Background and Aim: Evaluation of hearing-impaired children&aposs auditory skills by a valid test is very important before starting auditory training. There are many different tests available for languages other than Persian, and some limited Persian tests for children above 5 year of age as well. Accordingly considering the importance of early intervention, we aimed to design a test for evaluating auditory skills of 3-4 year-old hearing-impaired Persian (Farsi) children, which is not available to date.
Methods: The study method was test (scale) construction. The test named Tavana includes four subtests: detection, discrimination, identification and sentence comprehension. For determining content validity of the test, the vocabulary of 3-4 year-old normal-hearing and hearing-impaired children and also the comments of seven specialists were applied. We classified 10,10,8 and 6 sub skills for 1^st to 4^th subtests, respectively.
Results: The content validity of Tavana test&aposs subskills were 100%, 83%, 96% and 95%, respectively (mean=94%). Mean time for test performance was 82 minutes.
Conclusion: Content validity of Tavana test was 94% which was statistically valid compared to Modarres test (97%) and Mazaheryazdi test (88%).

Background and Aim: Rhyme awareness is an important criterion for speech, language and writing processing. In Iran, there is no auditory tasks of rhyme awareness available for assessment of 5-6 year-old Persian-speaking children. The aim of this study was to develop and to evaluate Persian rhyme awareness tasks in 5-6 year-old Persian-speaking children.
Methods: A hundred normal 5-6 year-old Persian-speaking children (50 girls and 50 boys) were randomly selected. The two rhyme awareness tasks of this study were rhyme detection and rhyme production. The validity and reliability of these tasks were studied by content validity index, intraclass correlation coefficient, and standard error of measurement. The correlation between tasks was studied by Pearson correlation and the mean scores of two sections were compared by easiness level method. The comparison of mean scores of girls and boys were evaluated by independent t-test.
Results: The results showed that the proposed tasks had appropriate validity and reliability. The ability of children in production section was significantly more than in detection section. The correlation of each of two sections with total tasks was significant (p<0.05). In addition, the mean scores of girls and boys were not statistically different (p>0.05).
Conclusions: The proposed tasks are appropriate for assessment of rhyme awareness skills with appropriate validity and reliability in both genders. Two Sections of the tasks had significant correlations and influence on together. The abilities of girls and boys were the same.

Background and Aim: Cued speech as a kind of communication method, is a system which utilizes several hand configurations and locations to supplement the normal visible manifestations of speech. This study was aimed to investigate the effects of Persian cued speech on the speech discrimination scores of hearing impaired children.
Methods: Sixteen 9-12 years old profoundly hearing impaired children were divided into two matched-groups of cases and controls. Cases were taught cued speech in a five-month period of 45-60 minutes daily therapy. Speech discrimination score test was tested pretest, post-test and three-week follow-up test in both groups. Mixed repeated measurement was used to analyze the repeated measures data.
Results: There was a significant difference between pretest (without cued speech) and the other two tests of post-test and follow-up (both with cued speech) in cases. The speech perception scores of the cases were almost completed (p=0.001) after cued speech practicing but no significant difference was seen in speech perception scores of control group.(p>0.05)
Conclusion: The results indicate that Persian cued speech is an efficient tool to increase speech discrimination scores of hearing impaired children.

Background and Aim: Speech intelligibility is defined as a measure of effectiveness of understanding speech. It has many applications such as nomination of speech disorder intensity. Different methods and speech tasks have been designed for assessment of speech intelligibility amongst which word identification tasks have high validity. This study aimed to provide a test to measure speech intelligibility among children aged 3 to 5 years old.
Methods: Many words were collected and content validity was assessed by 9 speech-language pathologists and 1 linguist. Thirty four words with a content validity above 70% were chosen as the test words and the speech-language pathologists collected suitable pictures for the words. One hundred boys and girls aged 3 to 5 years participated in the study. Inter-rater reliability was administered to assess the test reliability.
Results: An interclass correlation coefficient of 0.85 and spearman correlation coefficient of 0.81 was obtained for the speech intelligibility test.
Conclusion: Speech intelligibility test has appropriate validity and reliability and is suitable for assessment of intelligibility in 3 to 5 years old children.

