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Background and Aim: During speech development in normal children, cluster reduction is one of the natural phonological processes. Children begin to produce some consonant clusters from the age of 2 years but ability to produce all consonant clusters continues up to 9. The main objective of this investigation was assessing the ability of Persian-speaking children in production of consonant clusters in mono-syllable CVCC words.

Methods: In this cross-sectional and comparative study, production of 19 clusters with stop, fricative, affricate, nasal, and glide consonants in 38 words were tested in 200 Persian-speaking children at the age of 3 to 6 years in kindergartens of Tehran, Iran. Content validity indexes of 38 words were above 0.80 and Cronbach’s alpha of split half was 0.91.

Results: More than 75% of 3-years-old children were able to produce /xl/, /bz/, /rs/, and /xm/ clusters. Age was positively correlated with correct production scores of words (p=0.001) and was negatively correlated with cluster reduction scores (p=0.001).

Conclusion: Three-years-old normal Persian-speaking children may use cluster reduction in words with consonant clusters but this phonological process decreased by increasing of age so, most of the 6-years-old children could produce consonant clusters correctly. Place of articulation more than manner of articulation affect on correct production of consonant clusters.

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Background and Aim: Children with auditory processing disorders and impaired phonological working memory have difficulty in storing an accurate phonological representation of speech.

Therefore, it is highly important to assess phonological working memory in this population. One of the methods in assessing phonological working memory is to use a non-sense syllable test. The aim of this study is to create a valid and reiable non-sense syllable test in order to evaluate phonological working memory in Persian speaking children with auditory processing disorders.

Methods: In this cross sectional comparative study, 40 non-sense syllable words were developed according to the criteria of non-syllable word construction and under supervision of a linguistic specialist. The non-sense syllable test was assessed in 53 boys and 47 girls from 7 to 10 years of age. The content validity of the non-sense syllable words was assessed by experts. To evaluate the validity of the test, correlation between the results of the test and forward digit recall and backward digit recall tests were measured. The non-sense syllable test was performed twice to evaluate its relaibility.

Results: The validity of the non-sense syllable test was 95.5 (SD=2). The correlation coefficient between non-sense syllable repetition, forward digit recall, and backward digit recal l tests were 0.76 and 0.75 respectively (p<0.001). The correlation coefficient between different performances of non-sense syllable tests was 0.8 (p<0.001).

Conclusion: These findings show that the non-sense syllable repetition test can be used to evaluate phonological working memory in Persian speaking children from 7-10 years of age.

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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: Diabetes mellitus is a metabolic disorder that affects multiple systems including the auditory and vestibular systems. Patients with diabetes mellitus complain of tinnitus and dizziness. The objective of this study is to assess the effects of diabetes mellitus types I and II on auditory and vestibular systems.

Methods: We compared pure-tone audiometric results and cervical vestibular evoked myogenic potentials ( cVEMPs) between 15 patients with diabetes mellitus type I (43.80 with SD 4.246), 15 patients with diabetes mellitus type II (48.13 with SD 2.973), and 10 normal volunteers (45.30 with SD 4.448). Age range of the participants was 40-50 years old.

Results: Audiometric results showed normal hearing in both types of diabetes mellitus. In contrast, comparing amplitude of cVEMPs between diabetes mellitus and control groups showed statistically significant differences (p<0.05).

Conclusion: In spite of normal audiometric results in patients with diabetes mellitus types I and II, there was abnormal vestibular responses involving vestibular end-organ and related central pathway.

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Background and Aim : Hearing loss affects human adjustment with environment and may be followed by mental complications such as behavioral problems. This study was conducted to investigate the effectiveness of group behavioral management training of mothers based on the model of positive parenting on the rate of behavioral disorders of primary school deaf students in Isfahan.

