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The purpose of this research is to investigate the impact of speech therapy with Cognitive Behavior Therapy (CBT) on reducing the severity of stuttering & anxiety for adults who stutter in the city of Isfahan, Iran. The study used a semi-experimental design with pre-test/post-test control groups and it was conducted among 24 clients. The sample was selected through available sampling method among the clients suffering from stuttering and attended public speech therapy clinics of Isfahan. The measurement instruments were Stuttering Severity Instrument (SSI4) and Beck's Anxiety Inventory (BAI). After doing the pretest, clients were placed into one experimental group of speech therapy with CBT and one control group. Speech therapy for this research included ten 45-minutes sessions accomplished for each individual subject and CBT included ten 90-minutes group sessions. After finishing the therapy sessions, the posttest was executed on both groups. For statistical analysis of data, Analysis of Covariance was carried out. The research findings indicated that speech therapy with CBT reduced the severity of Stuttering and Anxiety. Speech therapy with CBT is effective in reducing Stuttering & Anxiety.

Introduction: Stuttering is a disruption in the fluency of speech that affects various aspects of human communication. Unhelpful thoughts and beliefs about stuttering are linked to the cognitive aspect of anxiety. Such beliefs can cause or exacerbate social anxiety in people who stutter. Early detection and treatment of such thoughts and beliefs may reduce the severity of social anxiety. The purpose of this study was to investigate the frequency of unhelpful thoughts and beliefs about stuttering and their correlation with anxiety and depression. Materials and Methods: 52 adults who stuttered were asked to complete the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI-II) questionnaires and the results were analyzed using descriptive statistics and Spearman correlation test. Results: Unhelpful thoughts and beliefs (such as feeling an inner compulsion to control stuttering, fearing that stuttering may occur at any moment and assuming that the others will attend to stuttering) was found with varying degrees in all people who stutter. These thought correlated positively and significantly with anxiety (r = 0.55, P < 0.01) and depression (r = 0.46, P < 0.01). Conclusion: There is a relationship between unhelpful thoughts and beliefs and the signs of anxiety and depression. Also the positive correlations between these behaviors indicate the importance of the attention to early signs of these thoughts and early treatment of mental health disorders in people who stutter. Keywords: Adult stuttering, Thoughts, Beliefs, Anxiety, Depression

مقدمه: پرخیشومی یک اختلال در تشدید است که در آن صدا در حین گفتار وارد حفره بینی می‌شود و به خصوص در واکه‌ها بیشتر قابل درک می‌باشد. اگر چه ارزيابي ادراكي، استانداردي طلايي براي ارزيابي پرخیشومی است، ولی دارای مشکلاتی است که از اعتبار آن می‌کاهد. تلاش‌های زیادی در جهت رشد و گسترش ارزیابی‌های دستگاهی و آکوستیکی دارای روایی و اعتبار انجام شده که می‌تواند مکمل ارزیابی‌های ادراکی باشد. هدف از مطالعه حاضر، به کارگیری و گسترش تجزیه و تحلیل آکوستیک طیف 3/1 اکتاو جهت ارزیابی کمی پرخیشومی در افراد شکاف کام دارای پرخیشومی و مقایسه آن با افراد طبیعی بود. مواد و روش‌ها: مطالعه توصيفی- تحليلي- مقطعي حاضر بر روی 20 فرد طبیعی (6 دختر و 14 پسر) با میانگین سنی 7/2 ± 01/8 سال و 10 فرد دارای شکاف کام (3 دختر و 7 پسر) با میانگین سنی 2/2 ± 17/8 سال انجام شد. افراد دارای شکاف کام توسط دو آسیب‌شناس گفتار و زبان ارزیابی شدند که شدت پرخیشومی این افراد متوسط تا شدید بود. از این افراد خواسته شد که واکه /i/ را به صورت کشیده تولید نمایند. نمونه‌های به دست آمده از نظر ارزیابی آکوستیکی و با نرم‌افزار Praat نسخه 5.2.2.7 مورد بررسی قرار گرفت. سپس این داده‌ها با استفاده از نرم‌افزار SPSS نسخه 16 و آزمون های آماریt Independent مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: دامنه پرخیشومی در افراد فارسی زبان نسبت به افراد طبیعی به طور معنی‌داری در فرکانس‌های مرکزی 630، 800، 1000 و 1600 بیشتر بود. نتیجه‌گیری: ارزیابی طیف 3/1 اکتاو در فرکانس‌های مرکزی یاد شده شاخص خوبی برای تبیین حضور سازه خیشومی در گفتار افراد دارای شکاف کام است. همچنین استفاده از تجزیه و تحلیل آکوستیک طیف 3/1 اکتاو جهت بررسی ویژگی‌های تشدید به صورت کمی مفید می‌باشد. کلید واژه‌ها: ارزیابی آکوستیک، آنالیز طیف 3/1 اکتاو، پرخیشومی، شکاف کام

