Narrative Microstructure and Macrostructure Skills of Persian-Speaking Children with Autism Spectrum Disorder.

Background: Studies examining narrative production skills in children with autism spectrum disorder (ASD) have demonstrated variable and inconsistent results. This study aimed to investigate to what extent narrative difficulties in children with ASD reflect difficulties with language. Methods: Accordingly, the spoken narrative skills of 16 children with ASD were compared with those of their 16 chronological age-matched (CAM) and 16 language-matched (LM) peers. A Kruskal-Wallis non-parametric test was then used to examine the differences between groups in regard to NTC, NSG and SI variables .For other studied variables (NTW, number of T-units, ATL and total score), one-way analysis of variances (ANOVA) was also used. Results: At the level of microstructure, the results showed that productivity (number of total words, total clauses, and T-unites) and syntactic complexity (average of T-unit length and subordination index) were predominantly similar in ASD and LM children. However, children with ASD scored lower than their CAM counterparts (P < 0.001). At the macrostructure level, we found that the total score of story grammar elements and the number of story grammars in the narrative production of children with ASD were lower than those in both CAM and LM children (P < 0.001). Conclusion: The present study, thus, showed that creating a coherent narrative could be more demanding for children with ASD than productivity and syntactic complexity.

Voice improvement following conventional speech therapy combined with singing intervention in people with Parkinson's disease: A three-arm randomised controlled trial.

BACKGROUND: Although speech and voice disorders are common in Parkinson's disease (PD), there is insufficient evidence to support the effectiveness of behavioural speech therapies in these patients. AIMS: This study aimed to examine the effects of a new tele-rehabilitation program, a combining of conventional speech therapy and singing intervention, on voice deficits in patients with PD. METHODS & PROCEDURES: This study was a three-armed, assessor-masked, randomised controlled trial. Thirty-three people with PD were randomly assigned to the combination therapy, conventional speech therapy, or singing intervention group. This study followed the Consolidated Standards of Reporting Trials guidelines for non-pharmacological treatment. Each patient participated in 12 tele-rehabilitation sessions over 4 weeks. The combination therapy group received speech and singing interventions simultaneously (respiratory, speech, voice, and singing exercises). Voice intensity as a primary outcome and the voice handicap index (VHI), maximum frequency range, jitter and shimmer as secondary outcomes were evaluated 1 week before the first intervention session, 1 week after the last intervention session and 3 months after the last evaluation. OUTCOMES & RESULTS: The results of repeated measures analysis of variance showed a significant main effect of time on all outcomes in all three groups after treatment (p < 0.001). There was a significant group effect for voice intensity (p < 0.001), VHI (p < 0.001), maximum frequency range (p = 0.014) and shimmer (p = 0.001). The combination therapy group demonstrated a significant outperformance in the VHI and shimmer than the speech therapy (p = 0.038) and singing intervention (p < 0.001) groups. The results of this study also indicated that combination therapy group compared to singing intervention group had a larger effect on voice intensity (p < 0.001), shimmer (p < 0.001) and maximum frequency range (p = 0.048). CONCLUSIONS & IMPLICATION: The results demonstrated that combining speech therapy with a singing intervention delivered through tele-rehabilitation might be more effective in improving voice problems in patients with PD. WHAT THIS PAPER ADDS: What is already known on the subject Parkinson's disease (PD) is a neurological disorder that frequently causes disturbances in speech and voice, which negatively affect patients' quality of life. Although speech difficulties occur in 90% of patients with PD, evidence-based treatment options for speech and language problems in these patients are limited. Therefore, further studies are required to develop and assess evidence-based treatment programs. What this study adds The findings of this study showed that a combination therapy program including conventional speech therapy approaches and individual singing intervention provided through tele-rehabilitation may have a greater effect on the improvement of voice problems in people with PD compared to speech therapy and singing intervention alone. What are the clinical implications of this work? Tele-rehabilitation combination therapy is an inexpensive and enjoyable behavioural treatment. The advantages of this method are that it is easy to access, appropriate for many stages of voice problems in PD, requires no prior singing training, encourages voice health and self-management and maximises treatment resources available to people with PD. We believe that the results of this study can provide a new clinical basis for treatment of voice disorders in people with PD.

