Vol 21 No 1 (2012)

Published: 2012-03-30

Research Article(s)

  • XML | views: 152 | pages: 1-7

    Background and Aim: Multiple sclerosis (MS) is a neurological disorder that involves central nervous system. Studies have showed that multiple sclerosis affects behavioral central auditory tests, such as masking release or masking level difference (MLD). The purpose of this study is to compare the masking level difference between multiple sclerosis patients and normal subjects.
    Methods: This cross sectional and non-interventional study was conducted on 32 multiple sclerosis patients aged between 20-50 years and 32 controls matched for age and gender in Faculty of Rehabilitation, Tehran University of Medical Sciences. masking level difference test was performed on each subject.
    Results: The mean masking level difference in the two groups was significantly different (p<0.01) however, gender did not prove to play a role in this difference.
    Conclusion: As part of the multiple sclerosis diagnosis panel, masking level difference test is an efficient modality for evaluation of hearing impairment and monitoring of rehabilitation progress.

  • XML | views: 119 | pages: 8-16

    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.

  • XML | views: 128 | pages: 17-25

    Background and Aim: A negative deflection with a 3-4 ms latency period has been reported to exist within the auditory brainstem response of some patients with profound hearing loss following a strong acoustic stimulus. This deflection, namingly the n3 or the acoustically evoked short latency negative response is assumed to be a vestibular-evoked potential, especially of saccular origin. Since the myogenic potential is also saccular in origin, the purpose of the present study was to investigate the relationship between these two tests in adults with profound hearing loss.
    Methods: The present cross sectional study was performed on 20 profoundly deaf volunteers(39 ears) who aged between 18-40 years old, randomly selected from available deaf adults in Tehran. The auditory brainstem response of all subjects was recorded following a 1000 Hz tone burst in 70-100dB nHL. Subjects were also tested for vestibular evoked myogenic potential.
    Results: Only 34 of 39 ears recorded myogenic potential that negative response was recorded in 27 of 34 ears with normal p13 and n23. In seven ears with normal p13 and n23, the negative response was absent. In 3 ears with no p13 and n23, the negative response was observed, and two none.
    Conclusion: In view of the high prevalance of the negative response in profoundly deaf ears with normal p13 and n23, it could be concluded that the negative response can be used when for any reason, it is not possible to record myogenic potential and be considered as a new test in vestibular test battery.

  • XML | views: 190 | pages: 26-37

    Background and Aim: Providing high quality health care is not possible without information related to the past and current condition of the patient. Records show which services, where, when and by whom was delivered. Documentation is referred to the process of precisely recording the information regarding patient care and treatment. The purpose of this study is to determine the essential data set required in audiology record keeping and designing a model for Iran.
    Methods: In an applied research of a descriptive-comparative type which was carried out in 2010, data elements of audiology records of domestic and foreign patient notes were used to compile a check list which was subjected to debate by Iranian audiologists in Delphi method. 110 audiologists and 17 faculty members responded to the opinion poll.
    Results: From 51 elements which were subjected to discussion, 37 elements by more than 75 percent of the participants, nine elements by 50 to 75 percent of the participants and five elements by less than 50 percent of the participants, were agreed upon. The only element to be considered more important by faculty members than audiologists was “Gender” (p=0.018). Seventy percent of the participants valued the effectiveness of information in patient records very high.
    Conclusion: The minimum data set for audiology records must include demographic information, past medical history, patient assessment and treatment plan. With reference to record design principles this information was used to develop amodel for patient audiology record which also included the necessary instructions for completing it.