Abstract Introduction: The purpose of this research is to examine the influence of "speech therapy with cognitive behavior therapy" on reducing the severity of stuttering amongst stuttering patients of 18 years old and above in the city of Isfahan. Materials & Methods: The study used a quasi-experimental design with pretest - posttest control group. The sample group included 24 people suffering from stuttering who attended public speech therapy clinics of Isfahan. For the diagnosis and severity of stuttering, stuttering severity instrument (SSI4) was used. After doing the pre-test, subjects were placed into one experimental group of speech therapy with cognitive behavior therapy and one control group. Speech therapy for this research included ten 45-minutes sessions which was done for each individual subject and cognitive behavior therapy included ten 90-minutes group sessions. After finishing the therapy sessions, the post-test was done. In analyzing the data, Analysis of Covariance & Mann-Whitney U test were deployed. Results: Data analysis showed that speech therapy with cognitive behavior therapy has a significant impact on reducing the severity of stuttering. Conclusion: speech therapy with cognitive behavior therapy is effective in reducing stuttering. Key words: speech therapy- cognitive behavior therapy-stuttering

Objective: Stuttering is not just a speech disorder. It can cause negative feelings and emotions in a person especially in children. Therefore, we need a standard tool to identify, study and measure these negative effects and then try to eliminate or reduce them. Considering the increased clinical and research needs for a valid and reliable tool to assess the negative effect of stuttering in Iran, this study aims to design and validate a questionnaire (parents form) for assessment of social/emotional /behavioral disorders in preschool children with stuttering Materials & Methods: This is a methodological study that was conducted in three steps in spring and summer of 2018 in Isfahan, Iran. Participants included 60 parents of preschool children with stuttering aged 3 to 5 years and 11 months (36 boys and 24 girls), who had referred to speech therapy clinics in Isfahan. In the first stage, 10 parents received in-depth and open-ended interviews to collect information about social, emotional and behavioral disorders in children with stuttering. Afterwards, based on these information and the opinions of experts in psychology and speech therapy, the main constructs of the questionnaire were identified: "uncompromising/ hyperactive behavior", "social skills", "communication skills", "aggression", "fear", and "separation anxiety". In the second stage, in order to determine the face validity, 10 experts were interviewed face to face. In order to determine the content validity, 15 other experts were asked to examine each item according. Content validity was determined by calculating the content validity ratio (CVR), content validity index (CVI), and total content validity (Lawshe method). Confirmatory factor analysis was used to examine the construct validity. In the last step, the internal consistency was determined by calculating Cronbach's alpha coefficient, and the relaibility was determined by test-retest method and intraclass correlation coefficient (ICC) Results: The initial version consisted of 61 items and 6 subscales. According to the experts, by merging items with overlapping concepts, the number of items were reduced to 40. In the face validity assessment stage, items were examined based on difficulty, relevance, and ambiguity. The phrases were read several times, and the opinions of experts were applied. Then, it was reviewed by two experts in Persian literature and finally was approved. The CVR and CVI vaues were obtained 0.76 and 0.90, respectively. For its internal consistency, the Cronbach's alpha coefficient was obtained 0.89 and ICC was more than 0.7 and significant (P

