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: High incidence of speech disorders in children with cerebral palsy could be related to a deficiency in processing of auditory stimuli. So it is vital to check out any peripheral or central disorders in auditory system using behavioral and electrophysiological auditory tests.
Methods: In a cross-sectional study, 15 children with spastic diplegia, mean age 5.77, SD 2.26 years, and 15 normal children, mean age 5.33, SD 1.80 years, were tested using pure tone audiometry, immittance and auditory brainstem responses. The results were compared between the two groups.
Results: Hearing thresholds and middle ear status were in normal range in all participants however, contralateral acoustic reflex thresholds were mostly elevated. Comparing absolute latency and interpeak latency intervals of auditory brainstem responses between the two groups, absolute latency interval of later waves, and in specific the V wave, was significantly longer in diplegic children (p=0.04) resulting in a longer III-V interpeak latency intervals (p=0.02).
Conclusion: Neurological disorders in ponto-reticulo-spinal pathway, pontine reticular nuclei and upper pons which are adjacent to auditory nuclei of lateral leminiscus and inferior colliculus result in auditory dys-synchrony and increased latency intervals in latter waves of auditory brainstem responses. This could also attributed to functional disorders in wave-generating sites in these patients.

Background and Aim: Hearing-impaired students have some delays in learning language skills such as reading because of hearing loss. To study the effect of promoting educational level on the development of reading comprehension, the students of the 4^th grade of elementary and last year guidance school were compared based on international test of reading literacy.
Methods: The project was cross-sectional and the tool used was the international standard booklet of PIRLS 2001. Thirty-six students selected with moderately severe and severe hearing loss from the 4^th grade of elementary and last year guidance school from Shahriar, Robatkarim, Karaj and Hashtgerd, Iran, exceptional schools. Comparative statistical analysis was performed using t-test.
Results: The first level (focus on and retrieve explicity information) showed a meaningful difference between the last year guidance school and the 4^th grade of elementary students (p<0.05), but there were no significant differences in other levels, make straightforward information-interpret and integrate ideas-examine and evaluate content, (p> 0.05).
Conclusion: Hearing-impaired students have difficulties in understanding in deep levels of reading despite promoting educational level. Thus, in making policies for special trainings, continuing the rehabilitation in guidance and high school levels to promote the complex levels of comprehension should be taken more into consideration.

Background and Aim: The dichotic auditory-verbal memory test (DAVMT) is useful in detecting auditory-verbal memory deficits and differences in memory function between the brain hemispheres. The purpose of this study was to prepare the Persian version of dichotic auditory-verbal memory test and to obtain its results in 18- to 25-year old normal individuals of both genders in Iran.
Methods: The Persian version of dichotic auditory-verbal memory test like the original one consisted of 18 lists of ten words. The lists were arranged such that 10 words were presented to one ear, with the reverse words simultaneously were presented to the other ear, constituting a dichotic test situation. After preparing the 18 lists, content validity was assessed by a panel of eight experts and then, the words of each list were recorded on CD in a dichotic mode. Thereafter, it was performed on one hundred and ten normal individuals with ages ranging from 18 to 25 years (mean age: 21.3 SD 1.9 years) and the scores were recorded on a specially designed scoring sheet.
Results: There was no significant difference between mean scores of 18 lists of the dichotic auditory-verbal memory test. The overall mean of CVI was 96% for the 18 lists and the mean score of dichotic auditory-verbal memory test was 6.5 SD 1.0 in the normal group.
Conclusion: Based on the obtained results, the Persian version of dichotic auditory-verbal memory test has a good content validity and can be used in detecting the auditory-verbal memory deficits.