Reading and phonological awareness improvement accomplished by transcranial direct current stimulation combined with phonological awareness training: A randomized controlled trial.

Phonological awareness (PA) training is a core intervention in dyslexia. Recently, transcranial direct current stimulation (tDCS) has been probed as a complementary intervention for increasing reading ability in dyslexia, but not for enhancing the efficacy of PA. The aim of the current study was thus to examine whether tDCS combined with a PA intervention improves reading, but also PA abilities as a proxy in children with dyslexia. A randomized, double-blind, sham-controlled clinical trial was performed to assess the effects of tDCS (applied bilaterally over the temporo-parietal junction with the anode placed over the left, and the cathode placed over the right hemisphere) combined with PA training on reading and PA abilities in dyslexic patients. Twenty-eight participants were randomly assigned to active (PA + anodal tDCS) or sham (PA + sham tDCS) groups. Each subject participated in 15 treatment sessions. PA and real/non-word reading were evaluated at baseline before the intervention, at the end of the fifth, tenth, and final intervention sessions, and then 6 weeks after intervention. In the active tDCS group, the mean scores of non-word reading and PA tests were significantly improved during, immediately, and 6 weeks after the treatment, as compared to the sham tDCS group. tDCS is thus a promising complementary intervention if combined with PA training to enhance PA and reading abilities in dyslexia for an extended period after treatment.

Speech sound production, speech intelligibility, and oral-motor outcomes of preterm children: Are they different from full term children?

We studied the speech sound abilities of preterm (PT) children. Thirty-one PT and twenty-nine full term (FT) children were recruited. Speech abilities were assessed in single word, story retelling, oral-motor, and intelligibility. PT group had poorer outcomes (Mean = 25.77, SD = 17.19) than FT ones (Mean = 5.9, SD = 4.97) for single word (p < 0.001). They obtained poorer results (Mean = 9.65, SD = 7.85) than FT peers (Mean = 2.95, SD = 3.34) in story retelling (p = 0.002) and intelligibility (Man-Whitney U = 89.50, p = 0.02). They obtained lower values for diadochokesis/patuku/(p < 0.001), isolated (p = 0.001), and sequenced movements (p = 0.02) but not for diadochokesis/patukejk/(p = 0.12). Significant values of correlation were found among single word scores with birth weight (r = -.54, p < .001) and gestational age (r = -0.67, p < .001) and story retelling scores with birth weight (r = -0.40, p = .013) and gestational age (r = -0.64, p < .001). The associations of single word score and maternal (r = -0.02, p = .85) and paternal education (r = -0.10, p = .41) were not significant. No significant relationships were obtained between story retelling score and maternal (r = 0.16, p = .34) and paternal education (r = 0.09, p = .59). The significant values were obtained for associations of intelligibility with isolated (r = 0.54, p = .001), sequenced movements (r = 0.59, p < .001), and diadochokesis/patukejk/(r = 0.39, p = .016) but not significant for intelligibility and diadochokesis/patuku/(r = 0.25, p = .13). Findings implied that speech abilities are weaker in PT children.

Development and psychometric evaluation of the Persian Grammar-Phonology Screening Test: A preliminary study.

This study aimed to develop a screening test for children suspected of developmental language disorders (DLD). The study was conducted in six steps. In the first two steps, we collected 34 sentences for the sentence repetition (SR) subtest, and 40 non-words for the non-word repetition (NWR) subtest, respectively. Experts determined the content validity in the third step and 19 sentences and 19 non-words were selected. In the fourth step, we draw simple pictures for the SR subtest. In the fifth step, two pilot studies were conducted on 30 and 35 Persian-speaking children aged 4.5-5.5 years, respectively. After calculating the discrimination index of the items, we removed items with the discrimination index less than 0.3. Nineteen sentences and 14 non-words remained in this step. In the sixth step, 92 typically developing (TD) children aged 4.5-5.5 and 10 children suspected of DLD were recruited. Then, we removed some items and evaluated the construct validity and reliability of the final form of the Persian Grammar-Phonology Screening Test (PGPST).The final form of the PGPST consisted of 16 sentences, and 11 non-words were developed. The correlation between the two subtests was 0.29. Children suspected of DLD in SR (p = .001) and NWR (p = .007) performed significantly worse than the TD children. The correlation between the two administrations of the test was 0.74 and 0.71, respectively, for SR and NWR. Cronbach's alpha was also 0.84 and 0.86 for the SR and NWR subtests, respectively. The PGPST is a quick and brief screening test with acceptable validity and reliability.

