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The disastrous effects of Hearing loss on speech and language development can be minimized by early interventions. Profoundly deaf or hard of hearing children not benefitting enough from other kinds of hearing aids are referred for surgically implanted electronic cochlear implant that provides a sense of sound or comprehension of speech. Evaluation and management of pediatric patients is performed by cochlear implant team which consists of different specialists and doctors. Selecting children for the implant surgery is performed based on the certain criteria suggested by Staller et. al. in 1991. All the patients undergo comprehensive medical and Audiological evaluations before the surgery.In this article we will review different process of cochlear implant surgery and pre- surgery Audio logical evaluations in brief.

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In the present longitudinal study, 20 deaf and 20 hearing children were observed during free play with their hearing mothers when the children were 22 months and 3 years of age. Compared to hearing children, deaf children were severely language delayed, with deaf 3-year-olds using less language (speech or sign) than hearing 22-month-olds. Deaf children communicated primarily through nonlinguistic vocalizations, with increasing use of gesture from 22 months to 3 years of age. Although mothers of deaf children used more visual communication than mothers of hearing children, they still primarily communicated through speech. In addition, deaf children did not visually attend to much of their mothers&apos communication. Therefore, deaf children received much less communication than hearing children. These results suggest that intervention efforts should be focused on increasing the quantity of perceived linguistic input by the child.

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

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Background and Aim: Specific language impairment (SLI) is one of the most prevalent developmental language disorders which is less considered in Persian researches. The aim of this study was to investigate the differences in some morpho-syntactic features of speech and other language skills between Persian children with specific language impairment and their normal age-matched peers. Moreover, the usefulness of the test of language development-3 (TOLD-3), Persian version, as a tool in identifing Persian-speaking children with this impairment, was investigated.
Methods: In a case-control study, the results of the test of language development and speech samples analysis of 13 Persian-speaking children (5 to 7 years old) with specific language impairment were compared with 13 age-matched normal children.
Results: The results of this study showed that there were significant differences between the scores of specific language impairment group and control group in all measured aspects of the TOLD-3 (p<0.001) the children with specific language impairment had a shorter mean length of utterance (p<0.001) and made less use of functional words in their speech (p=0.002) compared with their peers.
Conclusion: Such as specific language impairment children in other languages, all language abilities of Persian-speaking children with specific language impairment are less than expected stage for their age. Furthermore, the Persian version of TOLD-3 is a useful assessment instrument in identifying children with specific language impairment which is comparable to the

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Background and Aim: Staggered spondaic words (SSW) test examines central auditory nervous system . Some researches show stuttering causes hyperactivity in motor system of the right hemisphere and cerebellum and decreases activity in the left hemisphere. During stuttering also, central auditory processing is decreased . The aim of this study was to compare the Persian staggered spondaic word test results between persistent developmental stutterers and normal subjects.

Methods: Thirty people with persistent developmental stuttering were participants of this cross-sectional descriptive-analytic study, which were aged 11 to 40 years. The control group matched for gender and number with stutters. They were 8 females and 22 males, with the age of 11 to 40 years, without any stuttering history, neurological diseases and auditory disorders.

Results: Stutterers were in normal category in corrected staggered spondaic words test. The mean scores of errors of right compete, right ear, left compete, left ear and total in corrected s taggered spondaic words between control and stuttering group showed significant differences. There was a significant relationship between stuttering and effect, too (p<0.05).

Conclusion: Based on the obtained results of this study, stutterers may have different cortical and sub - cortical brain activity than people who have not stutter . Central auditory processing abilities of stutterers are weaker than normal people.

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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.

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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: 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: 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: 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: Various studies indicate that deaf children compared with hearing children have problems in all aspects of emotional development, including facial expression, emotional understanding of display rules, mixed and contradictory emotions and theory of mind. This article reviews studies of impaired emotional development in children with hearing impairment.

Recent Findings: Some findings indicate that young deaf children function similar to hearing children. The difficulty in understanding display rules experienced by deaf children can be explained by appealing to their inability to adequately express emotions in emotion-eliciting contexts, as opposed to their difficulty in understanding mental states. Overall, research findings indicate that emotional understanding in various aspects and dimensions is associated with children's language abilities.

Conclusion: Results obtained show that more aspects of deaf children 's emotional development (such as interpretation and recognition of facial expression) are similar to that of their peers. However, deaf children performed more poorly in tasks which required experience in understanding display rules and theory of mind . Recent findings generally demonstrate that language plays an important role in the emotional development of children. Therefore, deaf children in comparison to hearing children are less able performers.