---

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

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

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

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

---

Background and Aim: American Academy of Pediatrics (AAP) established standards for neonatal hearing screening programs in 1999. The main purpose of this study was to achieve exact statistical data of this program in Ahvaz, Iran, and to compare these results with the standards of American Academy of Pediatrics.

Methods: In this cross-sectional descriptive study, the data of neonatal hearing program in Ahvaz west health center from 2008 to 2011 were reviewed. Data were analysed by descriptive statistics.

Results: From 25073 neonates, 25 had hearing loss. The false positive and referral ratio to the diagnosis stage were 2.6 and 0.48 percent, respectively. 92 percent of hard of hearing infants were diagnosed before three months of life.

Conclusion: In comparison with the standards of American Academy of Pediatrics, all of the items, except two, were included completely or relatively complete. But, more efforts must be done to achieve the whole standards which are available.

---

Background and Aim: Attention has causal role in speech and language processing. Studies are limited about relation between attention and language development. As a result, the purpose of this study was to investigate the difference shifting attention function in children with developmental stuttering and fluent speech.

Methods: Thirty children who stutter (21 boys and 9 girls) and thirty children who did not stutter (21 boys and 9 girls) were evaluated. Shifting attention function was investigated using Wisconsin card sorting test. The data were analyzed via Kolmogorov-Smirnov, independent t, and Mann-Whitney U-tests.

Results: Between group analysis showed significant differences for all of the indexes in Wisconsin card sorting test . The number of categories completed in children who stutter was significantly less than that control group (p<0.05). But preservative errors, total errors, total tries, time of test performance and try for first pattern in children who stutter was more than in the control group and data differences were significant for all of the indexes (p<0.05).

Conclusion: The findings of this study show that children with and without stuttering are different in shifting attention function and children who stutter have weaker function in shifting attention. The findings were linked to emerging theoretical frameworks of stuttering development and that were taken to suggest a possible role for attention processes in developmental stuttering.

---

Background and Aim: In the process of assessing the nasalance scores in patient’s speech, it is vital to know about normative data in the speech of normal subjects. The main objective in this study was to obtain normative data on nasalance scores in normal Persian-speaking children aged 3.5 to 6.5 years.

Methods: In this cross-sectional and comparative study, nasalance was measured in the speech of 112 children (55 boys and 57 girls) in Tehran, Iran. After auditory screening and speech assessments, the subjects who get the sufficient criterions entered the study. Speech sample was obtained by imitation and repeating sentences (14 oral and 3 nasal sentences) and mean nasalance score was measured by Nasal view software.

Results: A mean nasalance score of 46.25% was obtained for nasal sentences and a mean score of 43.67% for fricative sentences, 43.41% for affricative sentences and 42.21% for stop sentences. There was higher nasalance scores in girls but the difference was not significant (p=0.201) there was a significant difference in nasalance scores between different age groups in stop (p=0.037), fricative (p=0.036) and nasal sentences (p=0.032).

Conclusion: Findings of this study prepared good statistical data about nasalance scores in normal Persian-speaking children aged 3.5-6.5 years. The study also revealed that nasalance scores can be different in sentences with same manner of articulation and can be affected by presence or absence of nasal consonants and even age.

---

Background and Aim: Auditory-perceptual assessment of voice a main approach in the diagnosis and therapy improvement of voice disorders. Despite, there are few Iranian studies about auditory-perceptual assessment of voice. The aim of present study was development and determination of validity and rater reliability of Persian version of the Consensus Auditory Perceptual Evaluation of Voice (CAPE -V).

Methods: The qualitative content validity was detected by collecting 10 questionnaires from 9 experienced speech and language pathologists and a linguist. For reliability purposes, the voice samples of 40 dysphonic (neurogenic, functional with and without laryngeal lesions) adults (20-45 years of age) and 10 normal healthy speakers were recorded. The samples included sustain of vowels and reading the 6 sentences of Persian version of the consensus auditory perceptual evaluation of voice called the ATSHA.

Results: The qualitative content validity was proved for developed Persian version of the consensus auditory perceptual evaluation of voice. Cronbach’s alpha was high (0.95). Intra-rater reliability coefficients ranged from 0.86 for overall severity to 0.42 for pitch inter-rater reliability ranged from 0.85 for overall severity to 0.32 for pitch (p<0.05).

Conclusion: The ATSHA can be used as a valid and reliable Persian scale for auditory perceptual assessment of voice in adults.

---

Background and Aim: Hearing impairment can have an impact on adolescents’ quality of life and can lead to their isolation and depression. The main purpose of this research was to study the effectiveness of a mental rehabilitation program based on positive thinking skills training on increasing happiness in a group of hearing impaired girls and boys.

