Vol 21 No 2 (2012)

Published: 2012-06-30

Review Article(s)

  • XML | views: 190 | pages: 1-18

    Background and Aim: A system that could make speech visible to deaf people has been dreamt of for long time. Several systems have been developed during recent decades; with the most popular being cued speech invented 50 years ago by Cornett (1967). The aim of this article is to review researches about cued speech and its efficacy on different language skills of hearing impaired children.
    Methods: In this article we reviewed researches on cued peech and its impacts on speech and literacy of hearing impaired children. We searched Medline, Proquest and Scopus search engines with the “cued speech” keyword and read all textbooks and thesis published between 1972 and 2011. Cued speech is an oral system which makes the sounds visible and accessible. It makes speech perception much simpler and improves lip-reading skills and ability of using residual hearing in hearing impaired children.
    Conclusion: Cued speech enhances children’s communication and speech perception and discrimination from early ages. It improves speech and ability to benefit from cochlear implantation. The original impetus behind cued speech was to improve literacy levels of hearing impaired children and it has been found to be uniquely successful.

Research Article(s)

  • XML | views: 108 | pages: 19-25

    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 4th grade of elementary in contrast with normalhearing 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 severprofound hearing loss selected from the 4th 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 hearingimpaired 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.

  • XML | views: 127 | pages: 26-34

    Background and Aim: Evaluation of voice problem involves perceptual, acoustic, aerodynamic and physiological measure. In recent years assessment of patients point of view use as a essential part of evaluation. The aim of this study was construct a questionnaire for assessment of physical, functional and emotional voice problems in adults.
    Methods: This study is a kind of constructing battery. Based on a comprehensive study of many foreign questionnaires, “The voice symptoms assessment” questionnaire in adult was produced. Its content validity was determined according to the judgment of 7 speech and language pathologists. This questionnaire administered to 60 voice patients (20 female and 40 male) between 18 to 60 years old that could read and write in Persian. The reliability of this questionnaire is determined by the method of Cronbach Alpha and split half.
    Results: Content validity index of this questionnaire was 0.94. Cronbach Alpha was high (more than 0.7) and Spearman-Brown coefficient of split half was 0.96. Correlatoin Coefficient was statistically significant between 3 parts and total questionnaire (p<0.01).
    Conclusion: “The voice symptoms assessment” questionnaire in adult has good content validity and reliability and reflects the wide range of physical, functional and emotional problems in voice patients. This questionnaire is simple for patients to complete and easy to score. It seems that use of this questionnaire, as part of a complete voice evaluation will be helpful in future.

  • XML | views: 104 | pages: 35-41

    Background and Aim: The relationship between language and stuttering is an important issue in development of children because initiation of stuttering is generally contemporaneous with the period of rapid language development in children. Phonological awareness is part of language function which simultaneously develops with language and is the basis for oral and aural skills. The purpose of this research is to evaluate the relationship between stuttering and phonological awareness and the importance of phonological awareness in the process of evaluation and treatment of stuttering.
    Methods: It was a cross-sectional comparative study. Conducted on 53 children aged 4 to 8 years in Tehran. Participants’ profile was made by examiner through interview with participants’ therapist, parents and instructor. Voice of stutterer children was recorded and the phonological awareness test was performed. Obtained data was analyzed.
    Results: Regarding the scores of phonological awareness test there were significant differences between stutterer and non-stutterer groups and also between different ages (p<0.05). Scores of phonological awareness test in children with different stuttering severities were not significantly different. Children younger than 4 years had the least scores while children older than 7 years had the most and the differences were statistically significant (p<0.05). This shows that the score improves by aging.
    Conclusion: Phonological awareness, age, type and severity of stuttering should be considered in assessment and treatment of Persian stutterer children aged 4 to 8 years old.

  • XML | views: 112 | pages: 42-49

    Background and Aim: Ocular vestibular-evoked myogenic potential (oVEMP) is a novel vestibular function test. This short-latency response can be recorded through contracting extraocular muscles by high-intensity acoustic stimulation and can be used to evaluate contralateral ocular-vestibular reflex. The aim of this study was to record and compare the amplitude, latency, asymmetry ratio and occurrence percentage of oVEMP (n10) and cervical VEMP (p13) responses in a group of normal adult subjects.
    Methods: We carried out a cross-sectional study on 20 adult subjects’ mean age 22.18 years, SD=2.19 with normal hearing sensitivity and no history of vestibular diseases. oVEMP and cVEMP responses in both ears were recorded using air conducted stimuli 500 Hz short tone burst, 95 dB nHL via insert earphone and compared.
    Results: cVEMP was recorded in all subjects but oVEMP was absent in two subjects. Mean amplitude and latency were 140.77 µv and 15.56 ms in p13; and 3.18 µv and 9.32 ms in n10. There were statistically significant differences between p13 and n10 amplitudes (p<0.001).
    Conclusion: This study showed that occurrence percentage and amplitude of oVEMP were less than those of cVEMP. Since these two tests originate from different sections of vestibular nerve, we can consider them as parallel vestibular function tests and utilize them for evaluation of vestibular disorders.

