Article in Press

Review Article(s)

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    Background and Aim: This article seeks to examine rights of deaf and unable to hear individuals in international documents as well as domestic Iranian law. In this review, supports in the mentioned documents are discussed and the weaknesses, strengths, objections, and challenges in the laws are analyzed and examined. Lack of access to community facilities lead to marginalization of deaf people. Access to community facilities is an important factor that creates equal opportunities and realizes rights of deaf people.
    Recent Findings: Iran’s accession to the Treaty on the Rights of disabled people, the Global treaty on Cultural, Public, Economic as well as Children’s title, is one of salient points of these protection laws. By implementing Iran’s national and global commitments regarding titles of the deaf, it is concluded that Comprehensive Law and its executive regulations have been adopted several years before accession to the Contract on the Disability, but they cover most of concepts of the Contract on Education.
    Conclusion: Given the Senate and the convention, no significant legal action was taken and the program did not address deaf directly. The lack of an effective mechanism for laws protecting the disabled people right is an institutional as well as structural obstacle for realization of disabled people, especially deaf.

Research Article(s)

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    Background and Aim: Adolescents with hearing loss face many communication problems and challenges due to their hearing impairment. This study aimed to investigate the effect of psychodrama on communication skills of adolescents with hearing loss.
    Methods: This is a quasi-experimental study with a pretest/posttest design using a control group. The study population consists of all adolescents with hearing loss aged 12–15 years studying at Naghme School for the Deaf in Yazd, Iran. A total of 24 adolescents were selected using a purposive sampling technique and were randomly assigned into groups of control (n=12) and intervention (n=12). The intervention group received psychodrama at nine sessions of 90 minutes, while the control group received no treatment. The Queendom Communication Skills Test (QCST) was used to collect data. Data were analyzed using descriptive and inferential statistics.
    Results: The mean and standard deviation of the pretest QCST score was 78.75±9.4 for the intervention group. After the treatment, the QCST scores was 105.08±6.28 for the intervention group. The results of ANCOVA showed an improvement in Queendom Communication Skills Test scores of adolescents after intervention (p<0.001).
    Conclusion: Psychodrama can improve communication skills of adolescents with hearing loss, which is verbal communication.

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    Background and Aim: Multiple sclerosis (MS) is neurological disease of the central nervous system. Central auditory nervous system can also be affected by MS. The present study aimed to evaluate monaural and binaural auditory processing in patients with MS.
    Methods: This cross-sectional study was conducted on 45 patients with MS and 45 normal peers as controls aged 25–45 years. They underwent a central auditory processing test battery including the Persian versions of Buffalo model questionnaire (BMQ), staggered spondee word (SSW) test, quick speech in noise test (QSIN), phonemic synthesis test (PST), and two-pair dichotic digit test (DDT).
    Results: The results of SSW test, QSIN test, PST, DDT and BMQ in the MS group were significantly different than in the control group (p≤0.001). The results showed the poor performance of patients compared to controls in some monaural and binaural auditory processing skills.
    Conclusion: Central auditory processing disorder is common among patients with MS. The BMQ is a suitable screening tool for identifying affected people. Dichotic listening skills, phonemic processing and speech perception in noise are impaired in MS patients which can have significant impacts on their quality of life.

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    Background and Aim: Hearing loss is considered a main cause of speech-language delay and academic performance retardation. This study aimed to detect the prevalence of hearing loss diagnosed for the first time in primary school children.
    Methods: A cross-sectional study has involved 624, randomly chosen, primary school children. The children have undergone hearing screening using tympanometry, and pure tone audiometry screening in order to detect the children with undiagnosed hearing loss.
    Results: Six thousand and twenty-four children underwent tympanometry which showed that 481 children have type A Tympanogram, 39 have type C, 16 have type A in one ear and type C in the other, 78 have type B, and 10 of them have type B in one ear and type C in the other. Then all children underwent pure tone audiometry screening and this showed that 565 children have responded to 20 dB for all frequencies, 42 have not responded to 20 dB at any frequency, 27 of them are from those children with type B Tympanogram, 10 children have not responded to 20 dB for frequencies >2000 Hz, 7 of them have not responded to 20 dB at any frequency in one ear with normal responses in the other.
    Conclusion: School age hearing screening is an important procedure to detect hearing loss in children in order to manage hearing loss as early as possible and avoid its consequences.