Human immunodeficiency virus (HIV) is a viral disease with immunodeficiency in human. So, it can involve different areas such as language, speech, motor and memory. The present research, as a case report, introducing the characteristics of phonological processes of a child who had Aids and lived in a nursery through referring and professional assessing in a speech therapy clinic. The child was a 4 year old boy who was in HIV base on blood test. Speech skills was assessed based on DEAP and language assessment was analyzed according to TOLD-P3. He talked with single word. He used two words sentences rarely. According to language assessment (TOLD-P3), semantic, syntax and phonology features were tested. So he was in emerging language stage. Also his expressive language was lower than his perceive language. In addition, based on DEAP-P test, phonological process of substitution type has been recognized most. Also, the most of the substitution phonological process which accrued have been velar fronting. This study showed that the most phonological process in a child with HIV was the process of substitution. It may be a risk factor for decreasing speech intelligibility. With regard to the results of the present research that showed that the subject had the disorder and there are limited researches in this area, it needs more surveys to help therapists to make a priority in therapeutic stages.

Introduction: Recent studies suggest that treatment should be begun immediately in children who have recently started to stutter. The purpose of this study was to design a telehealth application for parents of young children who stutter. It is an evidence-based treatment that can be administered from an early age compared to the current “wait and see” approaches. Materials and Methods: This research involved a qualitative content analysis. At first, a comprehensive review was performed on different well-established therapeutic programs, and their main therapeutic components were extracted via several sessions held by our focused group. Subsequently, six independent stuttering experts and five parents of stutter children were asked to rate the program’s items regarding its content and face validities by a 5-point Likert questionnaire. Finally, the entire program was used to form an easy to use, family-friendly software. Results: Seven therapeutic principles and five common factors were extracted from all available well-established stuttering treatment programs. They were designed in an easy to use software program. The final telehealth program was found to have a high face and content validities. Conclusion: This program might be used in future clinical practice for stuttering children under the age Four. However, its efficacy has yet to be examined.

Introduction: Working memory is one of the components of speech production and its deficiency can cause speech and language disorders. Several studies have suggested that children who stutter compared to normal children show some deficiencies in working memory. The aim of the present study was to investigation of the effectiveness of phonological working memory intervention on decreasing of severity of stuttering in preschool children. Materials and Methods: This study with single subject design targeted four children (5-6 years) who stutter. These children participated in a non-word repetition intervention, was scheduled in 18 sessions, over a total of six weeks and with a single subject research design (AB model). In order to analyze the data of the study, visual analysis of charts and quantitative analysis based on Cohen’s d effect Size were used. Results: Data analysis showed all participants recorded a statistically significant change, as a decline in percentage of syllables stuttered, following the intervention. Conclusion: The results from this study suggest that an intervention of phonological working memory eventuated in decreases of severity of stuttering in children participated in this study; conseqently, these results provide the preliminary evidence that supports the usage of a psycholinguistic approach for treatment the stuttering in children who stutter.

Abstract Introduction: results of researches on acoustic and motor aspects of speech of persons who stutter have shown that the perceptually fluent speech of stutterers differs from the speech of nonstutterers. One of these encoding and processing aspects of speech that measured in different studies is vowel formant transition features. Because variations in formant structure along the temporal and frequency domains reflect articulatory dynamics especially of the tongue, in study of motor speech ability of persons who stutter, this feature can be used. The purpose of this study is to compare the formant transition duration in fluent speech of those who stutter and those who do not. Materials and methods: In this descriptive-analytic study, 20 PWS and 20 normal counterparts, were asked to read 9 speech samples that insert in a carrier phrase. The responses were recorded and the duration were measured in milisecond by Praat software. Results: The results of the study showed that the average of formant transiotion duration in PWS was lower than that of normal subjects however this difference did not reach statistical significance. Conclusion: according to the result of this study motor speech processing in PWS is different with normal subject and the speed of articulator movement in PWS is faster than PWNS. Key words: stuttering, second formant transition, Praat software

