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.

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.

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.

Cluster production in speech of Persian-speaking cochlear implanted children.

OBJECTIVE: This study is to examine the final cluster processing in Cochlear implanted child and compare the hearing age factor with the chronological age one. INTRODUCTION: Scholars argue that, in a Cochlear Implanted (CI) child, the hearing age is the crucial factor in the speech rather than the chronological age. To determine which factor affects the production more, we examined the mastery of Persian final consonant clusters realization in CI children at one-to-two years of hearing experience and compared the result to Normal Hearing (NH) peers. METHODS AND MATERIALS: The study included 21 children in two categories of girls and boys. Using picture-naming task, we collected the data from participants. RESULT: Data analysis showed that all the children used the same set of phonological rules at their developmental stages of word final consonant cluster but the distribution of preferences differed between the groups. In one hand, Cluster reduction was the most produced phonological rule in both groups and on the other hand, CI children preferred breathing, coalescence and cluster simplification more than NH children did. Considering Gender, unlike NH girls and boys who had the same trend in their phonological system, CI girls were closer to complete production rather than boys. CONCLUSION: According to this survey, what seems to be important in speech production of CI children is years of hearing experience rather than chronological age. Girls tried different rules compared to boys for cluster production, but when the mastery over cluster production was achieved, there was no difference between girls and boys.

Effect of preterm birth on morphosyntactic development.

Background: Preterm children are at risk of deficits in language, including grammatical skills. The main purpose of this survey was to investigate whether Persian-speaking children born preterm differ in their morphosyntax ability compared to full-term children. Methods: Morphosyntactic performance was assessed in 86 Persian-speaking children (43 healthy preterm and 43 full-term children) aged 4 and 5 years using the Persian Developing Sentence Scoring (PDSS). Participants were matched for age, gender, and gestational age. Results: The healthy preterm children who participated in this study were significantly outperformed by the full-term children in the morphosyntactic evaluation (p<0.05). Furthermore, their grammatical skills, based on PDSS, were not as developed as 4 to 5-year-old full-term children. Gender, in general, and gestational age had no effect on the PDSS scores of preterm children (p>0.05). Conclusion: Preterm children, regardless of gestational age, are at risk of morphosyntax impairments, which may not be recovered during the normal development. Therefore, grammatical evaluation and treatment seem to be necessary for these children.

A comparison of morpho-syntactic abilities in deaf children with cochlear implant and 5-year-old normal-hearing children.

INTRODUCTION: Children with cochlear implants (CIs) have problems in morpho-syntactic abilities more than other language skills. The current study was aimed to evaluate the language samples of children with CIs by using a numerical measurement tool, Persian developmental sentence scoring (PDSS). METHOD: In this cross-sectional, descriptive, analytical study, 33 children (22 children with CIs and 11 with normal hearing) were recruited. Language samples of the children were recorded during the description of pictures. The PDSS was used as a reliable numerical measurement tool for analyzing the first 100 consecutive intelligible utterances. RESULTS: We found a significant difference in the mean PDSS total scores (p = 0.0001) between the normal-hearing children and deaf children using CIs for 5 years. Similarly, the results revealed a significant difference in the mean PDSS total scores (p = 0.0001) between the normal-hearing children and 5-year-old deaf children with CIs. There was no significant difference in the mean PDSS total scores between the two groups of children with CIs. CONCLUSION: Children with CIs can form simple sentences but probably exhibit poor abilities for using complex sentences and essential morphology items.

Working memory span in Persian-speaking children with speech sound disorders and normal speech development.

OBJECTIVES: The aim of this study was to compare working memory span in Persian-speaking preschool children with speech sound disorder (SSD) and their typically speaking peers. Additionally, the study aimed to examine Non-Word Repetition (NWR), Forward Digit Span (FDS) and Backward Digit Span (BDS) in four groups of children with varying severity levels of SSD. METHODS: The participants in this study comprised 35 children with SSD and 35 typically developing (TD) children -matched for age and sex-as a control group. The participants were between the age range of 48 and 72 months. Two components of working memory including phonological loop and central executive were compared between two groups. We used two tasks (NWR and FDS) to assess phonological loop component, and one task (BDS) to assess central executive component. Percentage of correct consonants (PCC) was used to calculate the severity of SSD. RESULTS: Significant differences were observed between the two groups in all tasks that assess working memory (p < 0.001). In addition, the comparison of the phonological loop of working memory between the various severity groups indicated significant differences between different severities of both NWR and FDS tasks among the SSD children (p < 0.001). Nevertheless, comparison of the central executive between various severity groups, which was assessed with the BDS task, did not show any significant differences (p > 0.05). The result showed that PCC scores in TD children were associated with NWR (p < 0.001), FDS (p = 0.001), and BDS (p < 0.001). Furthermore, PCC scores in SSD children were associated with NWR and FDS (p < 0.001), but not with BDS (p > 0.05). CONCLUSION: The working memory skills were weaker in SSD children, in comparison to TD children. In addition, children with varying levels of severity of SSD differed in terms of NWR and FSD, but not BDS.

