Vol 25 No 2 (2016)

Review Article(s)

  • XML | PDF | downloads: 1953 | views: 4188 | pages: 63-74

    Background and Aim: The aim of this article was to critically discuss the clinical application of a cognitive behaviour therapy (CBT) protocol for the treatment of hyperacusis and its asso­ciated distress.
    Methods: Narrative review
    Recent Findings: Reviewing the research lit­erature suggests that hyperacusis, anxiety and safety seeking behaviours may be linked. Therefore, it seems reasonable to suggest that clinical management of hyperacusis should also include addressing co-existing anxiety and avoidance behaviour. Although, there is strong evidence supporting the effectiveness of CBT in treating anxiety, the studies directly assessing the effect of CBT on hyperacusis are limited. In this paper, the clinical implementation of a CBT protocol for hyperacusis rehabilitation is discussed.
    Conclusion: Although a causal relationship bet­ween anxiety and hyperacusis is not clear, there is a growing body of evidence suggesting a pos­sible link between them. In the absence of a cure for hyperacusis, treatment of the anxiety component of the condition could be beneficial.

  • XML | PDF | downloads: 402 | views: 627 | pages: 89-97

    Background and Aim: Tinnitus is an auditory phantom percept in the absence of any objective physical sound source. Although advances have been made in its treatment, there is very low percent of patients that report an elimination of their tinnitus. A novel approach using noninv­asive neuromodulation has emerged as an inter­esting and promising modality for tinnitus relief. Our aim in this review is to investigate the efficacy and the specific parameters of some types of noninvasive neuromodulation using transcranial electrical stimulation (TES) namely transcranial direct current stimulation (tDCS), transcranial alternative current stimulation (tACS), transcranial random noise stimulation (tRNS). Then we will correlate the outcomes with the findings of the most newly neurobiol­ogic and neuroimaging researches.
    Recent Findings: Up to now, the optimal use of tDCS was to apply a current of 2 mA for 20 minute over both auditory cortex or dorsolateral prefrontal cortex. The results were somewhat good but still need more optimization. While there is no effects of tACS; tRNS is shown to have the more suppressive effects among the three types of TES, so it would be a promising therapeutic tool for modulating tinnitus. In addi­tion, recently many researches on tinnitus have shed light on the tinnitus generating network and it’s correlation to another functional brain networks. This article show how can the neuro­modulation be optimized by using these new concepts.
    Conclusion: Although the different techniques introduced revealed promising results, further research is needed to better understand how they work and how the brain responds to neuro­modulation.

  • XML | PDF | downloads: 665 | views: 886 | pages: 98-110

    Background and Aim: This article carries out a literature review of the quality and limitations of the narrative-based language intervention (NBLI) for preschool and school-age hearing aided and cochlear implanted children.
    Recent Findings: The authors conducted a comprehensive search of electronic databases such as Web of Science, Scopus, Pubmed, Google Scholar, Cochrane, and ProQuest from 1980 to 2015 for studies using all research designs except non-experimental studies. Of 1095 potentially relevant articles evaluated by two reviewers independently, eight trials met inclusion criteria.
    Findings: At least eight studies to date have reported findings for the efficacy of NBLI in this population. The current review involves a description of these studies. The review shows that all of the eight studies have limitations methodologically and preliminary results. Alth­ough the results of the studies were generally positive, each of the studies had a limited num­ber of participants, limited experimental control, and considerable variation in the procedures and materials used.
    Conclusion: It would appear that to determine the efficacy of NBLI approach in hearing aided and cochlear implanted children we should investigate in more depth in studies with higher methodological rigor, more sample size, and clear therapy protocol. Clinicians should be cautious when interpreting the results of these studies. Narrative intervention is at an emerging stage of evidence and need to further inves­tigations.

Research Article(s)

  • XML | PDF | downloads: 421 | views: 827 | pages: 75-81

    Background and Aim: Auditory processing disorders may have detrimental consequences on a child’s life, if undiagnosed and untreated. The multiple auditory processing assessment (MAPA), as a valid model, has been introduced for central auditory processing assessment and diagnosis in school children. The purpose of this study was to design and evaluate the Persian version of MAPA for auditory pro­cessing assessment in 9-12 year-old school children.
    Methods: The present study was conducted in two phases. First, the Persian version of the MAPA, consisting of five subtests, namely the monaural selective auditory attention, the trip­let dichotic digits test, competing sentences, quadruple pitch pattern test and Tap test was developed and compiled into a CD. Second, to assess the Persian version of MAPA, a study was conducted on 300 children of both genders, aged 9-12, who were selected from seven nor­mal primary schools. The children’s normal peripheral hearing was ensured through scree­ning, and then central auditory system was assessed through the Persian version of MAPA.
    Result: The results showed that the mean scores obtained in each of the five subtests increased with age (p>0.0001), and no signi­ficant differences was observed between the gender in the mean scores obtained in any of the five subtests (p>0.05). The results con­firmed high reliability of each of the tests as well as the mean score of all the five subtests (ICC=0.91).
    Conclusion: The Persian version of the MAPA has a high validity and test-retest reliability for the assessment of auditory processing in 9-12 year-old Persian-speaking children.