Background and Aim: Formant structure and vowel space are the most important acoustic characteristics of speech sounds. The purpose of this study was to determine formant frequency and vowel space in six Persian vowels.
Methods: This cross-sectional descriptive-analytic study was performed on 60 Persian students of Tehran University of Medical Sciences (30 males, 30 females) with their age ranging from 18 to 24 years. The subject articulated six Persian vowels in isolation and data was recorded by real-analyzer software. Then, the first three formant frequency of each vowel was determined for each subject. Vowel formant frequency averages were measured separately for each vowel and each gender. Vowel space was plotted. The difference between F0 in two groups was compared by Leven and independent sample t tests.
Results: Maximum and minimum values of F0 in both group was related to /æ/ and /a/ (135 Hz in males and 239 Hz in females) and /i/ (146 Hz in males and 239 Hz in females). Besides, F0 in females was significantly higher than males (p<0.001). Maximum and minimum values of F1 were related to /æ/ and /i/. Furthermore, maximum and minimum values of F2 were related to /i/ and /u/. Maximum and minimum values of F3 were related to /i/ and /u/.
Conclusion: The lowest vowels were /æ/ and /a/ and the highest was /i/. The frontest was /i/ and the backest was /u/. the spreadest vowel was /i/ and the roundest was /u/.

Background and Aim: Deafness is a heterogeneous disorder induced by genetic and environmental factors. It is the most common hereditary sensory-neural disorder that affects 1/1000 to 1/2000 of the newborns. More than 70% of hearing loss cases are caused by genetic disorders, 85% of which result from nonsyndromic autosomal recessive sensory-neural hearing loss. Up to now, more than 100 genes contributing in hearing loss have been determined. Alteration of these genes may result in hearing loss.
This study was performed to identify the inheritance patterns of deafness and its relation with ethnicity, gender and consanguineous marriages.
Methods: In this survey, data from 356 families affected by hearing loss and referred to welfare organization of Ahvaz during the time were collected based on sex, ethnic groups and relativeness.
Results: The results state a high frequency of autosomal recessive deafness caused by consanguineous marriages within Arab and non-Arab ethnic groups (p<0.05). But no significant difference in gender.
Conclusion: In conclusion, the high frequency of autosomal recessive deafness among the population with a high frequency of consanguineous marriages is considerable. The dominant pattern of deafness observed in this population was autosomal recessive.

Background and Aim: To date, the function of auditory efferent system remains unclear. There is evidence that medial olivocochlear bundle receives descending input from the cortex. In this study, the effect of auditory selective attention on stimulus-frequency otoacoustic emissions (SFOAE) was analyzed to investigate the modification of peripheral auditory system by auditory cortex activity in frequency specific mode.
Methods: Thirty-six normal hearing adult subjects with their age ranging from 18 to 30 years (mean age: 21.9 years) participated in this cross-sectional study. Contralateral suppression of stimulus-frequency otoacoustic emissions was recorded in the right ear at 2 KHz. In order to eliminate the auditory attention, subjects were instructed to read a text. Besides, in order to evaluate the effect of auditory attention on contralateral suppression, subjects were instructed to detect target tones in background noise at 1000, 2000, and 4000 KHz.
Results: A significant increase at contralateral suppression of stimulus-frequency otoacoustic emissions was observed in auditory selective attention conditions (p≤0.001). The largest magnitude of stimulus-frequency otoacoustic emissions suppression was seen at 2 KHz.
Conclusion: The results of this study indicated that the activities of medial olivocochlear bundle enhanced by contralateral auditory selective attention increase the magnitude of stimulus-frequency otoacoustic emissions suppression. In fact, these results provided evidence for influence of auditory cortex on the peripheral auditory system via corticofugal pathways in a frequency specific way.

Background and Aim: The words are the symbolic tools for communication. Nouns are the initial and the most frequent components of language that children acquire and use during the procedure of language development. Therefore, this study aimed to determine the noun perception and expression abilities in Persian-speaking children, as well as gathering the normative data for two picture-pointing and picture-naming tests.
Methods: In this cross-sectional study, 110 normal Persian-speaking children (54 girls and 56 boys), 2.5 to 4 year-old in four groups, were selected randomly throughout Arak kindergartens. Two pictorial perception and expression tests were performed in this study.
Results: Mean scores of perception and expression was statistically different between all age groups, except 3 and 3.5 year-old groups (p<0.05). There was no statistically difference between mean scores of girls and boys. In addition, a significant positive correlation between mean scores of perception and expression was shown (p=0.001, r=0.896).
Conclusion: The perception and expression abilities are different in 4 age groups. The two picture-pointing and picture-naming tests can show these differences. Regardless of rapid development of perception, perception and expression abilities develop in parallel, and the ability of girls and boys shows similar trends.