Abstract Bachground and aim: Subjective Scales are the tools for investigation of a disorder in view of the person who has the disorder. Subjective stuttering scale (SSS) investigate stuttering in three views such as severity, avoidance and locus of control in a unique protocol that can show the need to assessment of extra aspects of stuttering. The aim of the present research was Investigation of reliability and validity of the Farsi version of Subjective Stuttering Scale Questionaire. Method and Materials With the implementation of a pilot study and semi-structured interviews with17 adult who has stuttering formal validity and internal consistency of the scale (Subjective stuttering scale: SSS) was investigated. Then 20 adult who has stuttering complete modified questionnaire with (PSI: perception of stuttering inventory), (locus of control behavior scale: LCB) and calculating the percentage of stuttered speech samples recorded in order to assess the concurrent validity. The findings were analyzed bydescribtive statics, Cronbach's alpha and pearson correlation. Findings the results based on the Cronbach's alpha (α=0/92) showed that are valid. There is a significant correlation between SS% and the first question of SSS (α=0.01, r= 0.67) and also there is a significant correlation between avoidance sub-test of SSS and avoidance subtest of PSI(α= 0.05, r=0.75)but there was not a significant correlation between the locus of control sub-test of SSS and LBC scale (α= 0.15). This version of SSS has properconstruct validity. Conclusion The present research showed that the Farsi version of SSS is a reliable and valid tool for assessment of stuttering in severity, avoidance and locus of control in view of the person who have stuttering. Key words: stuttering, assessment, self assessment, locus of control, avoidance.subjective stuttering scale.

Background: The aim of this study was to compare the effects of olanzapine versus haloperidol to control the signs and symptoms of stuttering. Methods: Ninety-three patients were recruited in a 12-week single-blind randomized clinical trial, which was held between October 2009 and October 2010. Forty-three patients received olanzapine (5 mg/day) and 50 patients, haloperidol (2.5 mg/day). Before and after the study, they were evaluated by a speech pathologist by Van Riper`s questionnaire. The data were analyzed using the SPSS version 16. T-test was used to compare the data between the two groups. Results: Mean of stuttering score (SD) before treatment was 4.67 (0.81) and 4.40 (1.14) in haloperidol and olanzapine groups, respectively (P > 0.05). After treatment, the mean (SD) score was 2.87 (1.32) and 1.56 (0.71) in haloperidol and olanzapine groups, respectively (P = 0.000). Conclusions: It seems that olanzapine does have better impact in controlling stuttering, and it may be recommended to prescribe olanzapine for stutters as the first choice to control the stuttering under a careful follow-up.

مقدمه: سنجش شدت لکنت یک جنبه مهم و اساسی در انجام هر گونه اقدام پیرامون لکنت است. یکی از ابزارهای مهم و معتبر در سنجش شدت لکنت 4SSI می‌باشد. این ابزار امروزه به عنوان سنجش بخشی از لکنت در مقالات و همچنین ارزیابی نتایج درمان استفاده می‌شود. با توجه به این که ارزیابی نتایج درمان، یکی از بخش‌های مهم درمان مبتنی بر شواهد است و با در نظر گرفتن این موضوع که وجود و کاربرد این ابزارها در کشور ما بسیار محدود می‌باشند، بر آن شدیم که در این مطالعه به بررسی پایایی این ابزار معتبر و شناخته شده در زمینه سنجش لکنت بپردازیم. مواد و روش‌ها: این مطالعه از نوع توصیفی- تحلیلی و مقطعی می‌باشد. بعد از ترجمه چند مرحله‌ای آزمون مطابق با پروتکل IQOLA و بررسی روایی آن، پایایی ابزار بر روی 35 فرد بزرگسال مبتلا به لکنت با استفاده از 5 آزمونگر باتجربه مورد بررسی قرار گرفت. یافته‌ها: پایایی‌ها در این مطالعه با استفاده از روش‌های آماریICC ، One-way repeated measures ANOVA و Cronbach¢s alpha مورد بررسی قرار گرفت. پایایی آزمون در حالت میان آزمونگر با استفاده از روش‌های Cronbach¢s alphaو ICC برای هر پارامتر، 98/0- 93/0 و پایایی درون آزمونگر با استفاده از روش‌های آماری ICC و one- way repeated measures ANOVA برای هر پارامتر، 98/0- 85/0 گزارش گردید. نتیجه‌گیری: با توجه به پایایی بسیار بالای به دست آمده در این مطالعه، می‌توان نتیجه گرفت که نسخه فارسی آزمون 4SSI برای ارزیابی شدت لکنت در نمونه‌های فارسی زبان مناسب و بسیار کارامد است. کلید واژه‌ها: نسخه فارسی ابزار سنجش شدت لکنت، ویرایش چهارم (4SSI)، پایایی، بررسی بین‌المللی کیفیت زندگی (IQOLA)، درمان مبتنی بر شواهد

