Vol 31 No 3 (2022)

Review Article(s)

  • XML | PDF | views: 656 | pages: 148-157

    Background and Aim: Speech is known as the most important auditory signal that humans deal with it. Noise can mask speech and prevent spoken information from reaching us. Researchers have been trying to develop indexes to assess speech intelligibility. Speech Intelligibility Index (SII) is one of these indicators and we intend to introduce its nature and applications.
    Recent Findings: SII is a method that numerically demonstrates the ability to hear speech in difficult listening situations. The number 1.0 indicates that all spoken information is available, while 0.0 indicates that the person does not have access to any information. Hearing loss changes a person’s scores on this index, so we need to use corrective factors to more accurately estimate speech intelligibility. In children, the SII score is different from adults. This indicator can be used in the improvement of hearing aid fitting and more accurate adjustment of cochlear implants. The frequency importance function used to calculate SII has a unique shape in each language. Therefore, SII will also differ in different languages, depending on the nature of each language.
    Conclusion: SII has emerged as a practical indicator among objective assessments of speech intelligibility. Many have tried to extend and prepare it for use in different groups. Therefore, care should be taken about the use of this index in hearing-impaired people, children, with hearing aids or cochlear implant patients, etc. Evaluation of this index in other languages can help to better adjust the hearing aid based on the characteristics of each language.

Research Article(s)

  • XML | PDF | views: 441 | pages: 158-164

    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 backtranslation 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 testretest 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.

  • XML | PDF | views: 358 | pages: 165-174

    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.

  • XML | PDF | views: 150 | pages: 175-179

    Background and Aim: The psychometric function characteristics (e.g. threshold and slope) of the time-compressed words have not been investigated in previous studies to compile psychometrically homogeneous word lists. Therefore, this study aimed to investigate psychometric function characteristics of monosyllabic time-compressed Persian words to develop psychometrically equivalent time-compressed word lists.
    Methods: Two hundred most common monosyllabic words in Persian language were timecompressed at a rate of 40%-85% and presented to 21 participants with normal hearing at a fixed intensity level. The threshold and slope of the psychometric function for all words were determined using the logistic regression. The compression ratio (CR) for 5%-95% correct recognition was predicted based on the psychometric function fitted to the measured correct recognition score.
    Results: Mean CR 50% of the words was in a range of 53%-78%. The mean CR 50% and slope were not significantly different between consonant-vowel-consonant and consonantvowel-consonant-consonant words. The predicted CR for 5%-95% correct recognition varied from 61.5% to 88.4%. The final result was two 50-word lists of monosyllabic words with the same mean threshold and slope.
    Conclusion: Persian time-compressed monosyllabic words have different CR 50% and slope that may interact with their intelligibility.

  • XML | PDF | views: 428 | pages: 180-188

    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.

  • XML | PDF | views: 171 | pages: 189-195

    Background and Aim: When analyzing the gain-frequency response of a hearing aid, data can be analyzed both clinically and statistically. This study aimed to investigate and compare the gain-frequency responses using statistical and clinical analyses under active digital noise reduction (DNR-on) and inactive digital noise reduction (DNR-off) conditions.
    Methods: The gain-frequency responses of a hearing aid for one of the most well-known commercial digital hearing aid manufacturers were measured using the FP35 hearing aid analyzer (Frye Electronics Inc., USA) by presenting two types of signals (digital speech and composite noise) at input levels of 65 and 80 dB SPL under the DNR-on and DNR-off conditions. Data analysis was performed both statistically (using Wilcoxon signed rank test) and clinically (using 3 dB difference criterion).
    Results: A statistically significant difference was found in the gain-frequency responses for all speech and noise input levels between the two conditions; while a clinically significant difference was observed only at noise input levels of 65 and 80 dB SPL.
    Conclusion: For analyzing the hearing aid performance, both clinical and statistical analyses should be considered.

  • XML | PDF | views: 282 | pages: 196-207

    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.