Methods: In this experimental study, pre- and post-test plan with a control group was used. All of the hearing impaired students (girls and boys) in all high schools of southern parts of Tehran, Iran, in year 2012-13 were our statistical research community. 48 hearing impaired girls and boys were selected by multistage sampling including stratified, purposive, and random sampling. They were randomly divided into two groups of experimental and control. Each group consists of 12 boys and 12 girls. Positive thinking skills were trained to experimental groups during eight 45-minutes sessions, twice a week. We used the Oxford happiness questionnaire to assess the level of happiness.

Results: Using analysis of covariance showed that positive thinking skills training had meaningful and positive effect on increasing happiness of hearing impaired boys and girls in the experimental groups (p<0.01). Also, the mean happiness scores of boys and girls were meaningfully different (p<0.01).

Conclusion: Positive thinking skills training increases the happiness scores of hearing impaired adolescents. So, the approach taken in this study can be considered as an appropriate method for psychological-education interventions, counseling and treatment in hearing impaired adolescent.

---

Background and Aim: It is not known how electrocochleography components of action potentials (AP) and summating potentials (SP) are changed in response to CE-chirp stimulus using extra-tympanic electrodes. This study was done for comparing summating potentials and action potentials specifications in response to CE-chirp and click stimuli.

Methods: Electrocochleography components of action potentials and summating potentials were recorded in 16 normal hearing subjects (8 men and 8 women) aged 22-30 years (mean: 26.7 with SD 2.5 years) with audiometric (250-8000 Hz) hearing thresholds of 15 dB HL or better in response to click and CE-chirp stimulus at 90 dB nHL. Amplitude, duration, latency and area of summating potentials and action potentials and SP/AP amplitude and area ratios were compared.

Results: Among the measured parameters, action potentials amplitude in response to CE-chirp stimulus (0.41 with SD 0.26 µV ) was significantly smaller than action potentials amplitude in response to click (0.61 with SD 0.29 µV ) stimulus (p<0.005). Relative frequency of detecting summating potentials in response to CE-chirp (68.7%) was lower than (100%) click (p<0.005).

Conclusion: Recording electrocochleography component of summating potentials and action potentials with CE-chirp stimulus at high intensity level in normal hearing individuals shows no advantage over click stimulus. Small amplitude of summating potentials as a major problem of extra-tympanic electrocochleography cannot be solved using CE-chirp stimulus.

---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

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.

---

Background and Aim: Deaf children face many psychological problems due to their inability to hear. The present study investigates the effectiveness of art therapy (painting) in reducing the hopelessness and solitude experienced by these children.

Methods: An experimental design with pre- and post-testing and a control group was used. Multi-stage method was used for selecting 30 children with hearing impairment (age range: 7-10 years) from Isfahan. Subjects were randomly appointed to experimental and control groups. Data was collected using Kazdin hopelessness scale and Asher solitude scale. Analysis of covariance statistical method was used to analyze the data.

Results: Findings indicated a significant difference between feelings of hopelessness and solitude of deaf children in experimental and control groups (p<0.001).

Conclusion: From these findings it can be concluded that art therapy decreases the rate of hopelessness and solitude in deaf children and can be applied as an educational and therapeutic method.

---

Background and Aim: Deaf children face several compatibility issues because of their hearing impairment. The present study aims to investigate the effectiveness of psychodrama using pantomime on the social adjustment of 12-15-year-old deaf female students in Isfahan.

Methods: For this study, an experimental design was used with a pre-test and post-test and a control group. Thirty deaf subjects (12-15-year-olds) in Isfahan were selected randomly and allocated to experimental and control groups. To gather information, Rao’s Social Maturity Scale was used. The data were analyzed by the multivariate analysis of covariance s tatistical method (SPSS version 21).

Results: Our findings revealed that there was a significant difference between the performances of deaf students of both the groups in the post-test on social adjustment (p=0.0001).

Conclusion: The use of psychodrama increased the rate of social adjustment in deaf students.

---

Background and Aims: The dichotic listening subtest is considered as an important component of the test battery for auditory processing assessment in both children and adults. A randomized dichotic digits test (RDDT) was created to compensate for sensitivity weakness of double digits when detecting abnormal ear asymmetry during dichotic listening. The aim of this study was the development and initial evaluation of the Persian randomized dichotic digits test.

Method: Persian digits 1-10 (except for the bisyllabic digit, 4) uttered by a native Persian language speaker were recorded in a studio. After alignment of intensity and temporal characteristics of digit waveforms, lists 1 and 2 of the RDDT were reproduced. List 1 of the test was administered at 55 dBHL on 50 right-handed normal hearing individuals (with an equal sex ratio) in the age group of 18-25 years and hearing thresholds of 15 dBHL or better in audiometric frequencies.

Results: Mean (standard deviation) percent-correct score for right and left ears and right ear advantage of the subjects was 94.3 (5.3), 84.8 (7.7), and 9.5 (7.0) percent, respectively. Sixty percent of the subjects showed normal results and unilateral and bilateral deficits were seen in 24 percent and 16 percent, respectively.

Conclusion: It seems the Persian version of RDDT is the same as the original test as it is able to test ear asymmetry , unilateral and bilateral deficits in dichotic listening.