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Background and Aim: Children with speech and language disorders can have reduced diadochokinesis (DDK) rates. Although a relationship has been proposed between DDK and the rate of speech, there is no consensus among the experts and its credibility remains questioned. The purpose of this study was to compare oral DKK with the rate of speech and reading in normal students.

Methods: One hundred second grade female students participated in this descriptive-comparative study. The subjects were asked to read a text of their book, tell a story, and perform some oral DDK tasks. The elapsed time was measured by Cool Edit software. Descriptive statistics were used to describe the data. Data analysis was performed using Student t-test.

Results: Time history durations of DDK tasks /tâ/, /pâ/ and /kâ/ were 4.10, 4.15 and 4.74 ms, respectively. The rate of reading was 3.1 syllables per second and rate of talking was 2.8 syllables per second. No relationship between the rate of speech and DDK was found, still, we found a significant association between the reading rate and DDK in /kâ/ (p=0.03) and /pâtâkâ/ (P<0.01).

Conclusion: Relevant DDK tasks can be utilized in order to improve the reading rate. Reading rate was higher than speech rate and the rate of bilabial diadochokinesis in mono syllables is the highest rate that may be expected during the treatments.

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Background and Aim: As clinical audiometry assessment of each ear needs to know interaural attenuation (IA), the aim of this study was to investigate Persian speech IA in adults.

Methods: This cross-sectional, analytic study was performed on 50 normal hearing students (25 males, 25 females), aged 18-25 years old in Faculty of Rehabilitation, Tehran University of Medical Sciences. Speech reception threshold (SRT) was determined with descending method with and without noise. Then speech IA for Persian spondaic words was caculated with TDH-39 earphones.

Results: Mean speech IA was 53.06±3.25 dB. There was no significant difference between mean IA in males (53.88±2.93 dB) and females (52.24±3.40 dB)(p>0.05). The lowest IA was in females (45 dB) and the highest IA was in males (60 dB). Mother's language has no significant effect on speech IA.

Conclusion: We may consider 45 dB as the lowest IA for Persian speech assessment, however generalization needs more study on a larger sample.

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Background and Aim: Asking questions is one of the basic skills for getting information. "What", "Who", "Where", "Why", "How much", "How, etc. are question words frequently used for asking questions. Studies on the sequence of acquisition of question words in English speaking children follow a unique sequence. "What" is the first question word used by these children. We aimed to study whether Persian speaking children follow a unique pattern in the acquisition and use of question words as well.
Case: Two normal Persian speaking children (a boy and a girl) who were sent to the kindergarten of Faculty of Rehabilitation Sciences, Iran University of Medical Sciences by their parents were investigated. Children's spontaneous speech from 12 to 36 months was videotaped, and question words were extracted from phonetic transcription of both children's speech. In order to ask a question, both children initially used rising tone with /m/ or /hum/ before saying the first question word. Two first question words were "what" and "where" in both children's speech samples. Asking about the time with the question word /when/ was not appeared in their speech samples until 36 months. These two Persian speaking children also used Wh-question sequentially.
Conclusion: The result of this study was consistent with the results of other studies on English speaking children.

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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.

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

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Background and Aim: 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.

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Background and Aim: Neuroimaging techniques in audiovisual speech processing are innovative approach to neuroscience investigation that steadily influences the deep survey of highly mechanisms involved in this process. The purpose of this study was to evaluate brain activity via functional magnetic resonance imaging throughout audiovisual speech perception in Persian language.
Methods: Functional MRI was used to assess 19 normal 20-30 year old women while they had been presented syllable /ka/ visually and /pa/ auditory using block design method, in which it would provide two series of imaging, functional and T1-weighted. Subsequently, the results were analyzed and compared by FSL software.
Results: The results of this study pointed out that both middle and cortical regions of brain are activated in visual stimuli and its middle regions are activated in response to auditory stimuli. Hence, left anterior supramarginal, some parts of motor speech system including insular and cingulate cortex-precentral cortex were stimulated with visual stimulus and left posterior supramarginal as well as right supramarginal gyrus were stimulated with auditory stimulus. Moreover, in this investigation, McGurk effect was behaviorally proven in fifteen subjects.
Conclusion: It was hypothesized that the activation of unique region, supramarginal gyrus, with both audio and visual stimuli indicated the presence of commonplace region for phonologic processing of sensory inputs. In addition, auditory stimuli develop more intense activity and on the other hand, broaden-maximum voxel-as well as extra regions are demonstrated in response to visual stimuli. These points represent the unfamiliarity of normal individual brain to percept visual speech stimuli.