Introduction: To apply a comprehensive evidence-based approach to stuttering, there is a need for an instrument examining the totality of this disorder. Yaruss and Quesal (2006) published the “Overall Assessment of the Speaker’s Experience of Stuttering” (OASES) questionnaire to achieve this aim. OASES-A can be used for documenting multiple treatment outcomes of individuals with stuttering who are older than 18 years. The aim of this study was to determine the validity and reliability of Farsi version of OASES-A questionnaire. Materials and Methods: Face validity, internal consistency and reliability of OASES-A were evaluated thorough conducting a pilot study in which a semi-structural interview arranged for 10 people who stutter (PWS). 50 PWS were then asked to complete modified OASES-A and S-24 scale to determine concurrent validity. Finally, in order to determine test-retest reliability of Farsi version of OASES-A questionnaire, 5 stuttering people completed the form 2 times within a 7-to-10-day interval. Results: Cronbach's alpha coefficient, which was calculated for entire 4 parts of the Farsi version of OASES, was 82 to 97, implying that the Farsi version of OASES-A questionnaire had a good concurrent validity, internal consistency and reliability. Finally it was shown that all the items of the questionnaire have an appropriate validity and reliability. Conclusion: Results of the present study indicate that the validity and reliability of Farsi version of OASES are compatible with the original English version. Keywords: OASES-A, Stuttering, Validity, Reliability, Outcome measurement, Adulthood stuttering

Abstract Introduction: Some researcher suggest that stuttering is a temporal disruption of the simultaneous and successive programming of muscular movements required to produce a speech sound and they say speech motor in stutterers associated with reduced timing variable rather than non stutterers such as reaction time. Reaction time is a standard criterion that can show nature of differences of phonation between stutterers and non-stutterers. The aim of this study is determination and comparison of reaction time of phonation in stutterers and non-stutterers . materials and Methods: this was descriptive- analytic study and selected 22 stutterers and 22 no stutterers from 10-30 years old and request them when heard stimulation as quickly as possible in response then recorded both of stimulation and answers by Praat software and measured interval between them. Result: result of this study show mean of reaction time in stutterers is more than no stutterers and this difference is more significant in 20-30 years old. But differences in two group of age do not significant. Conclusion: to consider, there is problem in voice onset in stutterers so this problem can be result from slower VRT could result problem such as struggle, avoiding and anticipatory behaviors, disorder in neuro-motor factors, timing force that stutterers feel in this task that this problem specially in adult stutteres are more than children because they have more experience in stuttering. Keyword: stuttering, reaction time, fluent speech, Praat software

مقدمه: بررسي استراتژي و روش‌هاي درماني جايگزين در درمان لكنت با توجه به ويژگي‌هاي اين اختلال و طولاني بودن زمان درماني و احتمال بازگشت آن، از اهميت زيادي برخوردار است. طب سوزني به عنوان يك روش درماني در درمان لکنت، معرفي شده است. هدف از انجام این پژوهش، تعيين نتايج مداخله طب سوزني ليزري و مقايسه آن با گفتار‌درماني بر درمان افراد مبتلا به لكنت بود. مواد و روش‌ها: این مطالعه تحلیلی و به شیوه مورد- شاهدی بر روی 20 فرد دارای لکنت و 20 فرد فاقد لکنت انجام شدگرفت. در اين پژوهش همراه با گفتاردرماني، طب سوزني ليزری بر روي 10 نفر از افراد مبتلا به لكنت كه از كودكي دچار لكنت بودند، استفاده شد. سپس نتايج با يافته‌هاي حاصل از درمان 10 نفر افراد مبتلا به لکنت كه فقط تحت گفتاردرماني و لیزر‌درمانی دارونما قرار داشتند، مقايسه شد. تمام نمونه‌ها 12 هفته پس از پايان مداخله پی‌گیری شدند. داده‌ها با استفاده از آزمون‌های تحلیل واریانس یک طرفه مکرر و آزمون t مستقل و نرم‌افزار 18SPSS مورد تجزیه و تحلیل قرار گرفتند. یافته‌ها: همراه بودن گفتاردرماني با طب سوزني ليزري باعث افزايش تأثير‌گذاري درمان شده است و ثبات و باقي ماندن درمان نيز افزايش مي‌يابد و احتمال برگشت لكنت پس از درمان نيز كاهش مي‌يابد. سرعت گفتار و درصد کلمات لكنت شده قبل و پس از درمان در هر دو گروه الف و ب كاهش نشان داد، اما پي‌گيري درمان پس از 12 هفته نشان داد كه در گروه طب سوزني ليزري، نتايج ثبات درماني بيشتري داشت و تفاوت ميان دو گروه معني‌دار است. نتیجه گیری: نتایج نشان داد که استفاده از طب سوزنی لیزری یا لیزر درمانی همراه با گفتار درمانی تأثیرات زیادی بر درمان لکنت داشته و از عود یا بازگشت لکنت پس از پایان درمان که یک مسأله بسیار شایع است، نیز تا حد زیادی جلوگیری می‌کند. کلید واژه‌ها: لكنت، طب سوزني، ليزر، درمان، نتيجه