Methods: The research method was semi-experimental with pre and post-test plan and control group. Using multi-stage sampling method, 30 mothers whose children demonstrated behavioral disorders symptoms were chosen and randomly assigned into two experimental and control groups. Data gathering was by parents’ form of child behavior checklist with confirmed validity and reliability. The obtained data was analyzed using covariance analysis method.

Results: The results showed that there is significant difference between performance of experimental and control groups on the reduction of behavioral disorders symptoms in the post-test (p<0.001).

Conclusion: It could be concluded that mother training based on the positive parenting model is effective on reducing behavioral disorders of their deaf child, and thus can be applied as an effective intervention method.

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Background and Aim: Speech and language pathologists (SLP) often refer to phonological data as part of their assessment protocols in evaluating the communication skills of children. The aim of this study was to develop the Persian version of the phonological test in evaluating and diagnosing communication skills in Persian speaking children and to evaluate its validity and reliability.

Methods: The Persian phonological test (PPT) was conducted on 387 monolingual Persian speaking boys and girls (3-6 years of age) who were selected from 12 nurseries in the northwest region of Tehran. Content validity ratio (CVR) and content validity index (CVI) were assessed by speechtherapists and linguists. Correlation between speech and language pathologists experts' opinions and Persian phonological test results in children with and without phonological disorders was evaluated to investigate the Persian phonological test validity. In addition, the Persian phonological test test-retest reliability was investigated.

Results: Both content validity ratio and content validity index were found to be acceptable (CVR≥94.71 and CVI=97.35). The PPT validity was confirmed by finding a good correlation between s peech and language pathologists experts' opinions and Persian phonological test results ( r _Kappa =0.73 and r _Spearman =0.76). The percent of agreement between transcription and analyzing error patterns in test-retest (ranging from 86.27%-100%) and score-rescore (ranging from 94.28%-100%) showed that Persian phonological test had a very high reliability.

Conclusion: The results of this study show that the Persian phonological test seems to be a suitable tool in evaluating phonological skills of Persian speaking children in clinical settings and research projects.

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Background and Aim: Word definition is one of the complicated language skills that require education and linguistic awareness. In this study , comparison was made in word definition ability of children between ages of 4.5 to 7.5 years.

Methods: This study was cross-sectional and descriptive-analytical in nature . Participants included 107 girls and boys who where in age group 1 (54-65 months), age group 2 (66-77 months), and age group 3 (78-90 months). They were selected by multistage sampling method and recruited from nurseries and primary schools in 1, 7, and 17 municipal districts of Tehran . Word definition task was performed on each subject. The reliability was assessed by two independent values and the validity was determined by the content. Kruskal- Wallis and Mann-Whitney U statistical methods were used for analysis.

Results: Mean score of the content in word definition was significantly increased by age (p=0.001). In the second and third age groups there was no significant difference in the content of word definition. The most response that used in all ages was the functional response. With increasing age, error rate (p=0.002) and identical (p=0.003) responses significantly decreased however, percentage use of combination II (p<0.001) responses significantly increased.

Conclusion: By increasing age, quality of definitions in terms of content is improved and definitions change from functional and concrete responses to c ombination II definitions.

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Background and Aim: Cervical vestibular-evoked myogenic potential (cVEMP) is one of the diagnostic tests used in assessing vestibular function. Two aims of this study were to investigate implications of cervical vestibular evoked myogenic potential in children with spastic cerebral palsy (7-12 years), and to compare vestibular function in these children and normal children.

Methods: In this cross-sectional study, myogenic potential was recorded in 31 children with spastic cerebral palsy (8 girls, 23 boys,7-12 years of age, with mean age of 8.77 years old and standard deviation of 1.52 years) and 31 normal children (13 girls, 18 boys with mean age of 8.77 years and standard deviation of 1.52 years). Cervical vestibular evoked myogenic potential was recorded with 500 Hz tone burst. The recorded parameters included p13 and n23 latency, p13-n23 pick to pick amplitude, and threshold.