Speech intelligibility after repair of cleft lip and palate.

Background: Intelligibility refers to understandability of speech; and lack of it can negatively affect children's overall communication effectiveness. Children with repaired cleft lip and/or cleft palate (CL/P) may experience poor speech intelligibility. This study aimed at evaluating speech intelligibility in children with repaired CL/P who had not been referred to speech-language pathology clinics for early intervention. Methods: Sixty-four monolingual Persian-speaking children, 32 children with repaired CL/P, and 32 controls aged 3 to 5 years participated in this survey. Their speech intelligibility was evaluated through the Persian Speech Intelligibility Test and was normalized on children 3 to 5 years. Each speech sample was heard by a speech and language pathologist (SLP), as well as 2 nonprofessional listeners. Two objective measures of speech intelligibility including Percentage of Consonants Correct (PCC) and Percentage of Intelligible Words (PIW) were used in this research. Results: Children with CL/P were significantly outperformed by their peers in PCC (p= 0.0001) and PIW (p= 0.0001). More than half of the case group had compensatory errors and 40.6% had obligatory errors. The PCC and the PIW were statistically different in children with different rates of hyper nasality (p= 0.001). Conclusion: Speech intelligibility of children with CL/P is impaired due to their articulation disorders (obligatory and compensatory errors). This survey documents the necessity for speech therapy for increasing speech intelligibility in this population.

Relationship between Voice Complaints and Subjective and Objective Measures of Vocal Function in Iranian Female Teachers.

OBJECTIVES: Teachers are at high risk of developing voice problems because of the excessive vocal demands necessitated by their profession. Teachers' self-assessment of vocal complaints, combined with subjective and objective measures of voice, may enable better therapeutic decision-making. This investigation compared audio-perceptual assessment and acoustic variables in teachers with and without voice complaints. METHODS: Ninety-nine teachers completed this cross-sectional study and were assigned to one of two groups: those "with voice complaint (VC)" and those "without voice complaint (W-VC)." Voice samples were collected during reading, counting, and vowel prolongation tasks. Teachers were also asked to document any voice symptoms they experienced. Voice samples were analyzed using Dr. Speech program (4th version; Tiger Ltd., USA), and labeled "normal" or "abnormal" according to the "grade" dimension "G" from GRBAS scale. RESULTS: Twenty-one teachers were assigned to the VC group based on self-assessment data. There were statistically significant differences between the two groups with regard to self-reported voice symptoms of hoarseness, breathiness, pitch breaks, and vocal fatigue (P < 0.05). Fourteen participants in the VC group and 40 from the W-VC group were determined to demonstrate "abnormal" vocal quality on perceptual assessment. Only harmonic-to-noise ratio was significantly higher for the W-VC group (ES = 0.55). CONCLUSION: Teachers with and without voice complaints differed in the incidence, but not type of voice symptoms. Teachers' voice complaints did not correspond to perceptual and acoustic measures. This suggests a potential unmet need for teachers to receive further education on voice disorders.

The Persian developmental sentence scoring as a clinical measure of morphosyntax in children.

Background: Developmental Sentence Scoring (DSS) was developed as a numerical measurement and a clinical method based on the morphosyntactic acquisition in the English language. The aim of this study was to develop a new numerical tool similar to DSS to assess the morphosyntactic abilities in Persian-speaking children. Methods: In this cross-sectional and comparative study, the language samples of 115 typically developing Persian-speaking children aged 30 - 65 months were audio recorded during the free play and picture description sessions. The Persian Developmental Sentence Score (PDSS) and the Mean Length of Utterance (MLU) were calculated. Pearson correlation and one - way Analysis of variance (ANOVA) were used for data analysis. Results: The correlation between PDSS and MLU in morphemes (convergent validity) was significant with a correlation coefficient of 0.97 (p< 0.001). The value Cronbach's Alpha (α= 0.79) in the grammatical categories and the split-half coefficient (0.86) indicated acceptable internal consistency reliability. Conclusion: The PDSS could be used as a reliable numerical measurement to estimate the syntactic development in Persian-speaking children.

