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Objective: The purpose of study was identify hearing loss in thalassemic patients with history of Desferrioxamine (DFO) therapy. This study was carried out in a cross-sectional descriptive survey on 195 thalassemic patients (3-30 years old) in Gazvin Thalassemia center and Tehran pediatrics&apos medical center.
Methods: The patients underwent routine otolaryngologic history and physical examination, along with standard pure-tone audiometry.
Results: Hearing loss was present in 43.1% of patients. 16% of patients had conductive hearing loss and 4.6% of patient had sensory neural hearing loss. 22.5% of thalassemic patients had high-frequency sensory neural hearing loss and more importantly, high-frequency hearing loss attributable to Desferrioxamine ototoxicity was present in 12% of patients. Furthermore, these evaluations showed that there is a significant relationship between hearing loss and DFO usage and hearing loss too. There is no significant relationship between hearing loss and ferritin level between hearing loss and age of DFO usage too.
Conclusion: Management of these patients requires proper dosing of Desferrioxamine, along with regular otolaryngolgic and audiometric follow-up in order to prevent the effect of ototoxicity of desferal.

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Background and Aim: listening, speaking, reading and writing are considered the lingual skills. These skills are in direct relation with each other. Listening is the first skill learnt by the individual through development. If damaged by hearing impairment, listening can cause serious defect to lingual skills. The goal of our research was to study the effect of hearing loss on reading literacy in hearing impairment students in comparison with normal hearing students.
Methods: Study was performed using the examination booklets of Progress in International Reading Literacy Study (PIRLS) 2001. 119 hearing impairment students of 4^th grade primary school, last year guidance school, and last year high school levels in schools providing exceptional student education were included. These individuals were compared to 46 normal hearing students of 4^th grade primary school of ordinary schools. Comparative statistical analysis was performed using t-test.
Results: Reading literacy and literal contents understanding was shown to have a significant difference between normal hearing and whole hearing impaired student (p<0.05), except the ones in high school level with moderate hearing loss. There was also seen a significant difference between normal hearing and hearing impairment students in understanding of information contents (p=0.03).
Conclusion: Hearing loss has a negative effect on reading literacy. Consequently, curriculum change and evolution of educational programs in exceptional centers is needed, in order to promote reading literacy and to enhance rest hearing

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Background and Aim: Reading skill is one of the most important necessities of students&apos learning in everyday life. This skill is referred to the ability of comprehension, comment and conclusion from texts and receiving the meaning of the massage which is composed. Educational development in any student has a direct relation with the ability of the comprehension. This study is designed to investigate the effects of hearing loss on reading comprehension in hearing-impaired students compared to normal-hearing ones.
Methods: Seventeen hearing-impaired students in 4^th year of primary exceptional schools in Karaj, Robatkarim and Shahriyar, Iran, were enrolled in this cross-sectional study. Seventeen normal-hearing students were randomly selected from ordinary schools next to exceptional ones as control group. They were compared for different levels of reading comprehension using the international standard booklet (PIRLS 2001).
Results: There was a significant difference in performance between hearing-impaired and normal- hearing students in different levels of reading comprehension (p<0.05).
Conclusion: Hearing loss has negative effects on different levels of reading comprehension, so in exceptional centers, reconsideration in educational planning in order to direct education from memorizing to comprehension and deeper layers of learning seems necessary.

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Background and Aim: Hearing-impaired students have some delays in learning language skills such as reading because of hearing loss. To study the effect of promoting educational level on the development of reading comprehension, the students of the 4^th grade of elementary and last year guidance school were compared based on international test of reading literacy.
Methods: The project was cross-sectional and the tool used was the international standard booklet of PIRLS 2001. Thirty-six students selected with moderately severe and severe hearing loss from the 4^th grade of elementary and last year guidance school from Shahriar, Robatkarim, Karaj and Hashtgerd, Iran, exceptional schools. Comparative statistical analysis was performed using t-test.
Results: The first level (focus on and retrieve explicity information) showed a meaningful difference between the last year guidance school and the 4^th grade of elementary students (p<0.05), but there were no significant differences in other levels, make straightforward information-interpret and integrate ideas-examine and evaluate content, (p> 0.05).
Conclusion: Hearing-impaired students have difficulties in understanding in deep levels of reading despite promoting educational level. Thus, in making policies for special trainings, continuing the rehabilitation in guidance and high school levels to promote the complex levels of comprehension should be taken more into consideration.

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Background: Phonemic awareness is one of the most important predictors of reading skills that has been taught by different procedures. One of the procedures is implementation of direct instruction in instruction of phonemic awareness. Current study is one of the unique studies in Iran that investigate impact of direct instruction in phonemic awareness on reading achievement of students with reading disorder.
Case: Three male second grade elementary students with reading disorder in a regular school in district six of the office of education in Tehran were selected. Multiple-baseline across subjects was selected as a research design. The following tests were used as diagnostic criteria: reading and dyslexia test and Wechsler intelligence scale for children-revised. Moreover, a reading inventory consisting of 100 words was developed by researchers to assess the reading ability of the subjects. Data were collected in three phases: baseline, intervention, and follow-up. During the intervention phase, the intervention strategies were used while during baseline and follow-up, data were collected without any intervention. Comparing three phases of the study, we may conclude that intervention package consisting of direct instruction of phonological awareness was an effective strategy in reading achievement of all three students. In addition, follow-up data indicated that the effects of the intervention procedures were stable across time.
Conclusion: Direct instruction of phonological awareness was effective in reading achievement of students with reading disorder in elementary school and increasing their abilities in reading.