Results: Myogenic Potential was recorded in 31 normal children. They had bilateral responses. In children with cerebral palsy, 21 children showed bilateral responses, 3 children had only right-sided responses, 8 children had only left-sided responses, and two children did not show any responses. The statistical significant differences were shown between the two groups in n23, p13-n23 pick to pick amplitude, and threshold (p<0.05).

Conclusion: These findings showed that cervical vestibular evoked myogenic potential can be used in children with cerebral palsy. There were significant differences in myogenic potential parameters between the two groups. More studies are needed to investigate the causes of these differences.

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Background and Aim: Auditory lateralization is a binaural phenomenon that is the result of processing of interaural time and intensity cues in the central auditory system. The main advantage of this phenomenon in human is understanding speech in noisy environments due to the auditory sciene analysis and cocktail party effects . The aim of the present study was to assess the auditory lateralization ability in normal children.

Methods: Participants were 80 normal school age children (8-11 years) of both genders, 42 girls and 38 boys. Lateralization functions were determined by interaural time difference (ITD) ranging from -880 to +880 µs and interaural intensity difference (IID) ranging from -10 to +10 dB for high-pass and low-pass noise.

Results: Interaural intensity difference lateralization functions were linear , while the interaural time difference lateralization functions were S-shaped with a clear linear component from -220 to +220 µs and with an asymptote from -440 to -880 µs and +440 to +880 µs. Generally, interaural intensity difference errors were significantly less than interaural time difference tasks (p<0.0001). Age effect was only present in interaural time difference tasks (p=0.001).

Conclusion: According to these results, children with the age of 11 years performed better in lateralization using interaural time difference cues compared to other children whereas there was no difference in performance in all ages when using interaural intensity difference cues.

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Background and Aim: The cochlea and vestibule are related developmentally. Therefore individuals with severe to profound sensourineural hearing loss have additional risk for vestibular dysfunction. The aim of this study was to assess saccular function using vestibular evoked myogenic potentials (VEMP) in children with severe to profound sensorineural hearing loss (SNHL) who are candidates for cochlear implant.

Methods: Thirty children (17 males and 13 females) with bilateral severe to profound sensorineural hearing loss in the age range of 3-15 years participated in this study. 17 children (9 males and 8 females) with normal hearing in the age range of 3-13 years participated as the control group. All children in each group were evaluated for saccular function by performing vestibular-evoked myogenic potentials in both ears.

Results: Comparison of mean threshold values between the two groups revealed statistically significant difference (p<0.05). In addition, comparison of mean amplitude values between the two groups revealed statistically significant difference (p<0.05). However, comparison of p1 3 and n23 latency values between the two groups revealed no significant difference (p>0.05). Out of the 30 children with bilateral severe to profound sensorineural hearing loss eight children (26.66%) had absent VEMP responses in both ears.

Conclusion: Children with severe to profound sensorineural hearing loss who are candidates for cochlear implant ha d more potential for saccular abnormalities compared to normal-hearing children. Therefore, assessment of vestibular function is very important in this population.

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Background and Aim: Universal newborn hearing screening program (UNHS) using otoacoustic emission (OAE) has been expanded dramatically. The aim of this study was to compare the characteristics of OAE in different time periods.

Methods: In this cohort study, 54 well babies were tested using screening transient-evoked otoacoustic emission in 12, 24, 36, 48 hours and 1 week of their age in Tamin Ejtemaii hospital of Zahedan, Iran. Parameters of "pass" and "fail" level, duration of the test, repetition rate for getting definite result and cooperation level of the parents were analyzed.

Results: The failing rate decreased markedly with age. The major part of this decrement concerned to the age of 12 to 24 hours (left ear: p=0.012 and right ear: p=0.057). Only for the age of 12 hours, the test repetition reduced the failing rate significantly (left ear: p=0.001 and right ear: p<0.001). The test duration reduced significantly with age increment and decreased from the 75 second in age 12 hours to 21 second in age of 24 hours. The test time median for 36, 48 hours and one week of age was 13, 8.4 and 14.3 second, respectively. Among the 54 parents requested to come back for retest one week later, 5 (9.3%) cooperated.