Background and Aims: Main feature of auditory processing abilities is temporal processing including temporal resolution, temporal ordering, temporal integration and temporal masking. Many studies have shown the superiority of blinds in temporal discrimination over sighted subjects. In this study, temporal processing was compared in congenital blind subjects with sighted controls via gap in noise test (GIN).
Methods: This analytic-prescriptive non-invasive cohort study was conducted on 22 congenital blinds (11 males and 11 females) with a mean age of 26.22 years and 22 sighted control subjects (11 males and 11 females) with a mean age of 24.04 years with normal hearing in faculty of Rehabilitation Tehran University of Medical Sciences. Gap in noise test results, approximate threshold and percent of corrected answers, were obtained and then, were analyzed by Mann-Whitney non-parametric statistical test.
Results: There was a significant difference in the approximate threshold and the percent of corrected answers between congenital blinds and sighted control subjects (p<0.05). However, there was no significant difference between males and females in this regard (p>0.05).
Conclusion: Auditory temporal resolution ability, the lower approximate threshold and the more corrected answers in gap in noise, in blind subjects is better than the sighted control group and it might be related to the compensative neuroplasticity after visual deprivation.

Background and Aim: It is well established that adult sensory systems can reorganize following environmental changes hearing aid stimulates a deprived auditory system resulting in changes in received stimuli and may be capable of inducing changes within the auditory system abilities such as difference limen for intensity. Hearing aid fitting induces perceptual and physiological modifications. The present study was conducted to evaluate the effects of hearing aid use on the intensity discrimination performance.
Methods: The study group consisted of 30 monaural users of hearing aid with symmetrical moderate or moderately severe sensorineural hearing loss in both ears (15 males, 15 females), aged 45-65 years old with the mean of 57.73 and SD of 8.12 years. difference limen for intensity was measured at two frequencies, 500 Hz, 2000 Hz, and two intensity levels (10 dB SL, 40 dB SL). The results of fitted ears were compared with not-fitted ones.
Results: The results of the study showed better difference limen for intensity scores at high frequency and high intensity levels. A significant lower difference limen for intensity in fitted ears was observed compared with not-fitted ears (p<0.05), while there was no significant difference between the difference limen for intensity in the two groups at 500 Hz with 10 dB SL intensity (p=0.132).
Conclusion: Hearing aid use affects intensity discrimination performance. Besides, perceptual modification following use of hearing aid is confirmed by our study which suggests a possible functional plasticity due to hearing aid use. However, further

Background and Aim: The communication process includes both verbal and nonverbal elements. Nonverbal behavior or body language includes facial expression, eye contact, posture and prosody. Prosody conveys semantic or affective information to a listener. Nonetheless, so far in Iran no report on assessment of speech prosody comprehension in patients has ever been published. The aim of this study was to measure the validity and reliability of the prosody comprehension test specifically designed for the Persian language and culture.
Methods: This study is a type of test development. 73 sentences were orated by 22 professional vocalists in eight different prosodies. A total of 6582 voices were prepared which were listened by 200, 18-30 year-old students and a voice specialist. Having the content validity calculated for all voices, 1473 voices were found to be unanimously agreed upon by all participants in terms of emotional status which were analyzed by a voice specialist. Eventually, 169 voices were selected for developing the prosody comprehension test including the following four subtests: none motional prosody discrimination, emotional discrimination, naming of prosody and naming conflicts. Reliability of the test was determined by performing the test on 32, 18-60 year-old normal people.
Results: The designed test of comprehension prosody had 100% content validity ratio and 94% reliability and the correlation of test of prosody was 89% (p=0.001).
Conclusion: This test in Persian language has appropriate validity and reliability and is appropriate for assessment of prosody comprehension.

