Diagnostic ultrasound is a beneficial technique which can be used the audiologists based on essential instruction. Although there are a lot of barriers in relation to the size of the probe and the resolution of the pictures which are obtained,with this method some kind of information can be gained that is impossible to get by any other method. The ability of real- time A and B modes for direct visualization makes them useful tools to study the changes of the ear structures. Ultrasound system is a useful method to evaluate dizzy patients, which can be potentially used along with vestibular tests.

 In the current article we will have a look at the evolusion of audiological tests. Based on the Olsen's theory,having  knowledge about the history of audiological evaluation is not a click="function onclick() { this.style.backgroundColor='#b5d5ff'return hotWord(this) }" onmouseout="function onmouseout() { this.style.backgroundColor='transparent' }" onmouseover="function onmouseover() { this.style.cursor='default' }">platitudinous issue, Rather an audiologist should have a comprehensive knowledge about it and be involved in its progress. In this way he can attain enough expertise and science to make use of the technology.The oldest history regarding to this issue goes back to the 16th century,although It should be considered that other  related investigations about sound, hearing and related fields has heretofore been performed and the relevant investgigators should not be ignored.

Diagnostic ultrasound is a beneficial technique which can be used the audiologists based on essential instruction. Although there are a lot of barriers in relation to the size of the probe and the resolution of the pictures which are obtained, with this method some kind of information can be gained that is impossible to get by any other method. The ability of real- time A and B modes for direct visualization makes them useful tools to study the changes of the ear structures. Ultrasound system is a useful method to evaluate dizzy patients, which can be potentially used along with vestibular tests.

In the current article we will have a look at the evolution of audiological tests. Based on the Olsen's theory, having knowledge about the history of audiological evaluation is not a platitudinous issue, Rather an audiologist should have a comprehensive knowledge about it and be involved in its progress. In this way he can attain enough expertise and science to make use of the technology.The oldest history regarding to this issue goes back to the 16th century, although It should be considered that other related investigations about sound, hearing and related fields has heretofore been performed and the relevant investigators should not be ignored.

Materials and Methods: This study was performed in two parts: included development and standardization of the test and the second part was the evaluation stage. In the first section, Watson&aposs crieria fpr valid speech recognition tests for children was considered. In order to balance the lists phonemically, it was necessary to determine Persian phonemes&apos frequency -of- occurences. Thus, the frequency -of- occurences for 29 phonemes of Persian language in children&aposs and adults&apos speech were separately determined. There were significant differences between some phonemes&apos frequencies in the two samples. So&apos their frequencies in children&aposs speech was used to design the test. It should be mentioned that each list could contains only 25 vowels, while almost 32 ones were meeded according to the phonemically balancing procedure. Therefore, vowels and consonants were separately balanced. The required monosyllabic words were extracted from the books written for 4 to 6 years old children. Finally, four closed set (3- picture matrix) 25 word lists were prepared. The lists were recorded on magnetic cassette in one of the IRIB studios.To assess the test validity and reliabity, 33 normal hearing children were randomly selected from kindergartens over the city of Tehranand were tested at the Audiology Clinic of the Rehabilitation Faculty, Tehran University of Medical Sciences in 1998. The tests included: otoscopy, pure tone & immittance audiometry, establishing speech reception threshold, and speech recognition test - retest by these lists.
Findings: 1- Normal hearing children obtained 92-100 percent scores for each list at their most comfortable loudness levels through test - retest.
2- No significant difference was observed in test - retest scores in each list (p>0.05).
3-No significant difference obtained between the lists test or retest scores (p>0.O5).
4-No significant difference was observed between children&aposs scores in terms of their age and gender (p>O.OS)
Conclusion: this study, therefore, is reliable and valid. The lists are phonemically balanced and equal in difficulty. Due to the conditions under which the test was designed (including, phonemic balance, necessity of using the words that could be pictured and of the presence of tow other word in children&aposs vocabulary which is similar in auditory aspects), only the content validity for word familiarity decreased a little that could be overcome by introducing them through pictures prior to the start of the test.