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: Stress is associated with life satisfaction and also development of some physical diseases. Birth of a disabled child with mental or physical disability (especially deaf or blind children), impose an enormous load of stress on their parents especially the mothers. This study compared stress levels of mothers with hearing impaired children and mothers of normal children or with other disabilities.
Methods: In this study, cluster random sampling was performed in Karaj city. 120 mothers in four groups of having a child with mental retardation, low vision, hearing impairment and with normal children were included. Family inventory of life events (FILE) of Mc Cubbin et al. was used to determine stress level in four groups of mothers.
Results: The results of this research indicated a significant difference (p<0.05) between stress levels of mothers with hearing impaired children and mothers of other disabled and normal children in subscales of intra-family stress, finance and business strains, stress of job transitions, stress of illness and family care and family members "in and out&apos&apos. There was no difference between compared groups in other subscales.
Conclusion: Since deafness is a hidden inability, the child with hearing impairment has a set of social and educational problems causing great stress for parents, especially to mother. In order to decrease mother&aposs stress, it is suggested to provide more family consultation, adequate social support and to run educational classes for parents to practice stress coping strategies.

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: Hearing impairment through the primary episode of development has an undeniable effect on communicative language and cognitive ability of children. The purpose of this study was to compare primary verbal, nonverbal and mathematical concept formation, between children with and without hearing impairment.
Methods: In this study 88 children with normal and impaired hearing were compared in four-, five- and six-year old age groups. Normal children were selected randomly and the other group consisted of the available children with impaired hearing. To evaluate verbal, nonverbal and mathematic concepts, a test was designed and developed based on language and cognitive developmental scale in normal children.
Results: Significant difference was seen in the average scores in each concept class between normal and impaired hearing group in all age groups (p<0.05). There was no statistical significance between girls and boys. Hearing groups had statistical significant difference in each group of concepts (p<0.001). Age had statistical significance only in mathematics&apos concepts (p=0.001).
Conclusions: This study supports the necessity of assessing the understanding of verbal, nonverbal and mathematic concepts, as well as cognitive and verbal skills in children with hearing impairment, prior to any formal education program planning. The curriculum should be arranged according to these abilities and skills. Otherwise it would be hardly practical and functional for these children to go through the curriculum which is planned without any notion to their basic abilities.

Background and Aim: Phonological working memory is an important factor in speech and language development and the treatment of related disorders. Assessment of this kind of memory is based on non word repetition. The aim of this study was providing a non word repetition test to examine the capacity of phonological working memory and determining its validity and reliability.
Methods: This is a cross-sectional study. Initially 60 words were selected based on common Persian syllable structures. Then non words were created by changing one or two phonemes in each of the words. Words and non words were assessed by experts for the content validity and 25 non words were selected. 16 boys and 14 girls aged 4 years to 4 years and eleven months were selected by non-probability sampling from the childcares centers in regions 2 and 6 of Tehran. The test was performed twice by a single examiner to evaluate the reliability of test. Children non word repetition scores were determined and correlation analysis was conducted using the Pearson&aposs correlation coefficient.
Results: Our results show that a high coefficient correlation between different performances 0.76 (p<0.001).
Conclusion: These findings show that non word repetition test has high validity and reliability.

Background and Aim: Premature birth and low birth weight are regarded as two risk factors for impaired language development. Hence, information about primary period of language development in these children is important for early detection of children&aposs needs during their language development period. The goal of this study was to determine the expressive lexicon size in 18 to 36 month-old premature children with low birth weight and to compare them with their full-term peers.
Methods: In this prospective historical survey, using form II of the MacArthur-Bates Communicative Development Inventories (CDI), expressive lexicon size of 42 premature children with low birth weight who were 18 to 36 month- old and 42 full-term peers in three age groups with six month-intervals is evaluated. Forms were completed individually by mothers of children.
Results: Data analysis showed that the difference in expressive lexicon between the two groups was significant (p=0.025). Nonetheless, in each group the difference in expressive lexicon size between the three age groups was not significant.
Conclusion: The results of this study suggest that expressive lexicon size in premature children with low birth weight was smaller than their full-term matches and the development of lexicon size is delayed in these children. However, by increasing age, these children follow a similar development pattern in terms of lexicon size and eventually catch up with their full term counterparts. This study shows the importance of early intervention to expedite this compensatory mechanism in these children.

Background and Aim: In view of improvement in therapeutic outcome of cancer treatment in children resulting in increased survival rates and the importance of hearing in speech and language development, this research project was intended to assess the effects of cisplatin group on hearing ability in children aged 6 months to 12 years.
Methods: In this cross-sectional study, hearing of 10 children on cisplatin group medication for cancer who met the inclusion criteria was examined by recording auditory brainstem responses (ABR) using the three stimulants of click and 4 and 8 kHz tone bursts. All children were examined twice: before drug administration and within 72 hours after receiving the last dose. Then the results were compared with each other.
Results: There was a significant difference between hearing thresholds before and after drug administration (p<0.05). Right and left ear threshold comparison revealed no significant difference.
Conclusion: Ototoxic effects of cisplatin group were confirmed in this study. Insignificant difference observed in comparing right and left ear hearing thresholds could be due to small sample size. auditory brainstem responses test especially with frequency specificity proved to be a useful method in assessing cisplatin ototoxicity.