Prevalence of cleft lip and palate among four provinces in the West and North-West of Iran.

BACKGROUND: One of the most common anomalies in newborn infants is cleft lip and/or cleft palate (CL/P). In spite of several studies about the prevalence of this, no investigation evaluated this prevalence in the West and North-West of Iran. With due attention to different ethnic groups in this area, the aim of this study is to investigate whether the distribution of CL/P live births varies regionally in this area of Iran. MATERIALS AND METHODS: A cross-sectional study was conducted using hospital registry records to identify all children born with CL/P. The hospitals with a maternity unit were selected in the capital cities of four provinces in the West and North-West of Iran, East Azarbaijan, Kurdestan, Gilan, and Markazi. The population under study included all infants born alive from 2008 to 2012. RESULTS: During the study period, 107,317 live births were registered in the hospitals with a maternity unit of four cities, and 52 infants (0.485/1000 live births) were born with CL/P. The prevalence in Rasht, Arak, Sanandaj, and Tabriz cities was 0.557, 0.352, 0.503, and 0.559/1000 live births, respectively (P < 0.05), and in cleft types (P < 0.05). Of the 52 infants who were born with CL/P, 24 (46.15%) were girls and 28 (53.85%) were boys (P > 0.05), whereas the prevalence of CL/P based on sex was statistically different among the four provinces (P < 0.05). CONCLUSION: This study shows regional variations in the birth prevalence of clefts and various cleft types. The different effects of gender on the birth prevalence of CL/P from city-to-city may be explained environmentally and/or by genetic factors affecting the development of oral clefts.

Language sampling for children with and without cochlear implant: MLU, NDW, and NTW.

OBJECTIVES: Cochlear implants (CIs) can considerably improve the oral language of prelingual hearing-impaired children. However, because most studies have been performed with English speaking children, available information regarding Persian-speaking children is scarce. Therefore, this study compared measures of lexical diversity (numbers of different words and total words), and syntactic complexity (mean length of utterance) in Persian-speaking children with and without CIs. METHODS: A cross-sectional study with 20 children with CIs and 20 typically developing children was conducted. To collect the data, the children's language samples were gathered via picture descriptions. The first 50 utterances were analyzed. RESULTS: All measures were significantly different between children with CIs and their typically developing age-matched peers, whereas no differences between children with CIs and their typically developing hearing age-matched peers were detected (p<0.05). CONCLUSIONS: CIs have been recognized to be one of the most beneficial rehabilitation prostheses because they help children to acquire speech and language abilities similar to their typically developing hearing age-matched peers. After implantation, the performance of children with CIs is similar to the performance of normal children with the same hearing experience. The duration of the hearing experience after the implantation is an important factor for determining the development of speech and language abilities.

The Validity and Reliability of Autism Behavior Checklist in Iran.

OBJECTIVES: The aim of this study was to evaluate the psychometric features of the Persian version of the Autism Behavior Checklist (ABC). METHOD: The International Quality of Life Assessment (IQOLA) approach was used to translate the English ABC into Persian. A total sample of 184 parents of children including 114 children with autism disorder (mean age =7.21, SD =1.65) and 70 typically developing children (mean age = 6.82, SD =1.75) completed the ABC. Internal consistency, test-retest reliability, concurrent and discriminant validity, and cut-off score were assessed. RESULTS: The results of this study revealed that the Persian version of the ABC has an acceptable degree of internal consistency (.73). Test-retest comparisons using interclass correlation confirmed the instrument's time stability (.83). The instrument's concurrent validity with Gilliam Autism Rating Scale (GARS) was verified; the correlation between total scores was .94. In the discriminant validity, the autism group had significantly higher scores compared to the normal group. Receiver Operating Characteristic (ROC) analysis revealed that individuals with total scores below 25 are less likely to be in the autism group. CONCLUSION: The Persian version of the ABC can be used as an initial screening tool in clinical contexts.