Investigation of the effect of delayed auditory feedback and transcranial direct current stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: A randomized controlled trial.

BACKGROUND: Stuttering is a disorder that begins in childhood and can persist into adulthood. In the present study, it was hypothesized that the combined intervention of transcranial direct current stimulation (tDCS) and Delayed Auditory Feedback (DAF) would cause greater improvement in speech fluency in comparison to the intervention with DAF alone. METHODS: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effects of the combined intervention. Fifty adults with moderate to severe stuttering (25 females, 25 males, Mean age=26.92, SD=6.23) were randomly allocated to the anodal or sham tDCS group. In the anodal tDCS group, participants received DAF combined with anodal tDCS (1 mA), while the sham tDCS group was exposed to sham tDCS simultaneously with DAF. In this study, a 60-ms delay was used for DAF intervention, and tDCS was applied over the left superior temporal gyrus. Each individual participated in six 20-minute intervention sessions (held on six consecutive days). Speech fluency was assessed before and after the intervention. RESULTS: In the anodal tDCS group, the scores of the Stuttering Severity Instrument, Overall Assessment of the Speaker's Experience of Stuttering questionnaire, and the percentage of stuttered syllable reduced significantly (from average baseline rates of 8.45%, across three tasks, to 5.36% at the follow-up assessment) after the intervention. CONCLUSION: The results of this study suggest that delivery of anodal tDCS when combined with DAF may enhance stuttering reduction effects for six weeks following the intervention.

Electrophysiological correlates of stuttering severity: An ERP study.

Although a variety of theories have been proposed to explain the etiology of stuttering, the exact neurological origin of it is still uncertain. The aim of this study is to investigate the correlation between stuttering severity and ERP measures. The population of this study consisted of 12 adults with moderate, 12 adults with severe stuttering, and 12 fluent speakers as the control group. ERPs were recorded during an auditory task in which subjects should determine an oddball stimulus. The result of mismatch negativity (MMN) amplitude analysis revealed significant differences between severe stuttering and fluent speakers groups and between two stuttering groups. Moreover, the result showed significant differences between the three study groups for P300 amplitude. The findings of the present study suggest that the differences in ERP components are existed not only between people who stutter and fluent speakers but also between people with different levels of stuttering severity.

Effect of grammar intervention on vocabulary skills in children with a cochlear implant: A single-subject study.

Background: Previous studies have shown that children with cochlear implants have difficulty in grammar acquisition. Vocabulary acquisition and grammar abilities are important during language development. The purpose of this study was to investigate the effect of grammar therapy on the lexical ability of cochlear implanted children. Methods: Five children with cochlear implants and grammatical problems were treated using a grammar task designed for the current study. Before and after the treatment, repeated evaluations were performed using the Mean Length of Utterance (MLU) and Persian Developmental Sentence Scoring (PDSS) indices for grammar and NDW and NTW indices for vocabulary abilities; these show the number of different words and the number of total words respectively. Results: Grammar intervention was successful in cochlear implanted children of the present study. In addition, treatment of grammatical problems increased the lexical ability of all children; NDW and NTW scores increased, which was confirmed by the effect size indices. In the follow-up phase, the cochlear implanted children were able to maintain the increase in NTW and NDW values. Conclusion: Improving grammar skills in cochlear implanted children also increased their lexical ability. Therefore, grammar therapy helps to increase the vocabulary of children too.