Rehabilitation of deaf individual is one of the important subjects that has attracted attention of many researchers during past centuries. Different opinions have been established in this direction. Electrophysiologic tests were established and developed parallel to developments in rehabilitation. Therefore, opinion of using electrophysiologic test for evaluation and fitting of hearing aid became gradually popular. Ultimately, the electrophysiologic tests are used in evaluation and fitting of hearing aid in two ways:1-Direct way2- Indirect wayIn direct way aided ABR is obtained and special attention is paid to wave V. This technique has many difficulties. Inindirect way, electrophysiologic tests such, ECochG, OAE and ABR, AMLR, ALR and P300 and other objective tests are used, especially in infants and neonates for evaluating the state of hearing. Researches are continuing in this field. It is probable to have aided electrophysiologic responses with speech stimuli in near future.

Method & Material: This study examined the speech in noise test in 60 school age children with otitis media with effusion and 30 school age children with normal hearing in +5, 0 and -5 dB signal to noise ratio. The mean of age was 8.05 in study group and 8.25 in control group. Speech in noise test were performed for study group and control group in quiet an in noise. Speech noise presented ipsilaterally in both groups.Finding: The correlation of mean of SDS in +5, 0 and -5 dB signal to noise ratio between study group and control group, is significant.

Method & Material: This descriptive analytical survey was performed in pars Hospital, Tehran on 45 children (22 girls, 23 boys aged 2-5 years, 1377-78 (solar).Finding: In 2-3 years old group, accurdacy of PTA test (87/7%) was more than FNS test (66%). In 3-5 years old group, Specificity & NPV showed no significant differences, between two test.
Conclusion: Since the PTA showes greater possibility of false positive response than FNST, the accuracy of the latter test is greater the PTA.

This case can be placed in a neurologic classification. The patient is a child with learning disability in school activities. He was first referred to an audiological clinic because of a central auditory processing disorder (CAPD). His mother has noticed several hearing problems and this led us to the evaluations for his central auditory processing disorder. He has problems in hearing speech in noise and speech processing and need his friends repeat words during communication. no vestibular disorder was noticed nor any localization problem. The child has a good progress in school and only suffered problems in reading tasks. Intelligence quotient(IQ) was also normal.

Objective: As the cerebrovascular diseases (CVD) are among the most common anomalies that are directly or indirectly affecting the auditory cortex, studying in this area is important. We tried to evaluate the function of CANS in a group of 50-70 years old cerebrovascular accident (CVA) patients with no hearing complaint by competing sentences test (CST) as a dichotic speech test.
Method and Material: This cross-sectional analytical study was conducted at Loghman-e-Hakim hospital between 22, august 1999 and 20, July 2000 in a group of 30 normal 50-70 years old persons and a group of 40 patients with CVA including 30 patients with abnormal CT scan and 10 patients with normal CT scan.
Results: The results point out the mean scores of CST in the normal group were at normal range (80-100%) in both ears. And mean scores of CST decreased in the patients groups. There were significant difference between mean scores of CST in the patients with CVA and control groups. Conclusion: CST seems to be a valuable test in the CANS test batteries for the cerebrovascular diseases.

Background and Aim: Auditory neuropathy (AN) can be diagnosed by abnormal auditory brainstem response (ABR), in the presence of normal cochlear  microphonic (CM) and otoacoustic emissions (OAEs).The aim of this study was to investigate the ABR and other electrodiagnostic test results of six patients suspicious to AN with problems in speech recognition.
Materials and Methods: this cross sectional study was conducted on 6 AN patients with different ages evaluated by pure tone audiometry, speech discrimition score (SDS) , immittance audiometry , electrocochleography , ABR, middle latancy response (MLR), late latency response (LLR), and OAEs.
Results: Behavioral pure tone audiometric tests showed moderate to profouned hearing loss. SDS was so poor which is not in accordance with pure tone thresholds. All patients had normal tympanogram but absent acoustic reflexes. CMs and OAEs were within normal limits. There was no contralateral suppression of OAEs. None of cases had normal ABR or MLR although LLR was recorded in 4.
Conclusion: All patients in this study are typical cases of auditory neuropathy. Despite having abnormal input, LLR remains normal that indicates differences in auditory evoked potentials related to required neural synchrony. These findings shows that auditory cortex may play a role in regulating presentation of deficient signals along auditory pathways in primary steps.

