Background: In recent years there has been increased interest in the use of Al for assessing hearing handicap and for measuring the potential effectiveness of amplification system.AI is an expression of proportion of average speech signal that is audible to a given patient, and it can vary between 0.0 to 1.0.
Method and Materials: This cross-sectional analytical study was carried out in department of audiology, rehabilitation, faculty, IUMS form 31 Oct 98 to 7 March 1999, on 40 normal hearing persons (80 ears 19 males and 21 females) and 40 hearing impaired persons (61 ears 36 males and 25 females, 25-65 years old) with moderate to moderately severe SNI-IL The pavlovic procedure (1988) for calculating Al, open set taped standard mono syllabic word lists, and the real -ear probe- tube microphone system to measure insertion gain were used, through test-retest.
Results: 1/A significant correlation was shown between the Al scores and the speech recognition scores of normal hearing and hearing-impaired group with and without the hearing aid (P<0.05) 2/ There was no significant differences in age group & sex: also 3 In test-retest measures of the insertion gain in each test and 4/No significant in test-retest of speech recognition test score.
Conclusion: According to these results the Al can predict the unaided and aided monosyllabic recognition test scores very well, and age and sex variables have no effect on its ability. Therefore with respect to high reliability of the Al results and its simplicity, easy -to- use, cost effective, and little time consuming for calculation, it&aposs recommended the wide use of the Al, especially in clinical situation.

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: Nowadays, auditory perception is not a complete method to assess vowels quality and we need to use more objective instruments.In this study we want to determine and compare the persian vowels formants in normal and hearing Impaired students in 7ـ9 year old children of Isfahan.
Materials and Methods: This cross sectional study was performed on 64 normal and hearing impaired students. Background information was by interview and then, vowel production test was performed. First three formants of each vowel were obtained and recorded by speech studio soft ware and Dr. Speech device Data were compared between groups.
Results: Mean F₁ and F₂, and F₂/F₁ and F₃/F₁ ratio of Persian vowels between these three studied groups were different significantly. Mean F₃ of /o/, /e/ and /a/ in all groups was different significantly. Although we could not find such a significant differences for /u/, /i/ and /æ/ between these groups(p<0.05).
Conclusion: The most important difference between normal and hearing impaired children is their vowel Space, and we found that, the more sever the hearing impairment is, the closer vowel space will be seen. The hearing impaired children rely mostly on their proprioceptive sense because of their hearing deficiency and it causes less movement of the tongue, so they usually substitute vowels which have similar F₁ and F₂.

Background and Aim: Despite the abundance of literature about deaf children, few works specifically address the concept and practice of difficulties in parenting hearing-impaired children. The first interactions of the child are with his parents, and parents have the most important role in child improvements during early intervention programs. The main purpose of this paper was to investigate different aspects of parenting hearing-impaired children.   

Methods: In this article, we reviewed all aspects of parenting hearing-impaired children in papers from 1984-2009 in Medline, Scopus and Proquest and relative textbooks. The semi-professional role of parents of hearing-impaired children make them feel under excessive stress and this usually affects their other roles as fathers and mothers. Many factors including child age, type of hearing loss and parents' individual characteristics may influence the impact of child's hearing loss on parents.

Conclusion: Parenting a hearing-impaired child is both similar and different to parenting any other child. Where there are differences, there are usually challenges too. Taking support and advice from professionals and other parents are necessary and invaluable for parents of hearing-impaired children.

Background and Aim: Learning language is acquired in early childhood and gradually developed by new words and new structures. Hearing sense is the most important acquisition for learning this skill. Hearing disorders are barriers for natural language learning. The purpose of this study was to investigate the relationship between writing sentences and perception of written sentences in hearing-impaired and normal-hearing students.
Methods: A cross-sectional study was conducted among thirty hearing-impaired students with hearing loss of 70-90 dB and thirty normal hearing students. They were selected from 3^rd grade primary school students in Hamadan, a large city in Western Iran. The language skills and non language information was assessed by questionnaire, Action Picture Test, and Sentence Perception Test.
Results: Results showed that there was a significant relation between writing sentences and perception of written sentences in hearing impaired students (p<0.001), (r=0.8). This significant relation was seen in normal-hearing students as well (p<0.001), (r=0.7).
Conclusion: Disability of hearing-impaired students in verbal communication is not only related to articulation and voice disorders but also is related to their disability to explore and use of language rules. They suffer lack of perception of written sentences, and they are not skilled to convey their feelings and thoughts in order to presenting themselves by using language structures.