Delayed Auditory Feedback and Transcranial Direct Current Stimulation Treatment for the Enhancement of Speech Fluency in Adults Who Stutter: Protocol for a Randomized Controlled Trial.

BACKGROUND: Stuttering is a complex speech disorder that affects speech fluency. Recently, it has been shown that noninvasive brain stimulation may be useful to enhance the results of fluency interventions in adults who stutter. Delayed auditory feedback (DAF) is a method to enhance speech fluency in individuals who stutter. Adjunctive interventions are warranted to enhance the efficacy of this intervention. OBJECTIVE: Individuals who stutter have pathological activation patterns in the primary and secondary auditory areas. Consequently, in this study, we hypothesize that stimulation of these areas might be promising as an adjunctive method to fluency training via DAF to enhance speech therapy success in individuals with a stutter. We will systematically test this hypothesis in this study. METHODS: This study is designed as a randomized, double-blind, sham-controlled clinical trial. All participants will receive DAF. The intervention group will additionally receive real transcranial direct current stimulation, while the control group will be exposed to sham stimulation. The assignment of the participants to one of these groups will be randomized. Before starting the treatment program, 2 preintervention assessments will be conducted to determine the severity of stuttering. Once these assessments are completed, each subject will participate in 6 intervention sessions. Postintervention assessments will be carried out immediately and 1 week after the last intervention session. Subsequently, to explore the long-term stability of the treatment results, the outcome parameters will be obtained in follow-up assessments 6 weeks after the treatment. The primary outcome measurement-the percentage of stuttered syllables-will be calculated in pre-, post-, and follow-up assessments; the secondary outcomes will be the scores of the following questionnaires: the Stuttering Severity Instrument-Fourth Edition and the Overall Assessment of the Speaker's Experience of Stuttering. RESULTS: This protocol was funded in 2019 and approved by the Research Ethics Committee of the Iran University of Medical Sciences in June 2019. Data collection started in October 2019. As of February 2020, we have enrolled 30 participants. We expect data analysis to be completed in April 2020, and results will be published in summer 2020. CONCLUSIONS: We anticipate that this study will show an adjunctive effect of transcranial direct current stimulation, when combined with DAF, on stuttering. This should include not only a reduction in the percentage of stuttered syllables but also improved physical behavior and quality of life in adults who stutter. TRIAL REGISTRATION: ClinicalTrial.gov NCT03990168; https://clinicaltrials.gov/ct2/show/NCT03990168. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/16646.

Language therapy outcomes in deaf children with cochlear implant using a new developed program: A pilot study.

BACKGROUND: Cochlear implanted (CI) children have problems in most aspects of language and in particular with regards to grammar. Considering the lack of studies in the field of grammar treatment in CI children and bearing in the mind that CI children have the potential to develop language, the aim of the present study was to investigate the effect of treating grammar in CI children using a treatment grammar program. METHODOLOGY: first, the literature related to grammar were reviewed so as to extract different grammatical components for developing grammar treatment program and to make sentences for each element as well as to compile a manual for its implementation. Second, the validity of the sentences was examined using the Delphi method. Third, grammar treatment was performed on five CI children. Persian Developmental Sentence Scoring(PDSS) and Mean Length of Utterance(MLU) were used to evaluate them before and after treatment. RESULTS: Five grammatical classes were extracted, and the grammatical elements were classified in each category according to age. For all of the grammatical items, 2076 sentences were constructed. After applying the Delphi method, a total of 1936 sentences with Kendall's coefficient of concordance (W) of 71%, remained. Using this program, grammar treatment was effective in all five children. The PDSS and MLU increased in all five children during the treatment phase, which was confirmed by Percentage of Non-overlapping Data (PND), Improvement Rate Difference (IRD). During the follow-up period, the children showed that they were able to maintain the trained components. CONCLUSION: Cochlear implants have the potential to learn language skills, and the present study confirms their ability to learn grammar, using a comprehensive grammar treatment program.

Assessment of Speech Sound Production by Story-retelling in Persian Speaking Children: Introducing a New Instrument.

