normal-hearing group.
Methods: This was a descriptive-analytic study. The working memory and reading comprehension skills of 18 (8 male, 10 female) sever hearing-impaired children in year five of exceptional schools were compared by means of a reading test with 18 hearing children as control group. The subjects in the control group were of the same gender and educational level of the sample group.
Results: The children with hearing loss performed similarly to the normal-hearing children in tasks related to auditory-verbal memory of sounds (reverse), visual-verbal memory of letters, and visual-verbal memory of pictures. However, they showed lower levels of performance in reading comprehension (p<0.001). Moreover, no significant relationship was observed between working memory and reading comprehension skills.
Conclusion: Findings indicated that children with hearing loss have a significant impairment in the reading comprehension skill. Impairment in language knowledge and vocabulary may be the main cause of poor reading comprehension in these children. In hearing-impaired children working memory is not a strong predictor of reading comprehension.

Background and Aim: Pragmatics refers to speech interactions and the social aspect of communication in language contexts. Due to the crucial role of hearing in language skill development, hearing-impaired children have problems with all aspects of language, including pragmatics. These skills are crucial in children's daily life. There is a lack of Persian studies on hearing-impaired children. Therefore, the purpose of the present study is to describe some pragmatic skills of hearing and hearing-impaired children.
Methods: This descriptive case study was conducted on five hearing-impaired and two normal-hearing 6 year old children. Their pragmatic language skills were studied by the Persian story retelling test. in a quiet room. The children's re-told story was recorded, analyzed, and scored.
Results: There was no difference between the scores of hearing and severe hearing-impaired children. However, children with severe hearing loss and cochlear implant, and hearing children were different in maintaining the subject and sequence of events. Children with profound hearing loss and hearing aid, and hearing children had a significant difference in all aspects except main information. All subjects used conjunctions correctly.
Conclusion: The pragmatic skills of hearing-impaired children are weaker than hearing children. There are also differences between hearing-impaired children's abilities. This difference in pragmatic skills shows the difference in amount of hearing loss, kind of assistive device, effective use of remaining hearing, onset and quality of aural rehabilitation program, and other factors. Therefore, a research with a greater sample size is necessary to explain these differences.

Background and Aim: About 1.5 percent of exceptional children suffer from impaired hearing and this factor affects the teaching and learning process. The aim of this study was to investigate the effect of frequency of knowledge of results (KR) on the learning of children with hearing impairment.

Methods: Twenty-four individuals with hearing impairment with the mean age of 10.56 with SD 2.53 years (range: 7-14 years) were divided into three homogenous groups according to their records after pre-test. They practiced for eight sessions according to mentioned ways (feedback of 0%, 50% and 100%). The acquisition, learning and translation tests were run. MANOVA with repeated measures and ANOVA were used to analyze the data from the acquisition, retention and transition tests.

Results: All groups progressed during training and at various stages (acquisition, retention and transition). However, the results of the comparison between means of the three training groups showed significant differences in the acquisition process (p=0.008), learning (p=0.001) and transition (p=0.035). This means that feedback training groups (100%) had better performance in acquisition process, and also in retention and transition (50%).

Conclusion: According to the results of this study, too much feedback interferes with learning of tasks in individuals with hearing impairment and feedback (50%) had better learning. This finding shows that rules regarding feedback also affect the people with hearing impairment.

Background and Aim: The birth of a hearing-impaired child and raising him/her often brings special psychological feelings for parents, especially mothers who spend more time with the child. This study aimed to compare the general health status in mothers of hearing-impaired and hearing children.

Methods: This was a descriptive-analytic study. General Health Questionnaire was used to identify general health status and data were analyzed with independent-t test.

Results: The general health level of mothers of hearing-impaired children was lower than mothers of normal hearing children (p=0.01 ). The average scores of anxiety (p=0.01), depression (p= 0.01) and physical (p=0.02) symptoms and social function (p=0.01) of mothers of hearing-impaired children was higher than mothers of normal hearing ones (p=0.01).

Conclusion: Having a child with hearing impairment affects mothers’ general health status. Our findings show that it’s necessary to provide psychological and social support for mothers of hearing-impaired children.

Background and Aim: As word recognition score test is one of the most important tests in audiologic test battery and there is no study on reliability and validity of existing monosyllabic word lists, we decided to investigate this in people with noise induced hearing loss.

Methods: In this non-randomized descriptive-analytic study, 30 adults with noise induced high frequency hearing loss with the age of 18 to 46 years were evaluated. Construct validity was evaluated by comparing Mosleh lists with list NU-6 and reliability was achieved by test-retest (-two-week interval).

Results: The mean (SD) score of word recognition was 94.01 (3.95) percent for list 2, 90.40 (4.90) percent for list 4, 89.08 (4.43) percent for list 5, and 94.10 (4.11) percent for list 9. A reliability of 94% was achieved in all four lists . Regression analysis revealed that word recognition score (WRS) had decreased in proportion to pure tone average.

Conclusion: Four lists have good construct validity. All word lists are phonetically reliable too.

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.