Background and Aim: Evaluation of hearing-impaired children&aposs auditory skills by a valid test is very important before starting auditory training. There are many different tests available for languages other than Persian, and some limited Persian tests for children above 5 year of age as well. Accordingly considering the importance of early intervention, we aimed to design a test for evaluating auditory skills of 3-4 year-old hearing-impaired Persian (Farsi) children, which is not available to date.
Methods: The study method was test (scale) construction. The test named Tavana includes four subtests: detection, discrimination, identification and sentence comprehension. For determining content validity of the test, the vocabulary of 3-4 year-old normal-hearing and hearing-impaired children and also the comments of seven specialists were applied. We classified 10,10,8 and 6 sub skills for 1^st to 4^th subtests, respectively.
Results: The content validity of Tavana test&aposs subskills were 100%, 83%, 96% and 95%, respectively (mean=94%). Mean time for test performance was 82 minutes.
Conclusion: Content validity of Tavana test was 94% which was statistically valid compared to Modarres test (97%) and Mazaheryazdi test (88%).

Background and Aim: Reading skill is one of the most important necessities of students&apos learning in everyday life. This skill is referred to the ability of comprehension, comment and conclusion from texts and receiving the meaning of the massage which is composed. Educational development in any student has a direct relation with the ability of the comprehension. This study is designed to investigate the effects of hearing loss on reading comprehension in hearing-impaired students compared to normal-hearing ones.
Methods: Seventeen hearing-impaired students in 4^th year of primary exceptional schools in Karaj, Robatkarim and Shahriyar, Iran, were enrolled in this cross-sectional study. Seventeen normal-hearing students were randomly selected from ordinary schools next to exceptional ones as control group. They were compared for different levels of reading comprehension using the international standard booklet (PIRLS 2001).
Results: There was a significant difference in performance between hearing-impaired and normal- hearing students in different levels of reading comprehension (p<0.05).
Conclusion: Hearing loss has negative effects on different levels of reading comprehension, so in exceptional centers, reconsideration in educational planning in order to direct education from memorizing to comprehension and deeper layers of learning seems necessary.

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: 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: Hearing impairment can effect many educational abilities and will lead in a dealy in his growth. The objective of this research was to study the effect of hearing impairment on mathematical skill of hearing-impaired students of 4^th grade of elementary in contrast with normal-hearing students.
Methods: The project was cross-sectional and the tool used was the international standard booklet of mathematical questions. There has been 35 hearing-impaired students with range of moderately sever-profound hearing loss selected from the 4^th grade of elementary from exceptional schools in Ray, Pakdasht and Varamina, Iran, and 35 normal-hearing students were randomly selected from ordinary schools next to exceptional schools.
Results: By analyzing the outcomes, the normal-hearing students showed a better result in knowing, application, argument in aspects of cognitive in contrast with hearing-impaired students and there has been a meaningful difference (p<0.05). There was not a meaningful difference in mathematical skill between Ray, Pakdasht and Varamina, Iran in hearing-impaired and normal-hearing groups.
Conclusion: The hearing impairment effects learing of mathematical skill. It is important for hearing-impaired students to presentation various methods in instruction in progress deductive thought and cognitive structure and also development in concepts understand in mathematical domain in rehabilitation services.