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Background: Treacher-Collins syndrome is a congenital craniofacial disorder with multiple anomalies. This syndrome affects the maxilla, mandible, eyes, middle and outer ears, and soft palate. Conductive hearing loss due to the deformities of the middle and external ears is prevalent. The characteristics of this syndrome include multiple and serious threats to normal communication development in children. In this study, speech and language features of a Persian speaking child with this syndrome are presented.
Case: The case was an 8-year old girl with Treacher-Collins syndrome and bilateral moderate conductive hearing loss due to atretic canal. In language and speech assessments, moderate hypernasality, numerous compensatory errors and morphosyntactic deficits were observed. There were 13 phonemes that were incorrectly produced at least in one position. Besides, she used 22 types of phonological processes that were abnormal and disappear before the age of three in normal Persian speaking children.
Conclusion: Moderate hearing loss, velopharyngeal incompetency, malocclusion and dental anomalies, attention deficit/hyperactivity disorder (ADHD) and environmental factors resulted in severe speech and language disorders in this case. These disorders affected her academic performance as well. Moderate hypernasality, numerous compensatory errors, and excessive and abnormal use of phonological processes were not presented as prevalent characteristics of Treacher-Collins syndrome in other resources.

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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.

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Background and Aim: Although the ability of speech perception has been improved in implanted subjects with recent progress in technology, cochlear implantation alone is not enough and more aural rehabilitation is necessary. The aim of this study was to assess improvement of speech perception in children with cochlear implant.
Methods: Fourteen cochlear implanted children with a mean age of 5.5 years participated in this study. Auditory training was performed in 10 to 43 sessions. Speech recognition and perception were evaluated every 3 months. Third evaluation was done only for 4 patients.
Results: Mean total score of the first evaluation was 43.21%, of the second was 63.76%, and of the third evaluation was 78%. All children obtained complete score for sound awareness at the first evaluation. In environmental sounds discrimination, 71.3%, 84.36%, and 100% answered completely to the questions of three evaluations respectively. In speech sounds discrimination, 34.7% in the first, 57.04% in the second, and 85% in the third evaluation obtained the complete score, and in auditory memory, complete responses were 21% for the first, 57.12% for the second, and 83% for third evaluation. In story rephrasing and comprehension, no one answered to questions completely. However, 12.83% obtained the complete score in the second and third evaluations. There were statistically significant differences between the first and the second evaluation (p=0.002(.
Conclusion: Sound awareness ability seems to be achieved rapidly. Development of speech and environmental sound discrimination abilities, particularly speech comprehension which is the most important skill, need more impressive training.

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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.

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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.

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Background and Aim: Internal evaluation is an important part of organization monitoring. One of the Ministry of Health&aposs policies is to encourage educational departments to conduct internal evaluations. The aim of internal evaluation of department of speech therapy was appraising its education, research and treatment qualities and determining its strengths, weaknesses, opportunities and threats (SWOTs) to identify the ways of overcoming weakness and threats.
Methods: This descriptive cross-sectional study was conducted in 10 phases to evaluate 10 factors. Participants were undergraduate, graduate, and postgraduate students, academic staff, director of the department along with the patients. The internal evaluation software for educational and research centers released by Center of Medical Education Studies and Development was modified and utilized. Data was analyzed by calculating mean of means.
Results: Mean of means from highest to lowest scores were respectively as follows: the quality of diagnosis, treatment and dealing with patients 4.15 out of 5 as well as the quality of academic staff 3.5 were in the range of desirable category qualities of management and organizational structure 3.34, graduate students 3.21, teaching and learning processes 3.1, missions and goals 3.09, instructional methods and curriculum models 2.99, educational and research equipments 2.9, students 2.76 and research 2.67 were within the range of rather desirable category. Total score was 3.17 (63.4%) which was within the range of rather desirable category.
Conclusion: The department of speech therapy was in rather desirable state before merger. That result was appropriate according to the department&aposs conditions and supplies.

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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.

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Background and Aim: The current study has been designed based on the framework of the Stress Deafness Model (SDM), and aims at investigating native listeners&apos general perceptual sensitivity to the acoustic correlates of stress in Persian, a language with predictable stress. According to SDM, more regularity in a language implies poorer perceptual sensitivity of its native speakers, as regular stress patterns will not require lexical encoding.
Methods: The experiment was a modified method of adjustment task where subjects had to simulate stimuli played to them. A total of thirty five Persian speakers took part in the experiment and were placed in three groups based on their linguistic background. In addition to overall perceptual sensitivity, the effect of exposure to English and phonetic knowledge were also tested.
Results: Persian speakers showed a weak perception of stress correlates. It was found, however, that exposure to English will improve stress deafness among Persian natives (p<0.0001). However, the results failed to show any significant effect by phonetic knowledge. It was also shown that the duration had the most erroneous perception by participants (p=0.0001), while there was no statistically significant difference between understanding fundamental frequency clues and intensity perception by listeners.
Conclusion: Since Persian speakers showed an overall weak perception of stress correlates, the results support the predictions made by SDM.

