Background and Aim: Lack of early detection of and intervention for infants hearing loss results in a significant delay in speech and language development. So auditory rehabilitation plays an important role in improving the diminished communication ability. One of the most successful auditory training approaches is the SKI-HI parent-infant program. The purpose of this study was preparation and evaluation of Farsi-Language SKI-HI program for under 3-year-old hearing impaired  children.
Materials and Methods: After translation and modification of the text of the program, fifteen under 3-year-old children with bilateral severe sensory hearing loss who were fitted with appropriate behind the ear hearing aids received intervention for 6 months. The levels of the auditory skills were measured pre and post intervention. Intervention Efficiency Index (IEI), Pretest Developmental Rate (PDR) and Proportional Change Index (PCI) were computed.
Results: The data indicated that there was a significant difference between means of IEI and PDR which were 0.87 and 0.31, respectively. PCI was 3.38 indicated that the children&aposs auditory skills developed at about 2.38 times higher rate after SKI-HI intervention than they did before.  PCI confidence interval showed that development in  the population is 1.46 to 3.30 times higher after SKI-HI intervention (with 95% probability) the rate of auditory skills.
Conclusion: The auditory training with Farsi-language SKI-HI Parent-Infant program may efficiently affect development of auditory skills of hearing impaired children.

Background and Aim: Most of the studies indicates that the parents of the hearing impaired children show many mental health problems after the diagnosis of their children&aposs hearing impairment. Counselling with the parents of the hearing impaired children is one of the most important goals of any early intervention program. This paper describes a study to determine the effectiveness of a group counselling programme for parents of hearing impaired children.

Materials and Method: It was a semi-experimental study with a single group pretest-post test design. The participants were all the parents of hearing impaired children attending in an early intervention center. First the parents&apos mental health were assessed.Then the group counselling program was implemented. Program has involved six weekly 1.5 hour sessions. The format of each session included both lecture presentation and group discussion using cognitive behavioral procedure. Subjects were assessed before and immediately after group therapy by means of General Health Questionnaire(GHQ) and Symptom Check List 90 (SCL-90) questionnaires.

Resuts: The first part of the project had shown that over the half of the parents had considerable psychosocial morbidity. Comparisons showed a significant reduction from pretreatment to posttreatment in depression, anxiety and most of other psychological problems.

Conclusion: The study supports the effectiveness of group therapy programs in the treatment of parents of hearing impaired children. Concerning the progress of early detection programs for the children&aposs hearing impairment more studies should be done in the field of counseling with their parents.

Background and Aim: Hyperbilirubinemia during the neonatal period is known to be an important risk factor for neonatal auditory impairment, and may reveal as a permanent brain damage, if no proper therapeutic intervention is considered. In the present study some electroacoustic and electrophysiologic tests were used to evaluate function of auditory system in a group of children with severe neonatal Jaundice.
Materials and Methods: Forty five children with mean age of 16.1 14.81 months and 17 mg/dl and higher bilirubin level were studied, and the transient evoked otoacoustic emission, acoustic reflex, auditory brainstem response and auditory steady-state response tests were performed for them.
Results: The mean score of bilirubin was 29.37± 8.95 mg/dl. It was lower than 20 mg/dl in 22.2%, between 20-30 mg/dl in 24.4% and more than 30 mg/dl in 48.0% of children. No therapeutic intervention in 26.7%, phototherapy in 44.4%, and blood exchange in 28.9% of children were reported. 48.9% hypoxia and 26.6% preterm birth history was shown too. TEOAEs was recordable in 71.1% of cases. The normal result in acoustic reflex, ABR and ASSR tests was shown just in 11.1% of cases. The clinical symptoms of auditory neuropathy were revealed in 57.7% of children.
Conclusion: Conducting auditory tests sensitive to hyperbilirubinemia place of injury is necessary to inform from functional effect and severity of disorder. Because the auditory neuropathy/ dys-synchrony is common in neonates with hyperbilirubinemic, the OAEs and ABR are the minimum essential tests to identify this disorder.