Background and Aim: Central auditory processing disorders (CAPD) may have a variety of etiologies therefore, performing CAPD tests seem inevitable. Behavioral tests such as synthetic sentence identification (SSI) has gained considerable popularity because of high sensitivity to brainstem and cortical lesions, high diagnostic ability,  cost-benefiting, and also limitations of electrophysiologic tests. The purpose of this study was to prepare a Farsi-language version of SSI and to perform a primary evaluation. 
Materials and Method: Farsi SSI test was made and recorded on CD. Then sixty 20-to 35- year old normal-hearing participants were evaluated in audiology clinic, Faculty of Rehabilitation Sciences Iran University of Medical Sciences in three months.
Results: There is no significant difference between scores of Farsi and original versions of SSI. Gender has no significant effect on the scores.
Conclusion: According to this results, Farsi SSI is comparable to the original one. It can, therefore, be used in CAPD test battery.

Background and Aim: Assessment of central auditory processing skills needs various behavioral tests in format of a test battery. There is a few Persian speech tests for documenting central auditory processing disorders. The purpose of this study was developing a dichotic test formed of one-syllabic words suitable for evaluation of central auditory processing in Persian language children and reporting its preliminary results in a group of normal children.
Materials and Methods: Persian words in competing manner test was developed utilizing most frequent monosyllabic words in children storybooks reported in the previous researches. The test was performed at MCL on forty-five normal children (39 right-handed and 6 left-handed) aged 5-11 years. The children did not show any obvious problem in hearing, speech, language and learning. Free (n=28) and directed listening (n=17) tasks were investigated.
Results: The results show that in directed listening task, there is significant advantage for performance of pre-cued ear relative to opposite side. Right ear advantage is evident in free recall condition. Average performance of the children in directed recall is significantly better than free recall. Average row score of the test increases with the children age.
Conclusion: Persian words in competing manner test as a dichotic test, can show major characteristics of dichotic listening and effect of maturation of central auditory system on it in normal children.

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: One of the most common complaints, particularly among patients with normal or near normal low-frequency hearing, is that their voice sounds "hollow". This is associated with "Occlusion effect". The aim of this study was to comparison of occlusion effect in normal hearing subjects via Real Ear Measurement and Audiometric Bing test.
Materials and Method: Twenty volunteers with normal hearing (10 male, 10 female), with ages ranging from 18 - 24 years were enrolled in this study. First, audiometric Bing test was performed in frequencies of 250, 500, 750 and 1000 Hz. Then in real ear measurement, subjects were instructed to vocalize /â/ and /i/ for 5 seconds. Probe microphone was recorded the sound pressure in the ear canals. The degrees of occlusion effect unit were obtained for further analysis.
Results: The means of occlusion effect were present in all subjects. There was no correlation between the results of audiometric Bing test and real-ear measurement. No significant difference was obtained between genders and monaural or binaural occlusion in real-ear measurement. But in audiometric Bing test, the difference between monaural or binaural occlusion was significant(p<0.05).
Conclusion: The peak of occlusion effect varies significantly among hearing aid users, so the hearing aid must be tuned. Probe- microphone measures will assist in determination how much gain is enough, and where frequency- specific adjustments are needed.

Background and Aim: Balance disturbance is one of the non-auditory effects of noisy industrial environments that is usually neglected. The aim of the current study was to investigate the effect of occupational noise on vestibular system among workers with noise-induced hearing loss (NIHL), based on both vestibular evoked myogenic potentials (VEMP) and caloric tests.