  • XML | PDF | downloads: 497 | views: 636 | pages: 82-88

    Background and Aim: Children with hearing loss and children with intellectual developme­ntal disorders have defects in organizing and sensory integration. The aim of this study was to evaluate the effects of hearing impairment and intellectual disability on children's static and dynamic balance.
    Methods: This cross-sectional comparative stu­dy was conducted on 17 boys with congenital severe to profound sensorineural hearing loss (age 10.54 with SD=2.77), 30 boys with mild intellectual disability (age 10.23 with SD=2.05) and 42 normal healthy boys (age 9.42 with SD=1.79). Balance subtest of Bruininks-Oseretsky-2 test of motor proficiency was used in order to evaluate subjects’ static and dynamic balance. Statistical analysis was conducted usi­ng SPSS software through Kruskal-Wallis test and Duncan test.
    Result: The results show that there is a signi­ficant difference between groups in static and dynamic balance. (p<0.05), the post hoc test showed that the group with hearing loss and intellectual disability group were significantly different compared to the control group, while no significant difference was observed between hearing loss and intellectual disability group (p>0.05).
    Conclusion: Children with hearing loss and int­ellectual impairment compared to healthy chil­dren almost equally showed a lower balance performance and it is required to provide the children with rehabilitation programs to main­tain independence.

  • XML | PDF | downloads: 510 | views: 2515 | pages: 111-118

    Background and Aim: Parents’ evaluation of aural/oral performance of children (PEACH) questionnaire is used for children within any age group and any amount of hearing loss. The pur­pose of this study was translation, cultural adap­tation, determination of reliability and validity of the questionnaire, and assessment of its scores in children with cochlear implant versus normal group.
    Methods: Questionnaire was translated into Persian and was adapted to meet Iranian cultural context. After confirming face validity, the test was given to a group of normal children (n=54) and a group of cochlear implanted users (n=30). It was tested for reliability after two weeks.
    Results: Test results showed high Cronbach alpha (0.91) and total inter-class correlation of 0.99 which were higher than respective values in the original version. Significant difference was seen in comparison of scores between chil­dren with cochlear implant and normal children (p=0.026).
    Conclusion: Persian version of PEACH ques­tionnaire, which is the equivalence of the ori­ginal version, seems to have high validity and reliability and it is a useful tool for evaluating aural/oral performance of hearing impaired chil­dren.

  • XML | PDF | downloads: 272 | views: 426 | pages: 119-126

    Background and Aim: Kawasaki disease (KD) is an acute childhood febrile illness with world­wide incidence and the highest incidence occurs in Asian children, with coronary arteritis being the main complication. Sensorineural hearing loss (SNHL) has also been described as a comp­lication of KD in several articles. The aim of this study was to evaluate the prevalence of SNHL in patients with KD treated with intra vein immunoglobellin (IVIG).
    Methods: In this cross sectional study, we eval­uated 56 patients who received KD treatment between 2011 and 2015 by auditory brainstem evoked response (ABR), pure tone audiometry (PTA), and tympanometry. Also, we evaluated the prevalence of coronary arteritis, the time of beginning IVIG treatment from the onset of fever, the prevalence of thrombocytosis, and erythrocyte sedimentation rate (ESR) in acute or subacute phases of their disease.
    Results: During audiological evaluation, we found SNHL in one (2.6%) of the 36 patients. Other findings in the acute and subacute phases of KD included: 8 patients (22%) had coronary aneurysm, 17 (47%) thrombocytosis, 25 (69%) had elevated ESR, and the treatment with IVIG within 10 days of fever was done in 19 patients (53%).
    Conclusion: SNHL is a complication of KD which could extend beyond the treatment time. In this study, the patient with SNHL was treated with KD two years before the study and in the acute phase of KD, he had thrombocytosis > 500,0000, ccoronary artery aneurysm, ESR > 40. The treatment with IVIG was done within the first 10 days of fever onset.

  • XML | PDF | downloads: 417 | views: 643 | pages: 127-134

    Background and Aim: In spite of the effect of the left hemisphere domination on first langu­age acquisition in human, studies suggest activi­ties and the role of both hemispheres in learning second language. Therefore learning a second language requires more communication between the two hemispheres. Regarding the role of the corpus callosum as the only data-centric inter­face between the two hemispheres, the aim of this study was to evaluate and compare the vol­ume of the corpus callosum in monolingual and bilingual individuals.
    Methods: This cross-sectional study was cond­ucted on 24 samples, 16 simultaneous bilinguals (eight Kurdish-Persian, eight Turkish-Persian) and eight monolinguals with age range of 18 to 30 years, all right handed, and in equal numbers in both sexes (female and male), volume of cor­pus callosum determined by MRI. Data was analyzed by parametric and non-parametric sta­tistical tests.
    Results: The volume of corpus callosum is sma­ller in monolinguals in comparison with bilin­guals, in which a significant difference was obs­erved (p=0.04).
    Conclusion: According to the language data transmission and the rate of processing by the corpus callosum between two hemispheres, it seems for improving the quality of aural reha­bilitation, the findings of present study will be useful before performing programs like auditory training, language learning, and by development of neuroplasticity which is often decoded by sti­mulus that occur in the hemisphere in contrast to the dominant hemisphere.