Background and Aim: Reading skills, a complicated process, should be learnt and solely is not depend on sounds conforming with the written symbols on a page. Readers will be able to understand and perceive the deeper meaning of the text based on their experiences and knowledge obtained through reading. This research aimed to compare hearing-impaired students&apos reading literacy in exceptional and ordinary schools in Iran.
Methods: This cross-sectional study was done on 28 hearing-impaired students of the 4^th year of primary exceptional and ordinary schools of Shahr-e-Ray and Shahryar cities, Iran, using the Progress in International Reading Literacy Study (PIRLS 2006) booklets. Comparative statistical analysis was performed using Student&aposs t-test.
Results: The hearing-impaired students in ordinary schools had significantly (p<0.05) higher scores [mean (SD)] in reading literacy [3.67 (1.74)], comprehension of informational contents [4.21 (2.48)], and comprehension of literary contents [3.14(1.23)] than hearing-impaired students in exceptional schools [1.78 (1.06), 1.92 (1.49), and 1.64 (1.62), respectively].
Conclusion: Hearing-impaired students in ordinary schools meaningfully had higher performance of reading skills in comparison with hearing-impaired students in exceptional schools. It seems that an appropriate cultural bed should be provided in order to conduct these students and accept them in ordinary schools.

Background and Aim: There is a relation between language skills and science learning in educational approach. Hearing-impairment and delay in learning of language skills influence the progress of learning. The aim of this research was to study the effect of educational level elevation on growth of mathematical skill. Therefore, third grade hearing-impaired students of secondary school, and forth grade hearing-impaired and normal-hearing students of elementary school were compared in terms of mathematical skill.
Methods: The research was cross-sectional and the internationally standardized mathematics questions (2007) were selected as the tools of the test. The sample included 31 students of 4^th grade elementary and third grade of secondary school with sever hearing loss from exceptional schools, and 17 normal-hearing students were randomly selected from ordinary schools next to the exceptional schools in Robatkarim, Karaj, and Shahriyar cities, Iran.
Results: According to data analysis there was a meaningful difference between hearing-impaired students of forth and third grades and normal-hearing students in the three fields of knowledge, application and argument (p<0.05). There was a significant difference between the two hearing-impaired groups in knowledge (p<0.05), but they had no meaningful differences in the fields of application and argument (p>0.05).
Conclusion: No significant improvement was seen in the mathematical skill of hearing-impaired students by educational level elevation. Writing mathematical books for the pre-elementary courses, revision of teaching methods, and increasing teaching hours are necessary in mathematics.

Background and Aim: Stress is the source of many problems in human-kind lives and threatens people&aposs life constantly. Having hearing-impaired child, not only causes stress in parents, but also affects their marital satisfaction. The purpose of this study was comparing the stress and marital satisfaction status between the normal and hearing-impaired children&aposs parents.
Methods: This was a causal-comparative study. Eighty parents of normal children and 80 parents of hearing-impaired children were chosen from rehabilitation centers and kindergartens in city of Tabriz, Iran by available and clustering sampling method. All parents were asked to complete the Friedrich&aposs source of stress and Enrich marital satisfaction questionnaires.
Results: Parents of hearing-impaired children endure more stress than the normal hearing ones (p<0.001). The marital satisfaction of hearing-impaired children&aposs parents was lower than the parents of normal hearing children, too (p<0.001).
Conclusion: Having a hearing-impaired child causes stress and threatens the levels of marital satisfaction. This requires much more attention and a distinct planning for parents of handicap children to reduce their stress.

Background and Aim: The majority of people experience problems and stressors, such as job layoffs and illnesses during their lives. However, the way people cope with stress varies. According to previous research, use of effective coping strategies can significantly reduce stress and tension. The aim of the present study was to investigate the effectiveness of stress coping strategies on hearing-impaired students.
Methods: This is a quasi-experimental study with pre-test, post-test, and control group. The sample consisted of 40 hearing-impaired male students of guidance and high schools of the city of Sari, Iran, in the years 2010 and 2011. They were randomly selected and assigned to two experimental and control groups (n=20). The data collection tool was the General Health Questionnaire-28. The experimental group was administered eight sessions of stress coping strategies based on cognitive-behavioral techniques two hours weekly. Data were analyzed using statistical indices including mean, standard deviation, and two-way analysis of variance.
Results: There was a significant difference between the pre-test and post-test scores in the subscales of somatic symptoms, anxiety and insomnia, depression, and social function (p<0.05). Moreover, after the eight sessions the rate of general health of the experimental group was higher than the control group.
Conclusion: Stress coping strategies based on cognitive-behavioral techniques increased the general health of hearing-impaired people. Therefore, stress management training should be developed and expanded as an appropriate intervention.