  • XML | views: 102 | pages: 50-56

    Background and Aim: Due to defects of auditory feedback, children with hearing loss have inappropriate speech intonation. Consistently, results of previous studies have shown that cochlearimplanted children have some difficulties in their intonation. Intonation shows the type of the sentence which can be statement or question sentences. The purpose of this study was comparison of speech intonation in cochlear-implanted children and normal hearing children.
    Methods: The present study was performed on 25 cochlear-implanted children and 50 normal hearing children. Different pictures were shown to the subjects and they said statement and question sentences. All sentences were heard by eight speech therapists and perceptually judged. Using praat software mean base frequency and pitch alterations were measured.
    Results: In cochlear-implanted group, mean speech base frequency was higher and mean pitch alteration was lower than the control group. Mean experts’ scores in cochlear-implanted group were lower than the control group. Differences in all three variables were statistically significant (p<0.05). There was a significant direct correlation between duration of time that the children had cochlear implant and perceptual judgment scores (p<0.05).
    Conclusion: According to the results, cochlear implant prosthesis has limited efficacy in improving speech intonation; although their ability to produce speech intonation improves by increasing duration of the time that children have cochlear implant. Thus speech therapists should consider intervening on speech intonation in treatment program of cochlear-implanted children.

  • XML | views: 92 | pages: 57-65

    Background and Aim: Children with severe and profound hearing loss have difficulties in communicating with others and educating at school. Effects of learning environment on children’s language skills have been recently focused and educating those students in ordinary schools has been proposed. According to this view, we compared perception of antonyms and synonyms as a semantic aspect of language in students of ordinary, integrated and special schools.
    Methods: It was an analytic cross-sectional study. Three groups of students were enrolled: normalhearing students of ordinary schools and hearing-loss students of integrated and specials schools. Each group consisted of 25 students in fifth grade of elementary schools in Tehran city. Two written tests were used. Subjects wrote synonyms and antonyms for each word in the tests.
    Results: Results denoted significant differences between scores of normal-hearing and hearing-loss students and also between hearing-loss students of integrated schools and hearing-loss students of special schools (p<0.05). In all three groups of the students, perception of antonyms was better than antonyms (p<0.001). Speech processing rate in normal-hearing students were higher than both groups of hearing-loss students (p<0.001).
    Conclusion: The differences between normal-hearing and hearing-loss students shows that similar to other language skills, perception of synonyms and antonyms as a semantic aspect of speech is related to the hearing conditions and type of education. Moreover, the differences between two groups of hearing-loss students represent that speech stimulants and interaction with normal-hearing children could improve semantic aspect of speech in hearing-loss students.

  • XML | views: 160 | pages: 66-70

    Background and Aim: Having healthy non-handicapped children plays a major role in mental health of the family and decreases family and society’s costs. While consanguineous marriage could lead to expression of recessive genes and a variety of handicaps including deafness, the aim of present study was to scrutinize the prevalence of consanguineous marriage among parents of deaf and normal children as well as its relationship with deafness.
    Methods: In this study, 467 couples parenting normal children were selected by cluster sampling from elementary, guidance and high schools of Ardabil city and 423 couples parenting disabled children were selected non-randomly among which 130 had deaf children. Descriptive statistics was used to determine the prevalence of consanguineous marriage and chi-square test to compare prevalence of consanguineous marriage among parents of normal and deaf children.
    Results: Descriptive analyses showed that 80 out of 130 (61.54%) parents who had deaf children have had consanguineous marriage. Furthermore data analysis demonstrated that prevalence ofconsanguineous marriage was significantly higher among parents of deaf children (p<0.001).
    Conclusion: Consanguineous marriage plays a major role in expression of recessive genes and could lead to development of various handicaps including deafness. Increasing couples’ awareness about consequences of consanguineous marriage and conducting genetic counseling are indispensable.

  • XML | views: 181 | pages: 71-77

    Background and Aim: In different language approaches, reading is considered as a major skill. Language skills comprising listening, speaking, reading and writing are completely interlinked with each other. Thus, providing active application of listening and speaking skills, children will learn reading and writing skills easily. The aim of this research was to compare reading skills of hearing-loss students studying at exceptional schools with normal students of different degrees.
    Methods: The research was conducted post-traumatically using standardized 2006 PIRLS test. 80 students in fifth grade of exceptional primary schools, and first and fourth grade of exceptional high schools in Tehran City who had severe and or profound hearing loss were randomly selected along with 80 normal students in ordinary schools who were selected using available sampling method.
    Results: There were significant differences between reading comprehension of hearing-loss and normal students of all three grades (p<0.001). Reading comprehension in female students was significantly higher than the male ones (p<0.001). There were not any significant differences in mean reading comprehension scores of hearing-loss students in different grades which demonstrate that their reading skills had not developed in tandem with their age and school educations.
    Conclusion: This study shows that one of the significant concerns regarding hearing-loss students is their reading comprehension ability. Considering reading ability as one of the most important acquisitive abilities which students learn at school, evaluation of reading skills of hearing loss students as well as recognition of their strengths and weaknesses in this field is indispensable.