Background and Aim: Regions in the cochlea with no (or very few) functioning inner hair cells and/or neurons are called dead regions. The aim of this study was to identify the cochlear dead regions in moderate to profound sensory neural hearing impaired children through the Threshold equalizing noise (TEN_HL) test.
Materials and Methods: In this cross-sectional study, the TEN(HL) was performed for the all frequencies available on test CD, on 30 children with ages ranging from five to forteen years (mean age, 8.5 ±2.8 years old).
Results: In this study, 58.3% of ears were found to have a dead region for at least one frequency. Classifying by test frequencies, 20% were found to have a dead region, 24% to be inconclusive and 56% to have no dead regions. The difference between mean SNR(T) in ears with and without dead regions was statistically significant. The difference between mean absolute thresholds in two groups was statistically significant at 1000 Hz and below (p <0.05).
Conclusion: The results indicated a relatively high prevalence of dead regions in children with sensory neural hearing impairment, especially for frequencies at which the hearing loss exceeds 70 dB HL.

Background and Aim: Research conducted since the early 1900s has consistently identified differences between deaf and hearing children on performance of a wide variety of motor tasks, most notably balance. Our study was performed to test static and dynamic balance skills in congenital severe to profound hearing impaired children in comparison with normal age-matched children.
Methods: This cross-sectional study was conducted on 30 severe to profound hearing impaired and 40 normal children with age 6 to 10 years old. Bruininks-Oseretsky test of motor proficiency 2, balance subset with 9 parts was used for evaluation of balance skills.
Results: Hearing-impaired children showed 16.7 to 100% fail results in 7 parts of the balance subset. In normal children fail result was revealed just in 3 parts of the balance subset from 2.5 to 57.5%, and differences between two groups were significant (p<0.0001). There was a significant difference between two groups in two static balance skills of standing on one leg on a line and standing on one leg on a balance beam with eyes closed (p<0.0001).
Conclusion: It seems that development of static balance skills are longer than dynamic ones. Because severe to profound hearing-impaired children showed more weakness than normal children in both static and dynamic balance abilities, functional tests of balance proficiency can help to identify balance disorders in these children.

Background and Aim: Vestibular evoked myogenic potentials and acoustically evoked short latency negative response are two non-cochlear responses with probably saccular origin. The present study was conducted to determine the percentage of presence and the relation between these two responses in children with hearing loss.
Methods: Thirty children with profound congenital sensorineural hearing loss were studied.  Vestibular evoked myogenic potentials ellicitedby tone burst stimuli and acoustically evoked short latency negative response ellicited by click stimuli were recorded. Both responses were recorded at air conduction threshold level monaurally via an internal receiver.
Results: Vestibular evoked myogenic potentials in 53.3% of children and acoustically evoked short latency negative response in 40.0% of cases were recorded. There was a significant correlation between the percentage of recording these two responses (p=0.005). Gender and the stimulated ear had no effect on the results.
Conclusion: In almost half of these disabled children, both vestibular evoked myogenic potentials and acoustically evoked short latency negative response were recoreded. This finding may both indicate that hearing loss has no effect on the function of otolith organs in some children and vestibular deficits probably exist along with hearing impairment in others. This findng reiterates the importance of evaluation of vestibular system as part of standard auditory evaluations.

Background and Aim: Dichotic listening means presentation of two different auditory stimuli to each ear simultaneously. This study deals with the development of Persian version of Bergen dichotic listening test and its preliminary results on auditory attention and language laterality in adults with normal hearing.

Methods: Persian version of the Bergen dichotic listening test was instructed by six consonant-vowel syllables to evaluate three conditions of non-forced attention, attention to right and attention to left ears separately. Then, it was performed on 54 right-handed young adults with normal hearing and the mean age of 23.24 (SD=2.78) years from both genders.

Results: Frequency of correct response in the right ear was higher significantly in two conditions of non-forced attention (83.3%) and attention to the right ear (98.1%), and also was higher significantly in the left ear (-79.6%) in attention to the left (p<0.0001). Laterality index was 31.33% in non-forced attention, 73.30% in attention to the right and -37.50% in attention to the left which was significantly different (p<0.0001).

Conclusion: Right ear advantage was revealed in non-forced attention that was altered with selective attention to the right and left remarkably result from the effect of top-down processing of brain cortex on bottom-top processing of speech stimulus. These preliminary results showed the performance of Bergen dichotic listening test to test auditory attention and language laterality.