Conclusion: Age effect on referral rate were confirmed in this study high referral rate and poor parent cooperation were the main problems in universal newborn hearing screening program in Zahedan city.

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Background and Aim: Hearing impairment is one of the most stressful disabilities. The mental health of parents caring for children with hearing impairment is at risk. Therefore, technical support and intervention are very valuable for these families. These services are also useful for children’s development. The aim of this study was to assess the effectiveness of social work services on the social adjustment of parents of children with hearing impairment.

Methods: In this study, 37 parents of children with hearing impairment were selected as the sample population. Interviews and case studies were conducted to determine whether the parents were receiving social work services. The social adjustment scale was used to assess parents’ social adjustment. Analysis of variance (F) was used to analyze the data and information obtained from parents.

Results: Data analysis showed that there is a significant difference between parents who had received social work services and parents who had not received social work services (p<0.001).

Conclusion: According to the obtained results, parents who had received social work services experienced higher social adjustment. It can be said that providing assistance to parents of children with hearing impairment can improve their social integration.

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Background and Aim: Grammatical skills development of hearing-impaired children depends on using appropriate educational rehabilitation programs. This study aims to investigate the effectiveness of linguistic plays on the grammatical skills in hearing-impaired children with hearing aids.

Methods: Ten hearing-impaired children with hearing aids, aged between 5 and 7, were randomly assigned to two groups (5 children in each group). Each treatment group received 12 sessions on linguistic plays. The grammatical skills of these children were evaluated via the TOLD-P: 3 (Persian version) in addition, their level of intelligence was assessed by the Raven test.

Results: The difference between the scores of both control and treatment groups revealed a statistically significant difference in grammatical skills (t=7.61, p=0.001) and three subskills of the children who participated in the linguistic plays. These subskills include syntactic understanding (t=3.16, p=0.013), sentence imitation (t=1.71, p=0.006), and morphological completion (t=6.55, p=0.001). In other words, the findings suggest that linguistic plays have a significant impact on the improvement of the aforementioned skills in hearing-impaired children.

Conclusion: Results suggest that it would be beneficial to include linguistic plays as part of routine rehabilitation programs as a means of improving the grammatical difficulties of children. After partaking in linguistic plays, children significantly improved their ability to comprehend the meaning of sentences and also to recognize, understand, and use common Persian morphological forms.

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Background and Aim: Some children with speech sound disorder (SSD) have difficulty with phonological awareness skills therefore, the purpose of this study was to survey the correlation between phonological processes and phonological awareness.

Methods: Twenty-one children with speech sound disorder, aged between 5 and 6, participated in this cross-sectional study. They were recruited from speech therapy clinics at the Tehran University of Medical Sciences. They were selected using the convenience sampling method . Language, speech sound, and phonological awareness skills were investigated by the test of language development-third edition (TOLD-3), the Persian diagnostic evaluation articulation and phonology test, and the phonological awareness test. Both Pearson’s and Spearman’s correlations were used to analyze the data.

Results: There was a significant correlation between the atypical phonological processes and alliteration awareness (p=0.005), rhyme awareness (p=0.009), blending phonemes (p=0.006), identification of words with the same initial phoneme (p=0.007), and identification of words with the same final phoneme (p=0.007). Analyzing the correlation on the basis of the phoneme and syllable structure separately showed there was a significant correlation between the atypical phoneme structure and alliteration awareness (p=0.001), rhyme awareness (p=0.008), blending phonemes (p=0.029), identification of words with the same initial phoneme (p=0.007), and identification of words with the same final phoneme (p=0.003).

Conclusion: Results revealed a relationship between phonological processes and phonological awareness in children with speech sound disorder. Poor phonological awareness was associated with atypical phonological processes especially at the phoneme level.