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Background and Aim: Sustained attention refers to the ability to maintain attention in target stimuli over a sustained period of time. This study was conducted to develop a Persian version of the sustained auditory attention capacity test and to study its results in normal children.
Methods: To develop the Persian version of the sustained auditory attention capacity test, like the original version, speech stimuli were used. The speech stimuli consisted of one hundred monosyllabic words consisting of a 20 times random of and repetition of the words of a 21-word list of monosyllabic words, which were randomly grouped together. The test was carried out at comfortable hearing level using binaural, and diotic presentation modes on 46 normal children of 7 to 11 years of age of both gender.
Results: There was a significant difference between age, and an average of impulsiveness error score (p=0.004) and total score of sustained auditory attention capacity test (p=0.005). No significant difference was revealed between age, and an average of inattention error score and attention reduction span index. Gender did not have a significant impact on various indicators of the test.
Conclusion: The results of this test on a group of normal hearing children confirmed its ability to measure sustained auditory attention capacity through speech stimuli.

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Background and Aim: Time compressed speech test is one of the most common types of monaural central auditory processing tests assesses the temporal resolution. The aim of the present study was to evaluate the impact of compression rate and sex on results of this test among the young individuals with normal hearing.

Methods: The Persian version of time compressed speech test with six lists of 25 monosyllabic words was prepared in three compression rates of 0, 40 and 60 percent. 36 young people with normal hearing and age range of 18 to 30 years were assessed with time compressed speech test in the most comfortable level in each ear separately. Then scores were compared between two ears, genders and three compression rates.

Results: There was a significant difference between word recognition scores of three compression rates (p<0.0001). Significant difference was revealed between word recognition scores of both ears, just in the 60% compression rates. No significant difference was found between the word recognition scores of the two genders.

Conclusion: Word recognition scores decreases with increase of the presentation rate of speech stimuli. Time compressed speech test accompany with other audiologic tests can be used to examin the auditory temporal processing and speed of speech processing as a test battery.

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Background and Aim: Parkinson’s disease (PD) is a progressive neurological disorder resulting from significant decrease of dopamine in the brain. The main and most common symptom of speech disorder associated with Parkinson’s disease, which is kind of dysarthria, is reduction in speech intelligibility. Since this disorder represents damages to acoustic aspects, researchers are attracted to study the relationship between these two disorders. In this study, we assessed the comparison of speech vowels between normal people and patients with Parkinson’s disease.

Methods: In this cross-sectional study, 18 voice samples of patients with Parkinson’s disease and the same number of samples from normal people in a voiceless environment were recorded and analyzed by Praat software. Data analysis was performed by independent samples and Mann-Whitney tests.

Results: All variables investigated in two groups showed significant differences. In adults with Parkinson’s disease , F1-F0 in low vowels showed a considerable reduction in respect to normal people (p <0.001). In addition, F2-F1 in high vowels represented a significant decrease in these patients (p<0.05).

Conclusion: The results indicate that Parkinson’s disease affects formant frequency in patients compared with normal people. Reduction in speech intelligibility can be accurately measured using acoustic procedure.

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Backgrand and Aim: The measurement of speech intelligibility refer to determining the measure of speech intelligibility in communication. The speech intelligibility is used for decision-making in intervention, the determination of intervention goals, and the measurement of intervention outcomes. This study aimed to investigate the speech intelligibility among the children aged 36 to 60 months.

Methods: In this cross-sectional study, 360 healthy children (180 girls and 180 boys) were chosen among children of kindergardens in Khorramabad city, Iran. Speech sample of subjects was collected by calling pictures of Hydari et al 2010, speech intelligibility measurement test (2010). The voices of the subjects were tape-recorded and speech intelligibility of children was studied within 12 age-groups arranged by two months.

Results: The minimum speech intelligibility was concerned to 36 and 37 months old and the maximum was concerned to 58 and 59 months old. There was a significant differences among age-group 36 and 37 months old with 44 and 45 months old and above, age-group 38 and 39 months old with 55 and 54 months old and above, and age-group 40 and 41 months old with 58 and 59 months old (p<0.05 for all). There was no significant difference among other age groups. There was no significant difference between boys and girls.

Conclusion: Speech intelligibility has the highest growth during the age of 36 to 46 months and it had lowest growth during the age of 46 months and elder range.

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Background and Aim: Multiple sclerosis (MS) is one of the central nervous system diseases can be associated with a variety of symptoms such as hearing disorders. The main consequence of hearing loss is poor speech perception, and temporal acuity has important role in speech perception. We evaluated the speech perception in silent and in the presence of noise and temporal acuity in patients with multiple sclerosis.

Methods: Eighteen adults with multiple sclerosis with the mean age of 37.28 years and 18 age- and sex- matched controls with the mean age of 38.00 years participated in this study. Temporal acuity and speech perception were evaluated by random gap detection test (GDT) and word recognition score (WRS) in three different signal to noise ratios.

Results: Statistical analysis of test results revealed significant differences between the two groups (p<0.05). Analysis of gap detection test (in 4 sensation levels) and word recognition score in both groups showed significant differences (p<0.001).

Conclusion: According to this survey, the ability of patients with multiple sclerosis to process temporal features of stimulus was impaired. It seems that, this impairment is important factor to decrease word recognition score and speech perception.