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Background and Aim: Hearing impairment can effect many educational abilities and will lead in a dealy in his growth. The objective of this research was to study the effect of hearing impairment on mathematical skill of hearing-impaired students of 4^th grade of elementary in contrast with normal-hearing students.
Methods: The project was cross-sectional and the tool used was the international standard booklet of mathematical questions. There has been 35 hearing-impaired students with range of moderately sever-profound hearing loss selected from the 4^th grade of elementary from exceptional schools in Ray, Pakdasht and Varamina, Iran, and 35 normal-hearing students were randomly selected from ordinary schools next to exceptional schools.
Results: By analyzing the outcomes, the normal-hearing students showed a better result in knowing, application, argument in aspects of cognitive in contrast with hearing-impaired students and there has been a meaningful difference (p<0.05). There was not a meaningful difference in mathematical skill between Ray, Pakdasht and Varamina, Iran in hearing-impaired and normal-hearing groups.
Conclusion: The hearing impairment effects learing of mathematical skill. It is important for hearing-impaired students to presentation various methods in instruction in progress deductive thought and cognitive structure and also development in concepts understand in mathematical domain in rehabilitation services.

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Background and Aim: Reading skills, a complicated process, should be learnt and solely is not depend on sounds conforming with the written symbols on a page. Readers will be able to understand and perceive the deeper meaning of the text based on their experiences and knowledge obtained through reading. This research aimed to compare hearing-impaired students&apos reading literacy in exceptional and ordinary schools in Iran.
Methods: This cross-sectional study was done on 28 hearing-impaired students of the 4^th year of primary exceptional and ordinary schools of Shahr-e-Ray and Shahryar cities, Iran, using the Progress in International Reading Literacy Study (PIRLS 2006) booklets. Comparative statistical analysis was performed using Student&aposs t-test.
Results: The hearing-impaired students in ordinary schools had significantly (p<0.05) higher scores [mean (SD)] in reading literacy [3.67 (1.74)], comprehension of informational contents [4.21 (2.48)], and comprehension of literary contents [3.14(1.23)] than hearing-impaired students in exceptional schools [1.78 (1.06), 1.92 (1.49), and 1.64 (1.62), respectively].
Conclusion: Hearing-impaired students in ordinary schools meaningfully had higher performance of reading skills in comparison with hearing-impaired students in exceptional schools. It seems that an appropriate cultural bed should be provided in order to conduct these students and accept them in ordinary schools.

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Background and Aim: There is a relation between language skills and science learning in educational approach. Hearing-impairment and delay in learning of language skills influence the progress of learning. The aim of this research was to study the effect of educational level elevation on growth of mathematical skill. Therefore, third grade hearing-impaired students of secondary school, and forth grade hearing-impaired and normal-hearing students of elementary school were compared in terms of mathematical skill.
Methods: The research was cross-sectional and the internationally standardized mathematics questions (2007) were selected as the tools of the test. The sample included 31 students of 4^th grade elementary and third grade of secondary school with sever hearing loss from exceptional schools, and 17 normal-hearing students were randomly selected from ordinary schools next to the exceptional schools in Robatkarim, Karaj, and Shahriyar cities, Iran.
Results: According to data analysis there was a meaningful difference between hearing-impaired students of forth and third grades and normal-hearing students in the three fields of knowledge, application and argument (p<0.05). There was a significant difference between the two hearing-impaired groups in knowledge (p<0.05), but they had no meaningful differences in the fields of application and argument (p>0.05).
Conclusion: No significant improvement was seen in the mathematical skill of hearing-impaired students by educational level elevation. Writing mathematical books for the pre-elementary courses, revision of teaching methods, and increasing teaching hours are necessary in mathematics.

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Background and Aim: Multiple sclerosis (MS) is one of the central nervous system diseases can be associated with a variety of symptoms such as hearing disorders. The main consequence of hearing loss is poor speech perception, and temporal acuity has important role in speech perception. We evaluated the speech perception in silent and in the presence of noise and temporal acuity in patients with multiple sclerosis.

Methods: Eighteen adults with multiple sclerosis with the mean age of 37.28 years and 18 age- and sex- matched controls with the mean age of 38.00 years participated in this study. Temporal acuity and speech perception were evaluated by random gap detection test (GDT) and word recognition score (WRS) in three different signal to noise ratios.

Results: Statistical analysis of test results revealed significant differences between the two groups (p<0.05). Analysis of gap detection test (in 4 sensation levels) and word recognition score in both groups showed significant differences (p<0.001).