  • XML | views: 106 | pages: 38-45

    Background and Aim: Temporal resolution refers to the ability of perceiving changes over time. This study was conducted to prepare Persian version of the temporal resolution test, which was first introduced by Phillips (1994) and Stuart (1996), and to obtain its results in 18 to 25 year old normal individuals of both genders.
    Methods: To construct the Persian version of the temporal resolution test, like the original version, speech stimuli, continuous and interrupted noises were used. Speech stimuli comprised four lists of fifty words-monosyllabic lists, which were presented to the right ears first in quietness and then with continuous and interrupted noises on S/Ns of -20, -10, 0, +10 dB. The test was performed on thirty three right handed healthy individuals (14 male and 19 female with the mean age 21.02, SD=1.7 year old) in written response mode.
    Results: Significant difference was shown between test scores in quiet with each of the continuous (p<0.0001) and interrupted (p@0.0001) noises in four signal to noise ratios, and also between test scores of continuous and interrupted noise presentations (p<0.0001). No significant correlation was revealed between gender and test scores and age and test score and age in +10 dB S/N ratio.
    Conclusion: Conducting this test on a group of healthy individuals showed its application for measuring temporal resolution with speech stimuli.

  • XML | views: 127 | pages: 46-53

    Background and Aim: In view of improvement in therapeutic outcome of cancer treatment in children resulting in increased survival rates and the importance of hearing in speech and language development, this research project was intended to assess the effects of cisplatin group on hearing ability in children aged 6 months to 12 years.
    Methods: In this cross-sectional study, hearing of 10 children on cisplatin group medication for cancer who met the inclusion criteria was examined by recording auditory brainstem responses (ABR) using the three stimulants of click and 4 and 8 kHz tone bursts. All children were examined twice: before drug administration and within 72 hours after receiving the last dose. Then the results were compared with each other.
    Results: There was a significant difference between hearing thresholds before and after drug administration (p<0.05). Right and left ear threshold comparison revealed no significant difference.
    Conclusion: Ototoxic effects of cisplatin group were confirmed in this study. Insignificant difference observed in comparing right and left ear hearing thresholds could be due to small sample size. Auditory brainstem responses test especially with frequency specificity proved to be a useful method in assessing cisplatin ototoxicity.

  • XML | views: 101 | pages: 54-61

    Background and Aim: prosody is a very important factor in communication and includes such parameters as: duration, intonation, pitch, stress, rhythm etc. Intonation is the pitch variation in one sentence. Duration is the time taken to utter a voice. The aim of the present study was to evaluate some parameters of prosody such as duration and intonation curve in interrogative sentences among normal Farsi speaking adults in order to determine the characteristics of this aspect of language with an emphasis on laboratory testing.
    Methods: This study was performed as a cross-sectional one. The participants included 134 male and female Farsi speaking individuals aging between 18-30 years. In this study two interrogative sentences with open and closed answers were used. The voice samples were analyzed by Dr.speech -real analysis software. Data analysis incorporated unilateral analysis of variance and an intonation curve was drawn for each sentence.
    Results: The parameter of duration among men and women was significantly different (p:0.001). Duration in open questions was significantly longer than yes/no questions (p:0.001). The intonation curve of the two groups were similar.
    Conclusion: Men and women use duration changes, for making difference in prosody. On the whole, duration among women is longer than men. In open questions, the duration of sentences is mostly due to the question word. The intonation curve in open questions has more amplitude. Women show much more changes in basic frequency for transferring interrogative state in their expressions.

  • XML | views: 167 | pages: 62-68

    Background and Aim: Voice disorders assess with the help of laboratory equipments and perceptual evaluation. Voice samples involve vowel prolongation, text-reading or conversational speech. In Iran, Rainbow text and Grandfather text, were developed for assessing voice.
    Methods: This study was cross-sectional and descriptive-analytical. Mean and fundamental frequency variations range in 120 normal males and females aging from 20-59 years old were studied. Voice samples of reading both texts were gathered and compared.
    Results: Mean fundamental frequency in males in Grandfather text was 137.93 with SD 1.2 and in Rainbow text was 135.09 with SD 1.1 (p>0.05), in females Grandfather and Rainbow texts were 206.07 with SD 0.9 and 204.23 with SD 2.1, respectively (p>0.05). Fundamental frequency variations range in Grandfather text in males was 88.10 with SD 0.8 and in females was 116.77 with SD 1.3 and in Rainbow text in males was 90.92 with SD 1.1, in females was 116.08 with SD 1.2 (p>0.05). Mean fundamental frequency of males in each text didn't show significant difference in age groups and just in 50-59 age group of the female population showed significant difference. Fundamental frequency variations range didn't show significant difference in males and females in both texts.
    Conclusion: These two texts were the same in measurement of average and fundamental frequency variations range in adults. Significant difference showed between 50-59 age group of the female population and other groups.