Methods: Thirty male workers with noise-induced hearing loss and thirty male matched controls were examined by VEMP and caloric tests. Study parameters included unilateral weakness, p13 and n23 latencies, and p13-n23 amplitude. Caloric test was performed only for 20 patients.

Results: No significant difference was observed in unilateral weakness between the two groups. On the other hand, the difference in mean latencies of p13 in the right ear (p=0.003) and left ear (p=0.01) was significant between the two groups. However, the difference in n23 latency was significant only in the right ear (p=0.03). There was no significant difference between groups in p13-n23 amplitude.

Conclusion: It seems that pars inferior of vestibule is the susceptible part in individuals with NIHL. In general, abnormal findings in both VEMP and caloric tests were more common compared to functional symptoms such as vertigo, which may be due to central compensation and the symmetry of the disorder.

Background and Aim: As clinical audiometry assessment of each ear needs to know interaural attenuation (IA), the aim of this study was to investigate Persian speech IA in adults.

Methods: This cross-sectional, analytic study was performed on 50 normal hearing students (25 males, 25 females), aged 18-25 years old in Faculty of Rehabilitation, Tehran University of Medical Sciences. Speech reception threshold (SRT) was determined with descending method with and without noise. Then speech IA for Persian spondaic words was caculated with TDH-39 earphones.

Results: Mean speech IA was 53.06±3.25 dB. There was no significant difference between mean IA in males (53.88±2.93 dB) and females (52.24±3.40 dB)(p>0.05). The lowest IA was in females (45 dB) and the highest IA was in males (60 dB). Mother's language has no significant effect on speech IA.

Conclusion: We may consider 45 dB as the lowest IA for Persian speech assessment, however generalization needs more study on a larger sample.

Background and Aim: Reading is undoubtedly an essential skill for everybody in these years. Reading disorders or dyslexia can cause several problems for those who suffer from them. Early assessment and diagnosis play an important role in treatment of this disorder. The main aim of this study was determining the prevalence of reading disorder in first to fifth grade elementary school students. The subbasic aim was introducing the screening Inventory Reading Test (IRT) for diagnosis of the Students with reading disorder at elementary schools.

Methods: A total of 200 students (boys and girls) in five elementary education grades in Isfahan were selected through multi-stage random sampling method and assessed by IRT in 2008. Descriptive statistical analysis was performed using SPSS Software package version 13.0 for Windows.

Results: This survey revealed the highest prevalence of reading disorder in the first grade male students (25%), and the lowest in fifth grade female students (0%). The incidence of dyslexia in all grades generally was 10%. The overall incidence was 66% for male students and 34% for female students.

Conclusion: Reading disorder is more prevalent among male students than female students and the Inventory Reading Test is a satisfactory tool for rapid diagnosis of reading disorder.

Background and Aim: Speech as a motor phenomenon requires repetitive and rapid function of articulatory organs performing extremely fine movements. Practice on motor skills results in facilitation in treatment progress of children with phonological disorders. The purpose of this study was to compare motor skills in 5-year-old children with phonological and phonetic disorders.
Methods: Thirty-two children age 5 years, 16 with phonemical speech sound disorders and 16 with difficulty at a phonetic level participated in this study. TOLD Test was performed for linguistic skills investigation among children. Phonetic test, Wepman test, diadochokinesis and oral assessment was used for diagnosis between phonological and phonetic disorders. The children were also evaluated with Oseretsky motor developmental scale.
Results: In comparison, mean scores of movement skills between both groups showed significant difference (p=0.006) and children with phonetic disorder got significantly higher scores on all part of this test.
Conclusions: The findings of this study support the idea that speech sound disorders are frequently associated with motor problems, and that type of articulation disorder affects the motor performance in a different way. Phonological disorders seem to have more impact on motor performance than phonetic disorders. The results authenticate the need to pay more attention to the motor skills of children with articulation disorders.

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%).