Background and Aim: The relationship between language and stuttering is an important issue in development of children because initiation of stuttering is generally contemporaneous with the period of rapid language development in children. Phonological awareness is part of language function which simultaneously develops with language and is the basis for oral and aural skills. The purpose of this research is to evaluate the relationship between stuttering and phonological awareness and the importance of phonological awareness in the process of evaluation and treatment of stuttering.
Methods: It was a cross-sectional comparative study. Conducted on 53 children aged 4 to 8 years in Tehran. Participants&apos profile was made by examiner through interview with participants&apos therapist, parents and instructor. Voice of stutterer children was recorded and the phonological awareness test was performed. Obtained data was analyzed.
Results: Regarding the scores of phonological awareness test there were significant differences between stutterer and non-stutterer groups and also between different ages (p<0.05). Scores of phonological awareness test in children with different stuttering severities were not significantly different. Children younger than 4 years had the least scores while children older than 7 years had the most and the differences were statistically significant (p<0.05). This shows that the score improves by aging.
Conclusion: Phonological awareness, age, type and severity of stuttering should be considered in assessment and treatment of Persian stutterer children aged 4 to 8 years old.

Background and Aim: Due to defects of auditory feedback, children with hearing loss have inappropriate speech intonation. Consistently, results of previous studies have shown that cochlear-implanted children have some difficulties in their intonation. Intonation shows the type of the sentence which can be statement or question sentences. The purpose of this study was comparison of speech intonation in cochlear-implanted children and normal hearing children.
Methods: The present study was performed on 25 cochlear-implanted children and 50 normal hearing children. Different pictures were shown to the subjects and they said statement and question sentences. All sentences were heard by eight speech therapists and perceptually judged. Using praat software mean base frequency and pitch alterations were measured.
Results: In cochlear-implanted group, mean speech base frequency was higher and mean pitch alteration was lower than the control group. Mean experts&apos scores in cochlear-implanted group were lower than the control group. Differences in all three variables were statistically significant (p<0.05). There was a significant direct correlation between duration of time that the children had cochlear implant and perceptual judgment scores (p<0.05).
Conclusion: According to the results, cochlear implant prosthesis has limited efficacy in improving speech intonation although their ability to produce speech intonation improves by increasing duration of the time that children have cochlear implant. Thus speech therapists should consider intervening on speech intonation in treatment program of cochlear-implanted children.

Background and Aim: Recently, researchers have increasingly turned to study the relation between stuttering and syntactic complexity. This study investigates the effect of syntactic complexity on the amount of speech dysfluency in stuttering Persian-speaking children and adults in conversational speech. The obtained results can pave the way to a better understanding of stuttering in children and adults, and finding more appropriate treatments.
Methods: In this cross-sectional study, the participants were 15 stuttering adult Persian-speakers, older than 15 years, and 15 stuttering child Persian-speakers of 4-6 years of age. In this study, first a 30 minute sample of the spontaneous speech of the participants was provided. Then the utterances of each person were studied in respect to the amount of dysfluency and syntactic complexity. The obtained information was analyzed using paired samples t-test.
Results: In both groups of stuttering children and adults, there was a significant difference between the amount of dysfluency of simple and complex sentences (p<0.05).
Conclusion: The results of this study showed that an increase in syntactic complexity in conversational speech, increased the amount of dysfluency in stuttering children and adults. Moreover, as a result of increase of syntactic complexity, dysfluency had a greater increase in stuttering children than stuttering adults.

Background and Aim: Valid identification, prevention, and treatment of language disorders have a high priority for the clinicians. Story retelling is a method for studying language development which is faster than other procedures in implementing and analyzing, and has a reliable scoring system. The aim of this project is to construct story retelling test for assessing language structure in 6-7 year old, Persian children.
Methods: An appropriate story for 6-7 year old children was written by the help of a speech pathologist, a linguist, and a novelist. The validity of the constructed story was checked by 14 experts. Then related pictures were design and their validity was examined. The test was conducted on 72 children (36 girls, 36 boys) of 6-7 years. The reliability was administered with a test-retest design with a two week interval. The reliability of the scoring system was evaluated with inter-rater method.
Results: Content validity index for this test was 89%, interclass correlation was 83%, and standard error of measurement was 2.76. The interclass correlation for scoring system was 93% and Pearson&aposs correlation was 90%. Correlation of the test-retest scores was statistically significant (p<0.01).
Conclusion: This story retelling test has appropriate validity and reliability. It is suitable for quick assessment of language structure in 6-7 year old, Persian children.