Background and Aim: Voice disorders assess with the help of laboratory equipments and perceptual evaluation. Voice samples involve vowel prolongation, text-reading or conversational speech. In Iran, Rainbow text and Grandfather text, were developed for assessing voice.
Methods: This study was cross-sectional and descriptive-analytical. Mean and fundamental frequency variations range in 120 normal males and females aging from 20-59 years old were studied. Voice samples of reading both texts were gathered and compared.
Results: Mean fundamental frequency in males in Grandfather text was 137.93 with SD 1.2 and in Rainbow text was 135.09 with SD 1.1 (p>0.05), in females Grandfather and Rainbow texts were 206.07 with SD 0.9 and 204.23 with SD 2.1, respectively (p>0.05). Fundamental frequency variations range in Grandfather text in males was 88.10 with SD 0.8 and in females was 116.77 with SD 1.3 and in Rainbow text in males was 90.92 with SD 1.1, in females was 116.08 with SD 1.2 (p>0.05). Mean fundamental frequency of males in each text didn&apost show significant difference in age groups and just in 50-59 age group of the female population showed significant difference. Fundamental frequency variations range didn&apost show significant difference in males and females in both texts.
Conclusion: These two texts were the same in measurement of average and fundamental frequency variations range in adults. Significant difference showed between 50-59 age group of the female population and other groups.

Background and Aim: prosody is a very important factor in communication and includes such parameters as: duration, intonation, pitch, stress, rhythm etc. Intonation is the pitch variation in one sentence. Duration is the time taken to utter a voice. The aim of the present study was to evaluate some parameters of prosody such as duration and intonation curve in interrogative sentences among normal Farsi speaking adults in order to determine the characteristics of this aspect of language with an emphasis on laboratory testing.
Methods: This study was performed as a cross-sectional one. The participants included 134 male and female Farsi speaking individuals aging between 18-30 years. In this study two interrogative sentences with open and closed answers were used. The voice samples were analyzed by Dr.speech -real analysis software. Data analysis incorporated unilateral analysis of variance and an intonation curve was drawn for each sentence.
Results: The parameter of duration among men and women was significantly different (p≤0.001). Duration in open questions was significantly longer than yes/no questions (p≤0.001). The intonation curve of the two groups were similar.
Conclusion: Men and women use duration changes, for making difference in prosody. On the whole, duration among women is longer than men. In open questions, the duration of sentences is mostly due to the question word. The intonation curve in open questions has more amplitude. Women show much more changes in basic frequency for transferring interrogative state in their expressions.

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

Background and Aim: 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: Ocular vestibular-evoked myogenic potential (oVEMP) is a novel vestibular function test. This short-latency response can be recorded through contracting extraocular muscles by high-intensity acoustic stimulation and can be used to evaluate contralateral ocular-vestibular reflex. The aim of this study was to record and compare the amplitude, latency, asymmetry ratio and occurrence percentage of oVEMP (n10) and cervical VEMP (p13) responses in a group of normal adult subjects.
Methods: We carried out a cross-sectional study on 20 adult subjects&apos mean age 22.18 years, SD=2.19 with normal hearing sensitivity and no history of vestibular diseases. oVEMP and cVEMP responses in both ears were recorded using air conducted stimuli 500 Hz short tone burst, 95 dB nHL via insert earphone and compared.
Results: cVEMP was recorded in all subjects but oVEMP was absent in two subjects. Mean amplitude and latency were 140.77 μv and 15.56 ms in p13 and 3.18 μv and 9.32 ms in n10. There were statistically significant differences between p13 and n10 amplitudes (p<0.001).
Conclusion: This study showed that occurrence percentage and amplitude of oVEMP were less than those of cVEMP. Since these two tests originate from different sections of vestibular nerve, we can consider them as parallel vestibular function tests and utilize them for evaluation of vestibular disorders.

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: 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.

Background and Aim: Due to limitation of standardized tests for Persian-speakers with language disorders, spontaneous language sampling collection is an important part of assessment of language protocol. Therefore, selection of a language sampling method, which will provide information of linguistic competence in a short time, is important. Therefore, in this study, we compared the language samples elicited with picture description and storytelling methods in order to determine the effectiveness of the two methods.
Methods: In this study 30 first-grade elementary school girls were selected with simple sampling. To investigate picture description method, we used two illustrated stories with four pictures. Language samples were collected through storytelling by telling a famous children&aposs story. To determine the effectiveness of these two methods the two indices of duration of sampling and mean length of utterance (MLU) were compared.
Results: There was no significant difference between MLU in description and storytelling methods (p>0.05). However, duration of sampling was shorter in the picture description method than the story telling method (p<0.05).
Conclusion: Findings show that, the two methods of picture description and storytelling have the same potential in language sampling. Since, picture description method can provide language samples with the same complexity in a shorter time than storytelling, it can be used as a beneficial method for clinical purposes.