  • XML | views: 99 | pages: 69-75

    Background and Aim: The communication process includes both verbal and nonverbal elements. Nonverbal behavior or body language includes facial expression, eye contact, posture and prosody. Prosody conveys semantic or affective information to a listener. Nonetheless, so far in Iran no report on assessment of speech prosody comprehension in patients has ever been published. The aim of this study was to measure the validity and reliability of the prosody comprehension test specifically designed for the Persian language and culture.
    Methods: This study is a type of test development. 73 sentences were orated by 22 professional vocalists in eight different prosodies. A total of 6582 voices were prepared which were listened by 200, 18-30 year-old students and a voice specialist. Having the content validity calculated for all voices, 1473 voices were found to be unanimously agreed upon by all participants in terms of emotional status which were analyzed by a voice specialist. Eventually, 169 voices were selected for developing the prosody comprehension test including the following four subtests: none motional prosody discrimination, emotional discrimination, naming of prosody and naming conflicts. Reliability of the test was determined by performing the test on 32, 18-60 year-old normal people.
    Results: The designed test of comprehension prosody had 100% content validity ratio and 94% reliability and the correlation of test of prosody was 89% (p=0.001).
    Conclusion: This test in Persian language has appropriate validity and reliability and is appropriate for assessment of prosody comprehension.

  • XML | views: 196 | pages: 76-82

    Background and Aim: Premature birth and low birth weight are regarded as two risk factors for impaired language development. Hence, information about primary period of language development in these children is important for early detection of children’s needs during their language development period. The goal of this study was to determine the expressive lexicon size in 18 to 36 month-old premature children with low birth weight and to compare them with their full-term peers.
    Methods: In this prospective historical survey, using form II of the MacArthur-Bates Communicative Development Inventories (CDI), expressive lexicon size of 42 premature children with low birth weight who were 18 to 36 month- old and 42 full-term peers in three age groups with six monthintervals is evaluated. Forms were completed individually by mothers of children.
    Results: Data analysis showed that the difference in expressive lexicon between the two groups was significant (p=0.025). Nonetheless, in each group the difference in expressive lexicon size between the three age groups was not significant.
    Conclusion: The results of this study suggest that expressive lexicon size in premature children with low birth weight was smaller than their full-term matches and the development of lexicon size is delayed in these children. However, by increasing age, these children follow a similar development pattern in terms of lexicon size and eventually catch up with their full term counterparts. This study shows the importance of early intervention to expedite this compensatory mechanism in these children.

Case Report(s)

  • XML | views: 248 | pages: 83-93

    Background: Phonemic awareness is one of the most important predictors of reading skills that has been taught by different procedures. One of the procedures is implementation of direct instruction in instruction of phonemic awareness. Current study is one of the unique studies in Iran that investigate impact of direct instruction in phonemic awareness on reading achievement of students with reading disorder.
    Case: Three male second grade elementary students with reading disorder in a regular school in district six of the office of education in Tehran were selected. Multiple-baseline across subjects was selected as a research design. The following tests were used as diagnostic criteria: reading and dyslexia test and Wechsler intelligence scale for children-revised. Moreover, a reading inventory consisting of 100 words was developed by researchers to assess the reading ability of the subjects. Data were collected in three phases: baseline, intervention, and follow-up. During the intervention phase, the intervention strategies were used while during baseline and follow-up, data were collected without any intervention. Comparing three phases of the study, we may conclude that intervention package consisting of direct instruction of phonological awareness was an effective strategy in reading achievement of all three students. In addition, follow-up data indicated that the effects of the intervention procedures were stable across time.
    Conclusion: Direct instruction of phonological awareness was effective in reading achievement of students with reading disorder in elementary school and increasing their abilities in reading.