Introduction: The etiology of stuttering, which is estimated to have an incidence rate of 1%, and existent differences between stutterers and non-stutterers continues to be interesting and intriguing phenomena. The aim of the present study was to investigate EEG patterns in stutterers and non-stutterers resident in Isfahan. Materials and Methods: 31 stutterers and 31 non-stutterers participated in a case-control, double-blinded clinical trial study. Subjects were matched for age, sex, and education. None of subjects had cluttering, mental retardation, hearing loss, motor disorders, brain damage or history of medication use. EEG was performed in the same condition for all subjects and the results were statistically analyzed through independent t and exact fisher tests using SPSS version10. Results: The results of the present research showed that there were significant differences between two study groups (stutterers and non-stutterers) on the basis of frequency and amplitude. However, pathologic (epileptiform) waves did not significantly differ as these two groups were compared. Conclusion: The observed differences between stutterers and non-stutterers indicate brain functions differences which may affect processing, control, execution of speech. Key words: Stuttering, EEG, Brain functions

Introduction: Learning phonological awareness skills plays a very important role in the course of speech and language development and throughout academic education in that these skills help children express their mental concepts more precisely. The aim of the present research was to determine levels of phonological awareness competency among educable children with Down’s syndrome whose mental age ranged between 7 and 12 years and were resident of Isfahan, Iran. Materials and Methods: In this descriptive-analytic study, all Isfahanian children with Down’s syndrome were individually assessed by a phonological awareness test and their scores on different subtests of this test were recorded on a separate sheet exclusively designed for this purpose. Data were statistically analyzed via t-test using SPSS software version 16. Results: Although a superior performance was found in girls, there was no significant difference between boys and girls as far as phonological awareness skills were concerned. In both genders, the highest average score of phonological awareness competency across 12 areas, which were covered by the above-mentioned test, pertained to phonemic synthesis and the lowest average score of such competency was observed in the awareness of middle phoneme. Ranked from simplest to most complex, the following order of competency in phonological skills was observed for both male and female subjects: recognition of the first phoneme, recognition of the last phoneme, awareness of the last phoneme, rhyme detection, alliteration and omission of the first and the middle phoneme. Conclusion: Study results showed that, as a group, phonological awareness skills of girls were superior to those of boys but there were not statistically significant differences between them regarding these skills. This superiority can probably be explained by faster speech and language development in girls and their relatively more advanced use of speech and language skills as it is the case in normal population. Keywords: Down’s syndrome, Phonological awareness, Children

Introduction: Substantial delays in spoken language acquisition have been documented for children with severe to profound hearing loss. Accordingly, areas of linguistic research in this population have shifted from measuring vocabulary size to studies designed to understand word learning processes including semantic development. The purpose of this study was to determine the differences between students with hearing loss and their normal peers on the grounds of synonym comprehension. Materials and Methods: 78 fifth graders who were all resident in Isfahan participated in this descriptive-analytic cross-sectional study. Of this number, fifty-two students had normal hearing ability and remaining twenty-four ones had hearing loss attending special education classes. The data of interest were gathered via two paper-based tests in which synonyms of each word should be written once in the context of a sentence and once out of such context by each subject. Results: Hearing-loss and normal-hearing groups significantly differed from each other in both tests (P < 0.05). All students in both groups had significantly higher ability in understanding synonyms when words were embedded in the context of a sentence than on the occasions in which target words represented out of the context (P < 0.05). Conclusion: Due to differences between hearing and hearing-loss students, it seems that the semantic category of synonym words is affected by hearing impairment as are other language areas. In addition, the different performance of subjects in two tests implies that synonyms extracted from the context are more difficult than synonyms embedded in a semantic context. Keywords: Hearing Impairment, Semantics, Synonyms, Students, Understanding

