Linguistic and Metalinguistic Profiles of Persian-Speaking Children with Hearing Impairment: A Systematic Review of Observational Studies
Abstract
Background and Aim: Numerous studies have investigated the linguistic characteristics of Persian-speaking children with hearing impairment. Given the variability of findings across these studies, a systematic review is required to both identify research gaps and synthesize existing results. This systematic review aimed to answer the following question: in Persian-speaking children with hearing impairment compared to typically hearing Persian-speaking children, what is the profile of linguistic skills (phonology, morphosyntax, semantics, pragmatics) and metalinguistic skills (phonological awareness, syntactic awareness, semantic awareness)?
Recent Findings: Persian-speaking children with hearing impairment experience significant delays across most linguistic domains, particularly in phonetics/phonology (55% of studies), morphosyntax (16%), and semantics/pragmatics (13%). The most consistent deficits were observed in vowel production and perception, phonological awareness, grammatical omissions, tense marking errors, and comprehension of non‑literal meanings. Children with cochlear implants outperformed hearing aid users, and early implantation (before age 2) was associated with more favorable outcomes.
Conclusion: Persian-speaking children with hearing impairment demonstrate significant and persistent delays in both linguistic and metalinguistic skills compared to typically hearing peers. Early cochlear implantation and linguistically rich educational environments (e.g. mainstream schools) are associated with better language outcomes. Clinically, comprehensive language assessments should include both receptive and expressive skills, with targeted interventions focusing on phonological awareness, morphosyntax, and pragmatic abilities. Future research should prioritize neglected age groups (6–8 years and 10–15 years) and the understudied semantic-pragmatic domain.
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17. Rezaee H, Ahadi H, Aghamohammadi A. [The comparison of language development and lexical awareness indexes in bilingual (Azeri-Persian) hard of hearing and normal children]. JPSR. 2020;9(1):41-51. Persian. [DOI:10.22038/jpsr.2020.40712.1963]
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19. Ghazvini A, Khalilavi R, Sadeghi R, Yousefi A, Efrekharian K. [Development of Auditory and Speech Skills in Children Using Cochlear Implant]. J Rehab Med. 2020;8(4): 185- 194. Persian. [DOI:10.22037/jrm.2019.111166.1806]
20. Jeddi Z, Kassani A. Development of auditory, language, and speech skills of children with cochlear implants: A study of aural rehabilitation benefits. J Otolaryngol ENT Res. 2019;11(4):184-9. [DOI:10.15406/joentr.2019.11.00432]
21. Jalilevand N, Ebrahimpour M, Motasaddi Zarandi M, Kamali M, Fayazi L. Comparison of Verbal and Non-Verbal Communication Between Deaf Children with no Cochlear Implantation and Deaf Children 12-24 Months After Cochlear Implantation. Func Disabil J. 2018;1(4):1-7. [DOI:10.30699/fdisj.1.3.1]
22. Hasanvand M, Torabinezhad F, Abolghasemi J, Eslami M. Investigation of speech intonation in cochlear implant children in the imitation and reading tasks. Sci J Rehabil Med. 2020;9(1):194-200. [DOI:10.22037/jrm.2019.111116.1772]
23. Kord N, Shahbpodaghi MR, Khodami SM, Nourbakhsh M, Jalaei SH, Motesadi M. Investigation of perception of intonation in primary school ages cochlear implant children and comparison with normal hearing children. J Mod Rehabil. 2011;4(3-4):21-8.
24. Bahrami A, Pourgharib J, Torabinejad F, Kamali M, Salehi F. [The Persian Vowel Formant structure of students with Normal, Moderate and severe Hearing Loss aged 15-18 years in Esfahan]. J Res Rehabil Sci. 2007;3(2):42-52. Persian. [DOI: 10.22122/jrrs.v3i2.90]
25. Jafari N, Drinnan M, Mohamadi R, Yadegari F, Nourbakhsh M, Torabinezhad F. A Comparison of Persian Vowel Production in Hearing-Impaired Children Using a Cochlear Implant and Normal-Hearing Children. J Voice. 2016;30(3):340-4. [DOI: 10.1016/j.jvoice.2015.04.012]
26. Salehi F, Bahrami A, Pourgharib J, Torabinejad F, Kamali M. The Persian vowel formants in normal, moderate and severe hearing impaired students age 7-9 years in Isfahan. Audiol Vestib Res. 2009;17(2):42-52.
27. Jafari N, Yadegari F, Jalaie S. Acoustic Analysis of Persian Vowels in Cochlear Implant Users: A Comparison With Hearing-impaired Children Using Hearing Aid and Normal-hearing Children. J Voice. 2016;30(6):763.e1-763.e7. [DOI: 10.1016/j.jvoice.2015.10.006]
28. Naderifar E, Ghorbani A, Moradi N, Ansari H, Aghadoost O, Asadollahpour F, et al. Evaluation of formant frequencies in Persian speaking children with different degrees of hearing loss. Shiraz E-Med J. 2017;18(7):e13094. [doi: 10.5812/semj.13094]
29. Zamani P, Rahmanirasa A, Weisi F, Valadbeigi A, Farahani F, Rezaei M. Vowel Production in Persian Deaf Children with Cochlear Implant: is the Age of Implantation an Important Factor? Indian J Otolaryngol Head Neck Surg. 2014 Dec;66(4):407-13. [DOI: 10.1007/s12070-014-0727-1]
30. Asghari SZ, Nemati F, Akbari Mani R. [The effect of cochlear implantation on the acoustic features of Farsi vowels by hearing-impaired children]. Journal of Language Research. 2020;12(36):139-63. Persian. [DOI:10.22051/jlr.2020.26453.1711]
31. Jafary N, Torabineghad F, Eslami M, Ghorbani A, Jalaei S, Sameni J, et al. [Comparing the formant frequencies of three Persian long vowels produced by cochlear-implanted and normal-hearing children]. J Res Rehabil Sci. 2013;8(6):1045-53. Persian. [DOI:10.22122/jrrs.v8i6.724]
32. Jalil-Abkenar SS, Ashori M, Hasanzadeh S. [Comparing auditory perception in children with cochlear implant, hearing aids and normal hearing]. J Res Rehabil Sci. 2013;9(4):596-605. Persian. [DOI:10.22122/jrrs.v9i4.1035]
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How to Cite
1.
Abbasi H, Fayazi L, Ahadi H. Linguistic and Metalinguistic Profiles of Persian-Speaking Children with Hearing Impairment: A Systematic Review of Observational Studies. Aud Vestib Res. 2026;.