BACKGROUND: Speech and language pathologists should include connected speech assessment as part of their evaluation for children with speech sound disorders. The purpose of the present study was to design and validate an instrument for assessment of articulation by story-retelling for Persian children. METHODS: 261 typically developing children, aged 4-5 years old in Iran, Tehran, in 2016-2017, were recruited in the current study. First, two stories were designed. Next, the expert panel reviewed those two stories and selected one story for assessment. The strengths of the test for discriminating between the two age groups (48-54 months and 55-60 months) and between boys and girls were investigated for construct validity. Test-retest was performed for 15 children. Also, inter-rater reliability was evaluated via calculating the correlation between the two examiners' scores. Statistical Package for Social Sciences (SPSS), version 24, was used for statistical analysis. The significance level was set at (P<0.05). RESULTS: There was 80% or more agreement in experts' response to questions regarding content validity. All of the reliability values were higher than 0.85. No significant difference was observed between boys and girls (P=0.77), but there was a significant difference between the two age groups (P<0.001). There was a significant correlation between this test and phonetic test of the Persian version of diagnostic articulation and phonology (r=0.62, P=0.002). CONCLUSION: The Persian story for the assessment of speech sound production is a reliable and valid instrument that can be used to evaluate the articulation of Persian children.

The effect of phonological awareness on rapid automatized naming.

Background: Phonological awareness (PA) is a fundamental predictor of reading disability. However, researches on reading have indicated that PA assessment alone is not sufficient to prevent reading problems. Rapid automatized naming (RAN) has been suggested as another influential factor in reading deficits independent of PA. This study investigated the impact of phonological awareness on rapid automatized naming. Methods: This was a randomized clinical trial study in which 62 Persian monolingual first graders were recruited from 3 schools using convenience sampling. Inclusion criteria were lack of deficits with sensory-motor skills and knowledge of the Persian alphabets. Measures of PA and RAN were utilized. The participants were randomly assigned into either the intervention or the control group. The intervention group was divided into small groups of 4-6 children who received thirty 40-minute training sessions in PA. T test, Mann-Whitney, and Wilcoxon tests were used for data analysis. Results: The results revealed that the RAN time was significantly reduced (p≤0.001), with a significant increase in PA scores (p≤0.001). In addition, there was a significant inverse relationship between some of the measures of the phonological awareness subtests and rapid automatized naming (eg, phonemic blending & RAN (numbers): ρ=-0.52 with p≤0.001). Conclusion: The findings showed that in the initial assessment, PA and RAN had a significant relationship, but RAN could be significantly improved by PA training.

Development of the Persian syntax comprehension test.

OBJECTIVES: Lack of formal tests to assess the various dimension of language in Persian is one of the main challenges of speech and language pathologists in Iran. The purpose of this study was to develop a Persian Syntax Comprehension Test to assess the syntax comprehension in Persian speaking children aged 4-10 years old. METHODS: the study included four phases. In the first phase, syntactic structures of Persian were extracted and then, items generation was performed. In the second phase, content validity was determined and images were designed for the items. In the third phase, two pilot studies were carried out and difficulty and discrimination indices for items were determined and in the last phase, 788 typically-developing children (436 children aged 4-6 and 352 children aged 6-10 years old) and 15 children with Developmental language disorder were recruited then, psychometric properties (construct and concurrent validity, test-retest, and split-half reliability) were evaluated. In the final step, standard score and percentile were calculated. We used Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) for the statistical analysis of the data. The significance level was (P < 0.05). RESULTS: Final version of Persian syntax comprehension test contains 24 syntactic structures and 96 items. Items' Difficulty indices were between 0.33 and 0.90. There was a significant difference among the age groups for the mean total score of the Persian syntax comprehension test. In addition, a high correlation existed between total scores of this test and those of grammar understanding subtest of Test of langue development (r = 0.52, P < 0.001). The correlation of total Persian syntax comprehension test score of the two rounds of test performance and the split-half coefficient were estimated to be 0.56 and 0.85, respectively. CONCLUSION: It seems that the Persian Syntax comprehension test has satisfactory values for the reliability and validity measures, and it can be used as a suitable instrument by researchers and clinicians.