مقدمه: اختلال رشدي خواندن نوعي از نقص در خواندن و نوشتن است كه در آن فرد مبتلا داراي هوش طبيعي است و از مشكلات آموزشي و يا عاطفي رنج نمی برد با وجود عوارض رواني و پيامدهاي ناشي از عدم توانايي كافي در خواندن و نوشتن در زندگي فردي و اجتماعي مبتلايان، علت شناسي‌های آن به طور كامل مشخص نيست و روش تشخيص ي بيولوژيك براي آن پيدا نشده است. هدف از اين مطالعه مقايسه ميانگين دامنه وديرش موج P100 در دو گروه ديس لكسيك و غير ديس لكسيك و دو حالت مختلف محرك بينايي و استفاده از VEP جهت تشخيص ديس‌لكسيا بوده است . مواد و روش‌ها: پژوهش حاضر يك مطالعه تحليلی - مقطعی بود که 20 كودك ديس لكسيك و 20 كودك غير ديس لكسيك از پايه‌های دوم تا پنجم دبستان شهر اصفهان را مورد بررسي قرار داد كه به صورت تصادفي انتخاب شده بودند. تمام افراد در دو حالت مختلف تمايز محرك يبيناي تحت آزمون VEP قرار گرفتند. افراد ديس لكسيك به وسيله آزمون سياهه خواندن مورد شناسايي قرار گرفته بودند . يافته‌ها: كاهش تمايز سبب افزايش معنی‌دار ديرش موج P100 در تمام افراد شد يول ، مقايسه بين گروه معنی‌دار نبود. اما كاهش تمايز سبب كاهش ناچيز دامنه موج P100 در افراد غير ديس لكسيك و افزايش دامنه در افراد ديس لكسيك شد. تفاوت‌های بين فردي و بين گروهي دامنه موج P100 معنی‌دار نبود . نتيجه‌گيري: با توجه به آن كه تغيير تمايز محرك بينايي در آزمون VEP سبب تفاوت معني دار بين گروه‌ها نشد، روش مناسبی براي تشخيص ديس لكسيا نمي‌باشد. همچنين به دليل آن كه افراد ديس لكسيك در تمام شرايط برگزاري آزمون، عملكردي مشابه يا بهتر از غير ديس لكسيك‌ها داشتند، نظريه نقص مگنوسلولار در ديس لكسيك‌ها تأييد نمی‌شود. كليد واژه‌ها: ديس لكسيا، VEP ،مگنوسلولار

Background: Investigation of strategies and methods of therapy in stutterers regarding to its characteristics, length of treatment, and relapse of stuttering is very important. Acupuncture has been introduced as a therapeutic method for the treatment of stuttering. The aim of the present research was the identification of the results of intervention of laser acupuncture in comparison with speech therapy in stutterers. Materials and Methods: This clinical - trial and case control research was conducted on 20 stutterers and 20 non-stutterers. In the present study, speech therapy and laser acupuncture were used on 10 persons who had developmental stuttering from childhood. Results: The results were compared with the data of speech therapy and placebo laser in 10 control subjects. All of the subjects were followed up for 12 weeks after the intervention. The obtained data showed that accompanying of speech therapy with laser acupuncture resulted the increasing of maintenance and therapeutic effects of stuttering treatment and decreasing of relapsing. The speech rate and percent of stuttered words before and after the intervention in both groups (A and B) were decreased. Following the results after 12 weeks showed that the results were stable in laser group more than the other group and there was a significant difference between the two groups. Conclusion: The results of the present study showed that using of laser acupuncture therapy accompanying by speech therapy has many effects on the treatment of stuttering and prevents the relapsing of stuttering that is very common.