Background and Aim: Developing appropriate curriculum for the education of deaf children depends on identifying the needs of this group. We aimed to examine educational rehabilitating needs of hearing-impaired children from the point of view of their parents.

Methods: In this descriptive survey study, data gathering tool was a researcher-made questionnaire completed by 64 parents of deaf children.

Results: Parents expressed that fitness of training with the students in school, willingness to participate in the program, and the use of a uditory-verbal therapy as a good way were the main notification preferences to families of hearing-impaired children, exceptional centers, and advertisements. They emphesied that lack of appropriate facilities, children's pertinacity, and their lack of cooperation prevented the implementation of training programs and curriculum in educational centers and home. Good verbal communication and speech was as the parents' first priority expectation of their child at the end of course. There was a significant difference between parents' opinions about the educational needs and rehabilitation (p<0.05). No significant difference was seen between the parents' suggestions about educational problems of hearing-impaired children (p>0.05). Also, there was no significantly association between the gender of child or the educational level of parents with the parents' view.

Conclusion: It seems that parents should be supported by training workshops and consulting. Also, most of the children in this study were trained auditory-verbally and the results do not mean that other educational and rehabilitation methods have not the discussed characteristics.

Background and Aim: Concerning the important role of parents of hearing-impaired children in auditory-verbal therapy, this study mainly focused on preparing a Persian version of the “Parental needs questionnaire” and analyzing its validity and reliability.

Methods: First, the original English version of the questionnaire “the needs of hearing-impaired Children’s Parents in Auditory-Verbal Therapy” translated to Persian, based on the approved translation protocol of International Quality of Life Assessment by world health organization. Then, the Persian version presented to seven experts for validating the content and their feedbacks were applied into the questionnaire. Finally, the questionnaire presented to parents of 51 hearing-impaired children who attend in auditory-verbal therapy, and the collected results were analyzed statistically.

Results: The overall mean of content validity index in 32 items of the questionnaire was 0.87. The overall Cronbach’s alpha of this questionnaire was 0.86 in the test and 0.99 in the re-test phases.

Conclusion: Based on the obtained results, the Persian version of the questionnaire has a satisfactory content validity and reliability and could be used in clinics and medical centers for analysis of parental needs.

Background and Aim: Hearing is one of the most vital sensational abilities. Learning, which is the most basic ability for human compatibility to mental development, is affected by hearing ability. The main goal of this article was to review the effect of hearing impairment on educational achievement of hearing-impaired students, especially in the field of basic learning skills (reading, writing, and mathematics).

Methods: In this article, the researches on the effect of hearing impairment on educational achievement were reviewed. There were 37 articles extracted from different databases such as Iran Medex, Scopus, PubMed, Magiran, Iran Journal, Google Scholar, and 12 credible books published from 1944 to 2013. In order to search in these databases, educational achievement and other related keywords were used.

Conclusion: Hearing impairment affects listening skills, which is a mental process and is known as the first lingual skill. Subsequently, other lingual skills and learning abilities like educational achievement are affected as well. In order to decrease the educational gap in hearing-impaired students, it is very important to interfere in early stages and use of presentation methods to improve lingual skills in educational system.

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: 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.

Background and Aim: The hearing defects in deaf and hearing-impaired students also affect their cognitive skills such as memory in addition to communication skills. Hence, the aim of this study was to compare visual working memory in deaf and hearing-impaired students with that in normal counterparts.

Method: In the present study, which was a causal-comparative study using the André Rey test, 30 deaf and 30 hearing-impaired students were compared with 30 students in a normal group, and they were matched based on gender, intelligence, educational grade, and socioeconomic status.

Findings: Findings show that there is significant difference between the three groups’ subjects (p<0.05). The average of the normal group was more than that of the other two groups. However, the difference between the two auditory impaired groups was not significant (p>0.05).

Conclusion: Function of deaf or hard-of-hearing students in the visual working memory task was weaker in comparison with the normal counterparts, while the two deaf and hard-of-hearing groups have similar functions. With a better identification and understanding of the factors that affect the development of this cognitive ability, we can offer new methods of teaching and reduce many of the disadvantages of this group of people in the different fields of cognitive science.