Development and validation of a new scale for assessment of speech stimulability in Persian speaking children.

OBJECTIVES: Speech and language pathologists need to assess speech stimulability as a crucial component of assessment in clients with speech sound disorders. The purpose of the current survey was to develop and validate an instrument to assess speech stimulability in Persian speaking children. METHODS: The present study was accomplished in two steps. In step I, the test material was developed based on extensive literature review, and five experts were requested to make judgment on the content validity of the test. We evaluated other psychometric properties in step II. A pilot study was performed by the administration of the test on 25 children, and then the correct answer percentages of 100 participants for each item of the Persian test of speech stimulability were calculated. The participants were divided into four groups by six-month intervals. Inter-rater reliability, test-retest, and internal consistency were computed for the reliability measures. Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) was used for the statistical analysis of the data. The significance level was (P < 0.05). RESULTS: The final version of the test includes 132 items (consonant and vowel singleton words and sentences). There was no significant difference among experts' judgment in the content validity of the items (P > 0.05). All of the children could easily repeat the items in the pilot study. The participants were stimulable more than 80% for all of the consonants except/ʒ/and 100% for the vowels in the items of the final version of the Persian test of speech stimulability. All of the reliability values (inter-rater reliability, test-retest, and internal consistency) were higher than 0.8. CONCLUSION: Investigation of psychometric properties of the Persian test of speech stimulability showed that this test is a valid and reliable scale to assess the speech stimulability in Persian speaking children.

The relationship between comprehension of syntax and reading comprehension in cochlear implanted and hearing children.

OBJECTIVES: There is a large variation in the function of cochlear implanted children in language assessments. However, they usually have poorer performance in language abilities compared with their normal hearing peers. The purpose of the present study was to determine the relationship between syntax comprehension and reading comprehension in cochlear implanted and hearing children in the third to fifth grades of the elementary school and to identify the relationship between their reading comprehension and the age of receiving a cochlear implant as well as the duration of receiving speech therapy in cochlear implanted children. METHODS: A total of 15 cochlear implanted children and 15 hearing children studying in the third to fifth grades of the elementary school participated in the present descriptive-analytic and cross-sectional study. Two skills of reading comprehension and syntax comprehension were evaluated in these two groups of children. RESULTS: The results showed that there was a significant relationship between reading comprehension and comprehension of syntax in cochlear implanted children (P < 0.001). According to the linear regression, the score of reading comprehension increases with the increase in the score of syntax comprehension. No significant relationship was observed between reading comprehension and the age of receiving a cochlear implant (p = 0.337) and the duration of receiving speech therapy (p = 0.227). CONCLUSION: Based on the findings of the present study, it can be concluded that focusing on comprehension of syntax for intervention can improve reading comprehension. Particularly, it seems that working on structures which are complicated for the children helps to improve their reading comprehension.

Single word test for the assessment of speech sound production in Persian speaking children: Development, validity and reliability.