Conclusion: According to this survey, the ability of patients with multiple sclerosis to process temporal features of stimulus was impaired. It seems that, this impairment is important factor to decrease word recognition score and speech perception.

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Background and Aim: Hearing is one of the most vital sensational abilities. Learning, which is the most basic ability for human compatibility to mental development, is affected by hearing ability. The main goal of this article was to review the effect of hearing impairment on educational achievement of hearing-impaired students, especially in the field of basic learning skills (reading, writing, and mathematics).

Methods: In this article, the researches on the effect of hearing impairment on educational achievement were reviewed. There were 37 articles extracted from different databases such as Iran Medex, Scopus, PubMed, Magiran, Iran Journal, Google Scholar, and 12 credible books published from 1944 to 2013. In order to search in these databases, educational achievement and other related keywords were used.

Conclusion: Hearing impairment affects listening skills, which is a mental process and is known as the first lingual skill. Subsequently, other lingual skills and learning abilities like educational achievement are affected as well. In order to decrease the educational gap in hearing-impaired students, it is very important to interfere in early stages and use of presentation methods to improve lingual skills in educational system.

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Background and Aim: Auditory and visual processing along with phonological and visual spatial working memory are the problems that patients with dyslexia struggle with. So, the aim of this project was to investigate the effectiveness of computerized cognitive training on the working memory performance of children with dyslexia.

Methods: The study conducted under the quasi-experimental method with pre- and post-test along with the control group. 25 children with dyslexia aged 7 to 12 years in grades 1-5 assigned to the experimental (15) and control (10) groups the experimental group received 30 sessions of the Brain Ware Safari intervention program. NAMA scale and Working Memory Test Battery for Children (WMTB-C) were conducted to assess reading and working memory performance of the subjects. MANCOVA, ANCOVA and effect sizes were utilized to analyze the data.

Results: There were significant differences between pre- and post-tests of the experimental and control groups on the forward and backward block recall subtests of WMTB-C and not the mazes memory. Regarding the subscales of NAMA scale, we found no significant differences in the reading performance but analysis of effect sizes showed positive effects at least on the 6 subscales.

Conclusion: The Brain Ware Safari computerized cognitive training can improve visual spatial working memory of children with dyslexia and probably may affect the reading performance.

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Background and Aim: CE-Chirp stimulus has been developed for stimulating more apical regions of the cochlea. Inadequacy of clinical information on the latency and amplitude characteristics of ABR evoked by CE-chirp at different levels in addition to discrepancy in identifying earlier ABR waveforms using CE-chirp stimulus are the reasons of this study.

Methods: This study was done by recoding ABR to click and broad-band CE-chirp stimuli in the right ear of 15 non-randomly selected normal-hearing individuals with age range of 20-30 years old. Frequency of recordable waves I and III, as well as threshold, amplitude, and latency of wave V were compared in response to click and CE-Chirp at 20-80 dB nHL.

Results: At 80 dB nHL, click stimulus evokes waves I and III more frequently than chirp stimulus (p=0.012 and p=0.016 respectively). At 20 and 40 dB nHL, wave V latency evoked by CE-Chirp is significantly longer than wave V latency evoked by click (p=0.012 and p=0.0001 respectively) however, at 80 dB nHL wave V latency evoked by CE-Chirp is shorter than click (p=0.0001). Wave V amplitude for CE-Chirp is significantly larger than for click at levels of 20, 40 and 60 dB nHL (p=0.0001, p=0.0001 and p=0.013 respectively). Wave V threshold is approximately 5 dB lower with CE-chirp compared to click (p=0.014).

Conclusion: Except at high levels, CE-Chirp evokes wave V with larger amplitude and lower threshold than click. Possibility of recording earlier ABR waves is reduced with CE-chirp stimulus.

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Background and Aim: Grammatical skills development of hearing-impaired children depends on using appropriate educational rehabilitation programs. This study aims to investigate the effectiveness of linguistic plays on the grammatical skills in hearing-impaired children with hearing aids.

Methods: Ten hearing-impaired children with hearing aids, aged between 5 and 7, were randomly assigned to two groups (5 children in each group). Each treatment group received 12 sessions on linguistic plays. The grammatical skills of these children were evaluated via the TOLD-P: 3 (Persian version) in addition, their level of intelligence was assessed by the Raven test.

Results: The difference between the scores of both control and treatment groups revealed a statistically significant difference in grammatical skills (t=7.61, p=0.001) and three subskills of the children who participated in the linguistic plays. These subskills include syntactic understanding (t=3.16, p=0.013), sentence imitation (t=1.71, p=0.006), and morphological completion (t=6.55, p=0.001). In other words, the findings suggest that linguistic plays have a significant impact on the improvement of the aforementioned skills in hearing-impaired children.

Conclusion: Results suggest that it would be beneficial to include linguistic plays as part of routine rehabilitation programs as a means of improving the grammatical difficulties of children. After partaking in linguistic plays, children significantly improved their ability to comprehend the meaning of sentences and also to recognize, understand, and use common Persian morphological forms.