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Background and Aim: Phonological awareness (consisting of phoneme, syllable and intra-syllable awareness) is an important part of receptive and expressive language it facilitates reading and writing skills through phonological re-coding. Multiple studies in several languages have studied the relationship between phonological awareness and dictation. This research is based on a study of the relationship between phonological skill and spelling score in first-grade Persian students.

Methods: Four hundred first-grade students participated in the study, including 209 girls and 191 boys. A phonological awareness test was individually administered for each student and then a spelling exam was administered in groups. The correlation between the two tests was studied using a simple regression model. The comparison of mean scores of girls and boys was evaluated employing an independent t-test.

Results: A correlation coefficient of 0.82 was obtained between phonological awareness and spelling proficiency (p<0.001). Phonological skill sub-tests also showed a significant correlation with spelling proficiency (highest for phoneme awareness r=0.34 and lowest for rhyme awareness r=0.12). The mean scores of girls and boys differed significantly (p<0.05).

Conclusion: There is a strong positive association between phonological awareness and spelling proficiency. Therefore, if phonological skill is improved, spelling score can be enhanced.

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Background and Aim: Empathy is a basic human skill that is important in daily life. The purpose of this study was to evaluate the role of the theory of mind in predicting empathy.

Methods: This study adopted a causal-comparative design. 40 students with profound hearing impairment and 40 students with normal hearing, aged between 8 and 14, participated in the study. Instruments including false belief tasks and empathy questionnaires were distributed to the participants. For multivariate analysis of variance, a correlation analysis and multiple regression methods were used.

Results: Results indicated a significant difference between the total score of false belief tasks and empathy in students with hearing impairment and those with normal hearing (p<0.001 ). A significant relationship between the theory of mind and empathy was found in both groups (p<0.01). Also theory of mind could predict the empathy (p=0.001).

Conclusion: Based on the obtained results, significant reduction in the theory of mind and empathy was seen in students with hearing impairment. Therefore, training programs that focus on social skills are required for students with hearing impairment in order to address this problem. Moreover, training materials need to be tailored to their cognitive understanding.

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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: Students with hearing impairment show delayed development of theory of mind (ToM) compared with normal children. One factor impacting development of theory of mind is parent-child interaction. The present study investigated the relationship between maternal emotional intelligence and theory of mind in students with hearing impairment.

Methods: The present study employed correlational research. 40 students with profound hearing impairment (age range: 8-14 years) and their mothers were selected to participate. Measurement instruments included the false belief task and emotional intelligence questionnaire. The questionnaire was completed by mothers. Correlational analysis and multiple regression methods were used for data analysis.

Results: Results indicated no significant correlation between the total score on false belief task and the emotional intelligence score and its components (p>0.01). Multiple regression analysis showed that maternal emotional intelligence and its components cannot predict student's scores in false belief tasks (p>0.01).

Conclusion: The results show that there is no significant correlation between maternal emotional intelligence and theory of mind in students with hearing impairment. Therefore, maternal emotional intelligence cannot predict the development of theory of mind in students with hearing impairment.

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Background and Aim: School-aged children with borderline intelligence quotient (IQ) have different comprehension and narrative skills compared with normal children. This research compared dysfluencies and story comprehension of these students with normal students.

Methods: In a cross-sectional study, 30 students with borderline intelligence quotient and 25 normal students were compared. Stratified random sampling was used for selection of students. Picture-elicited narrative and comprehension tests were used to study students. The Mann-Whitney U test and the analysis of covariance Spearman correlation test were used for data analysis.

Results: Students with borderline intelligence quotient produced word dysfluencies and phrasal nonfluencies more than normal students (p=0.005, p=0.01, respectively). They also performed more poorly in story comprehension (p=0.002). There was a significant association between phrasal disfluency and story comprehension (r=-0.21).

Conclusion: Students with borderline intelligence quotient show more dysfluencies in narration and are weaker in story comprehension. There are negative associations between phrasal disfluency and story comprehension.