OBJECTIVES: Single word tests are used frequently to determine clients' speech sound errors. These tools are user-friendly and popular for speech and language pathologists. The aim of this study was to design and validate a single word test for the assessment of speech sound production for Persian speaking children. METHODS: The present study included two phases. In phase I, test material was developed. Psychometric properties were evaluated in phase II. In the next phase, 525 typically developing Persian-speaking children with the age range of 3-5 years old were studied. Statistical Package for the Social Sciences, version 24.0 (SPSS, Inc., Chicago, IL) was used for statistical analysis of this study. The significance level was set at (p < 0.05). Pilot study was performed by administrating the test on 25 typically developing children, construct validity: by administrating the test on 400 typically developing children and the comparison of performance of the children in 4 age groups (discriminative validity regarding age and by administration of this test and phonetic subtest of Persian version of diagnostic evaluation of articulation and phonology on 100 children (convergent validity)). Inter-rater reliability was performed by transcription and scoring of samples of 25 children and calculation of Intra Correlation Coefficient (ICC) was calculated. Test-retest was completed by administrating the test two times on 30 children with two weeks intervals. Internal consistency was achieved by the calculation of the correlation of the items of test. RESULTS: The final version of the test includes 70 target words for assessment of the consonants in three positions, vowels in medial position and consonant clusters (CVCC). There was 80% or more than it for the percentage agreement between experts for the content validity. There wasn't any significant difference between experts' responses about items of the test. 4 pictures were revised based on children's responses for the pilot study. All of the reliability values (test-re test, internal consistency and inter-rater reliability) were higher than 0.85. There was a significant difference between the four age groups for the mean value of Persian single word test for speech sound production (p < 0.0001). There was a high correlation between the score of this instrument and the scores of participants in the Phonetic sub-test of the Persian version of Diagnostic evaluation of articulation and phonology(r = 0.934, p < 0.0001). CONCLUSION: It seems that the Persian Speech sound Production Test is a reliable and valid tool that can be used to measure speech sound errors for Persian speaking children.

Story retelling skills in Persian speaking hearing-impaired children.

OBJECTIVES: Since the pragmatic skills of hearing-impaired Persian-speaking children have not yet been investigated particularly through story retelling, this study aimed to evaluate some pragmatic abilities of normal-hearing and hearing-impaired children using a story retelling test. METHODS: 15 normal-hearing and 15 profound hearing-impaired 7-year-old children were evaluated using the story retelling test with the content validity of 89%, construct validity of 85%, and reliability of 83%. Three macro structure criteria including topic maintenance, event sequencing, explicitness, and four macro structure criteria including referencing, conjunctive cohesion, syntax complexity, and utterance length were assessed. The test was performed with live voice in a quiet room where children were then asked to retell the story. The tasks of the children were recorded on a tape, transcribed, scored and analyzed. RESULTS: In the macro structure criteria, utterances of hearing-impaired students were less consistent, enough information was not given to listeners to have a full understanding of the subject, and the story events were less frequently expressed in a rational order than those of normal-hearing group (P < 0.0001). Regarding the macro structure criteria of the test, unlike the normal-hearing students who obtained high scores, hearing-impaired students failed to gain any scores on the items of this section. CONCLUSIONS: These results suggest that Hearing-impaired children were not able to use language as effectively as their hearing peers, and they utilized quite different pragmatic functions.

A Comparison of Persian Vowel Production in Hearing-Impaired Children Using a Cochlear Implant and Normal-Hearing Children.

OBJECTIVE: Normal-hearing (NH) acuity and auditory feedback control are crucial for human voice production and articulation. The lack of auditory feedback in individuals with profound hearing impairment changes their vowel production. The purpose of this study was to compare Persian vowel production in deaf children with cochlear implants (CIs) and that in NH children. METHODS: The participants were 20 children (12 girls and 8 boys) with age range of 5 years; 1 month to 9 years. All patients had congenital hearing loss and received a multichannel CI at an average age of 3 years. They had at least 6 months experience of their current device (CI). The control group consisted of 20 NH children (12 girls and 8 boys) with age range of 5 to 9 years old. The two groups were matched by age. Participants were native Persian speakers who were asked to produce the vowels /i/, /e/, /ӕ/, /u/, /o/, and /a/. The averages for first formant frequency (F1) and second formant frequency (F2) of six vowels were measured using Praat software (Version 5.1.44, Boersma & Weenink, 2012). The independent samples t test was conducted to assess the differences in F1 and F2 values and the area of the vowel space between the two groups. RESULTS: Mean values of F1 were increased in CI children; the mean values of F1 for vowel /i/ and /a/, F2 for vowel /a/ and /o/ were significantly different (P < 0.05). The changes in F1 and F2 showed a centralized vowel space for CI children. CONCLUSIONS: F1 is increased in CI children, probably because CI children tend to overarticulate. We hypothesis this is due to a lack of auditory feedback; there is an attempt by hearing-impaired children to compensate via proprioceptive feedback during articulatory process.