  • XML | views: 182 | pages: 78-86

    Background and Aim: Early diagnosis of hearing loss lead to early intervention and improvement of developmental skills of children with hearing loss. The present study aimed to determine the mean age of hearing loss diagnosis and cochlear implantation (CI) in hearing impaired children and to compare the age of performing cochlear implantation in children who were identified by newborn hearing screening with those who were not.
    Methods: This cross-sectional study was conducted on 96 children with severe to profound sensorineural hearing loss who received cochlear implantation in Amir-e-Alam cochlear implantation center between the years 2008 and 2010. For data gathering, we assessed subjects’ medical archives, interviewed with their parents and took medical history including demographic information, birth history and hearing loss history.
    Results: Mean age of hearing loss suspicion, diagnosis, hearing aids administration, Initiation of rehabilitation program, performing cochlear implantation and mean age when cochlear implantation was utilized were 6.73 (SD=5.79), 9.35 (SD=5.79), 13.41 (SD=6.10), 16 (SD=6.36), 41.25 (SD=11.12), and 42.15 (SD=11.00) months, respectively. There was statistically significant difference between them (p<0.05). 43.8% of hearing impaired children had been identified by newborn hearing screening. There was statistically significant difference between cochlear implantation operation age of children who were identified by newborn hearing screening with those who were not (p<0.0001).
    Conclusion: In spite of notable reduction in the age of hearing loss diagnosis and intervention during recent years, compared to international indices it is still tardy. Conducting newborn hearing screening can significantly reduce these ages.

  • XML | views: 117 | pages: 87-95

    Background and Aim: Internal evaluation is an important part of organization monitoring. One of the Ministry of Health’s policies is to encourage educational departments to conduct internal evaluations. The aim of internal evaluation of department of speech therapy was appraising its education, research and treatment qualities and determining its strengths, weaknesses, opportunities and threats (SWOTs) to identify the ways of overcoming weakness and threats.
    Methods: This descriptive cross-sectional study was conducted in 10 phases to evaluate 10 factors. Participants were undergraduate, graduate, and postgraduate students, academic staff, director of the department along with the patients. The internal evaluation software for educational and research centers released by Center of Medical Education Studies and Development was modified and utilized. Data was analyzed by calculating mean of means.
    Results: Mean of means from highest to lowest scores were respectively as follows: the quality of diagnosis, treatment and dealing with patients 4.15 out of 5; as well as the quality of academic staff 3.5 were in the range of desirable category; qualities of management and organizational structure 3.34, graduate students 3.21, teaching and learning processes 3.1, missions and goals 3.09, instructional methods and curriculum models 2.99, educational and research equipments 2.9, students 2.76 and research 2.67 were within the range of rather desirable category. Total score was 3.17 (63.4%) which was within the range of rather desirable category.
    Conclusion: The department of speech therapy was in rather desirable state before merger. That result was appropriate according to the department’s conditions and supplies.

Case Report(s)

  • XML | views: 108 | pages: 96-108

    Background: Children usually produce their first words when they are 10-15 months old and go through simple to complex speech by passing some stages. One of the criteria for examining development of children’s language is mean length of utterance (MLU). The main purpose of this study was calculating mean length of utterance and grammatical morphemes used by Farsi-speaking children during their 12-60th months of life.
    Case: It was a longitudinal descriptive study. Every month during children’s 12 to 60th months of life, 120-minute spontaneous speech samples of two children in kindergarten were videotaped and transcribed. The girl said her first word at the age of 12, and the boy said his first word at the age of 16 months. Combining words and constructing two-word utterances started at 18 and 20th months of the girl’s and the boy’s lives respectively. First grammatical morpheme appeared before the 24th month of children’s lives and when mean length of utterance was lower than 2 morphemes. Singular verb suffixes were acquired sooner than the plural ones. Both children started using six subject identifiers of Farsi language before 36th month of their lives.
    Conclusion: The speech development in Farsi-speaking children follows the same pattern as other children, starting from one-word utterances and complicates gradually by increasing the number of words, word combinations and using grammatical morphemes. The important point is that Farsispeaking children started to use grammatical morphemes when their mean length of utterance was lower than two morphemes.