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    Background and Aim: Central auditory processing disorder (CAPD) is seen in a wide array of populations, including children and adults. CAPD is characterized by deficits in one or more auditory abilities, causes difficulties in auditory discrimination, temporal and binaural processing although hearing thresholds are in the normal range. Children's auditory performance scale (CHAPS) is a screening instrument. This study examined the reliability and validity of the Arabic version of children's auditory performance scale.
    Methods: In this cross-sectional study, 50 healthy children were included. The children's ages ranged from seven to nine years, and they passed the screening test using distortion product otoacoustic emissions before administering the scale in the translation process, the back-translation method was used, in addition to the face validity procedure. Teachers fulfilled the questionnaire in the presence of an audiologist. After two weeks, the scale was re-administrated, and then the statistical analysis was done to examine the reliability and validity of Arabic version of CHAPS (CHAPS-AR).
    Results: The internal consistency was examined with Cronbach’s α (α=0.997), for test-retest reliability, Pearson's (r) was examined (r=0.994) and when executing the face validity, five experts agreed that the CHAPS-AR has a clear structure, syntax and it is easy to understand and use.
    Conclusion: The Arabic version of CHAPS can be considered a reliable and valid screening instrument for clinical and research use.

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    Background and Aim: Occupational noise exposure is considered the second most common risk factor in the industry, which results in auditory and non-auditory health effects. The possibility of cognitive decline as one of the non-auditory health effects may be associated with noise-induced hearing loss (NIHL). This study aimed to investigate the cognitive decline among textile workers with NIHL.
    Methods: A total of 30 male textile workers (mean age: 41.2±4.1 years and mean years of noise exposure: 18.9±5.4 years) with symmetrical NIHL (mean 49.3±4.5 dB at 4 kHz) and 30 healthy male textile office staff (aged-matched) with normal hearing and no history of noise exposure were included in this study. Exclusion criteria were included any deficit in ear function, neurological problems, and head trauma. Hearing thresholds were obtained by air and bone conduction audiometry. Workers’ cognitive performance was investigated by two psychological tests: Corsi block and Stroop tests.
    Results: The Corsi block indicators including block span (p=0.022) and visuospatial working memory (p=0.002) showed a significant difference between the two groups. Also, the Stroop test indicators including total test time (p<0.001) and response time (p<0.001) showed a significant difference between the two groups. Multiple linear regression analyses showed that workers with a higher hearing threshold at 3 kHz had a lower cognitive performance from both tests.
    Conclusion: Our findings support the role of NIHL as a risk factor of developing cognitive decline in textile workers.

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    Background and Aim: Today, hearing loss affects various aspects of executive functions and cognitive rehabilitation is important in increasing planning capacity and working memory. The purpose of this study was to investigate the effectiveness of cognitive rehabilitation on planning and working memory of executive functions in cochlear implanted children.
    Methods: This study was a semi-experimental clinical trial. Using the purposive sampling method, 24 hearing-impaired children with cochlear implants were randomly divided into two groups: an experimental group (12 subjects) and a control group (12 subjects). The experimental group received 12 treatment sessions based on a protocol of cognitive rehabilitation program for executive functions (spatial planning and working memory), while the control group did not participate in this program. We assessed executive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB), which assessed the Stockings of Cambridge (SOC) and Attention switching task (AST).
    Results: The results of MANCOVA were shown to be effective at the post-test stage for improving executive function in the experimental group (p≤0.001). But there was no significant difference in stockings of Cambridge problem solve and stockings of Cambridge move 4 between two groups after the intervention.
    Conclusion: There was a significant increase in spatial planning and spatial working memory of the experimental group. Cognitive rehabilitation can be a useful intervention to improve spatial planning and spatial working memory in cochlear implanted hearing-impaired children.