  • XML | PDF | downloads: 154 | views: 273 | pages: 208-217

    Background and Aim: Motor development is a continuous process throughout life. Hearing impairment in childhood may have significant effects on motor development. This study compared the motor development of normal-hearing and hearing-impaired children at early developmental ages.
    Methods: This research was a cross-sectional study. A total of 149 children aged six to eighteen months were selected and divided into three groups: normal-hearing children (NHC) (55 girls and 65 boys) selected by convenient sampling strategy, non-rehabilitated hearing impaired children group (NRHIC) (11 girls and 13 boys) selected by purposive method, and rehabilitated hearingimpaired children group (RHIC) (3 girls and 2 boys) selected by the census method. The Denver developmental screening test 2 (DDST-ll) was used to assess motor development. The obtained data were analyzed by Kruskal-Wallis, Mann-Whitney U tests, and curve drawing.
    Results: The fine motor development of the NHC (9.63±28.83) was significantly greater than the RHIC (-18 ±26.83) and NRHIC (–21.25±30.26) groups, but there was no significant difference between the RHIC and NRHIC groups. In gross motor development, the NRHIC (–32.71±41.26) group had a more significant delay compared to the NHC (13.38±37.73) and RHIC (0±21.21) groups, but there was no significant difference between the NHC and RHIC groups.
    Conclusion: Hearing rehabilitation can partially compensate for the developmental delay in gross skills, but this compensation has not occurred for fine motor skills. The development of fine motor skills requires a precise synergy of small muscles and the nervous system.

  • XML | PDF | views: 214 | pages: 218-231

    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.

  • XML | PDF | views: 155 | pages: 232-237

    Background and Aim: Cochlear implants (CIs) can lead to the development of verbal communication in areas such as sound repertoire, speech intelligibility (SI), and conversational skills. The SI refers to the ability to make recognizable speech sounds. Children with CIs may experience poorer SI than normalhearing (NH) children. This study aims to compare the SI between children with CIs and NH peers matched for chronological age and hearing age.
    Methods: The speech samples of 40 monolingual Persian-speaking children, including 20 children with CIs and 20 NH children were used in this study. The children’s SI was analyzed using three measures of the percentage of correct consonants, percentage of correct vowels, and percentage of intelligible words. One speech-language pathologist and two non-professional listeners transcribed each speech sample.
    Results: The results showed no significant difference in any measures of SI between CI children and NH hearing age-matched peers, but there was a significant difference between CI children and NH chronological age-matched peers (p<0.05).
    Conclusion: The SI in Persian-speaking children with CIs is the same as in NH hearing age-matched peers, but it was poorer compared to NH chronological age-matched peers. If the children with hearing impairments receive CIs sooner, their SI can be greater. Cochlear implantation improves SI by increasing the hearing experience.

Case Report(s)

  • XML | PDF | views: 155 | pages: 238-242

    Background and Aim: This study shows the clinical symptoms pertinent to auditory neuropathy spectrum disorder (ANSD) for a 16-year-old girl with Brown-Vialetto-Van Laere Syndrome (BVVL). The results have been followed for six years between 2015 and 2021.
    The Case: In the present study, auditory test battery including tympanometry, acoustic reflex, pure tone audiometry, transient evoked otoacoustic emissions and auditory brainstem response were utilized and repeated three times during six years.
    Conclusion: In the first session, the results revealed bilaterally normal transient evoked otoacoustic emissions, absent acoustic reflexes (ipsilateral and contralateral), mild to moderate low tone loss in the pure tone audiometry, no auditory brain stem responses at high stimulus intensities and different polarities and present cochlear microphonic component in single polarities. In the second session, pure tone audiometry showed slight to mild high tone loss but the other tests demonstrated their same results. In the final session, the latter results were repeated. In this comprehensive follow up study, the patient with BVVL demonstrated clinical symptoms of auditory neuropathy spectrum disorder in which auditory system showed an impairment in the auditory temporal synchronization and encoding.