Background and Aim: Verb is one of the most important aspects of a sentence, and verb deficit is a noticeable part of developmental language disorders. In Iran, there is no standard test for evaluating this aspect of language in children. This study aimed to develop and evaluate a picture verb test for 36-54 month-old normal Persian-speaking children, and assess its ability to differentiate between children.
Methods: A list of verbs that could be depicted was collected and content validity was assessed by seven speech therapist. 55 verbs were selected. Then, three pictures were prepared for each verb and one of those pictures was chosen by the same seven specialists. 106 children aged 36-54 months participated in this study. They were divided into three groups (36-42, 42-48, and 48-54 months). Reliability of this test was assessed by Spearman&aposs correlation and internal consistency. Correlation between children&aposs scores and their age was calculated.
Results: Content validity index of all verbs were 1. Spearman&aposs correlation of 0.89 and internal consistency of 0.60 was obtained. By deletion of item method, the Kuder-Richardson score was enhanced to 0.71. There was a significant correlation between children&aposs ability to respond and their age (r=0.76, p < 0.001).
Conclusion: This test is a suitable tool for assessment of verbs in 36-54 month-old Persian-speaking children and can differentiate between three groups under study.

Background and Aim: Social interaction plays an essential role in acquisition of speech and language as one of the most important developmental factors. The recent studies indicated that language abilities have a close relationship to social skills. The aim of this study was to determine the relationship of development of expressive language and dimensions of social skills in 4-6-years-old Persian-speaking children.
Methods: In this study, 123 normal Persian-speaking 4-6-year-old children (76 boys and 47 girls) who had all the specific criteria for normality were randomly selected from several preschools in Shiraz, Iran. During the first stage of testing, test of language development (TOLD) was administered to investigate language development of participants later, the social skills rating system (SSRS) including the teachers&apos and parents&apos forms were completed by the parents and teachers of participants. The data were analyzed using Pearson&aposs correlation coefficients.
Results: The correlations between expressive language and dimensions of social skills were significant (p<0.001), but teachers&apos form had a greater correlation with language development (p=0.031). Besides, Pearson&aposs correlations between teachers&apos and parents&apos forms was not significant (p=0.27).
Conclusion: According to our results, expressive language develops along with social skills development. On the other hand, these results are based on the differences between home and educational environment in social skills achievements of children. These findings are to be considered to provide crucial training in both environments for the children to improve the development of their expressive language.

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: Families who have a child with hearing deficiency deal with different challenges, and mothers have a greater responsibility towards these children because of their traditional role of caregiver so, they deal with more psychological problems. The aim of this study was to compare the psychological well-being and coping styles in mothers of deaf and normal children.
Methods: In this cross-sectional and post event study (causal-comparative method), 30 mothers of deaf students and 30 mothers of normal students from elementary schools of Ardabil, Iran, were selected using available sampling. The Ryff psychological well-being (1989) and Billings and Moos coping styles (1981) questionnaires were used in this study. The data were analyzed using MANOVA test.
Results: We found that in mother&aposs of deaf children, psychological well-being and its components was significantly lower than mothers of normal children (p<0.01 and p<0.05, respectively). There was a significant difference between two groups in terms of cognitive coping style, too (p<0.01). However, mothers of deaf children used less cognitive coping style.
Conclusions: It seems that child&aposs hearing loss affects on mothers psychological well-being and coping styles this effect can be visible as psychological problems and lower use of adaptive coping styles.

Background and Aim: Oral habits have hazardous effects on children&aposs speech which are sometimes irreversible and permanent. This study was planned to assess these oral habits among children in day-care centers of Tehran, Iran.
Methods: In this descriptive, cross-sectional study, 400 children were selected through multistage sampling from 16 day-care centers in Tehran, Iran, They were 24 to 72-month old. Bottle feeding, pacifier usage and digit sucking were determined. After interviewing parents, oral examination [using Paediatric oral skills package (POSO)] and doing standard Phonetic test, a questionnaire was completed for each child.
Results: Sixty eight had one oral habit. The most prevalent habit was digit sucking (52.9%). The prevalence of bottle feeding, both digit sucking with bottle feeding, and pacifier habit were 38.2%, 7.3% and 1.4%, respectively. There were significant relationship between digit sucking and malocclusion (p<0.001, r=0.4) and hard palate malformationand (p<0.001, r=0.39). Besides, a significant relationship between bottle feeding and  malocclusion (p<0.001, r=0.25) was conduted. Digit sucking had significant relationship with lisping, too (p<0.001, r=0.37). There was no gender priority in oral habits.
Conclusion: Oral habits cause permanent structural conversion in speech producing and oral status.