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    Background and Aim: Cognitive and auditory processing deficits are seen in older individuals with normal hearing sensitivity. Studies on older individuals with hearing impairment have assessed the cognitive function and correlated with hearing devices benefit. Since auditory processing can also affect speech perception abilities, and there is a possible relationship between cognition and some of the auditory processing abilities, it is essential to assess the relationship between auditory processing abilities and hearing aid benefit in naïve and experienced hearing aid users in older adults.
    Methods: Fifty individuals in the age range of 51 to 70 years with mild to moderate hearing loss participated in the study. There were 30 participants without any hearing aid experience and 20 participants with hearing aid experience for at least six weeks. Their auditory processing abilities were tested using gap detection test, duration pattern test, speech perception in noise, dichotic consonant-vowel test, masking level difference, forward and backward span tests. The hearing aid benefit was assessed using aided speech perception in noise measures and International Outcome Inventory-Hearing Aids questionnaire in Kannada.
    Results: Spearman’s correlation showed only correlation between auditory closure ability and binaural integration abilities with hearing aid benefit in experienced users. There was no correlation between any other auditory processing abilities and hearing aid benefit.
    Conclusion: There is a correlation between a few auditory processes and hearing aid use in elderly individuals with mild to moderate hearing loss.

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    Background and Aim: The flexibility to control the gain in different frequency regions by setting compression parameters in a larger number of compression channels in hearing aids will be advantageous to individuals with a sloping audiogram. The objective of the study was to compare the aided speech identification scores and speech quality ratings in quiet for three aided conditions (i.e. 4-channel, 8-channel, and 16-channel), with syllabic and dual compression, at two input levels (60 dB SPL and 80 dB SPL) in individuals with flat, gently sloping, and steeply sloping sensorineural hearing loss.
    Methods: The participants were 36 native speakers of Kannada adults with sensorineural hearing loss. In a repeated-measures design, aided speech identification score for sentences in quiet and speech quality ratings were obtained at two input levels (60 dB SPL and 80 dB SPL) with three hearing aids (having 4-, 8-, & 16- channels), programmed for dual and syllabic compression settings.
    Results: The results revealed that there was no significant difference in the aided speech identification scores and speech quality ratings, in different aided conditions, in the three groups.
    Conclusion: There was no additional perceptual benefit in quiet with an increase in the number of channels (from 4 to 16) in hearing aids, either in syllabic or dual compression, at conversation speech level or loud speech level, in individuals with different audiogram configurations.

Study Protocol

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    Background and Aim: Deficit in cognitive functions and central executive function is one of the popular hypotheses on the underlying cause of tinnitus. These factors are not only the complications but are also involved in the generation of tinnitus. In this study, bifrontal transcranial Direct Current Stimulation (tDCS) and conflict processing will be used in the form of auditory Stroop training to improve cognitive performance and inhibition control for tinnitus management.
    Methods: This study will be carried out on 34 chronic tinnitus patients. The initial evaluations include the tinnitus psychoacoustic evaluations, determination of the tinnitus handicap through tinnitus handicap inventory, and examining the annoyance and loudness of tinnitus through visual analog scale after which the participants will be investigated in two groups. The first group will receive sessions of tDCS followed by six sessions of conflict processing training. The second group will first receive tDCS in the sham form be followed by six sessions of auditory Stroop. The evaluations will be repeated after each intervention.
    Discussion: Studies have shown that successive sessions of conflict processing training can enhance cognitive plasticity and inhibition function. As conflict processing training has not been addressed as rehabilitation training in the people suffering from tinnitus, these processes will be designed in four tasks as rehabilitation exercises in Farsi language and applied along with tDCS to the people with chronic tinnitus to decrease and control tinnitus by improving cognitive and inhibition control.
    Trial registration: Iranian Registry of Clinical Trials (IRCT20120215009014N366) on Sep 17th, 2020.