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Background and Aim: Learning disability(LD) is one of the most prevalent problems among elementary school children. Approximately 10 percent of all elementary school children suffer from this problem. It has been determined that learning disability is predominantly accompanied with subtle impairment in central auditory nervous system. The main idea of this study was to evaluate middle latency auditory evoked potential (MLAEPs) in learning disabled children.

Materials and Method: This cross-sectional study investigated middle latency auditory evoked potential in children with learning disability (n = 31) compared to normal children (n = 31). Latencies and amplitudes of MLAEPs results with different stimulus intensity and binaural stimulation were compared between two groups.

Results: Compared to control group, learning disabled children exhibited smaller amplitudes for all the components except the right ear Na and Pa. There is no significant difference between two groups for latencies of the components.

Conclusion: It seems that middle latency auditory evoked potential may be useful in diagnosis and evaluation of learning disabled children although more investigation is required.

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Background and Aim: One of the most common complaints, particularly among patients with normal or near normal low-frequency hearing, is that their voice sounds "hollow". This is associated with "Occlusion effect". The aim of this study was to comparison of occlusion effect in normal hearing subjects via Real Ear Measurement and Audiometric Bing test.
Materials and Method: Twenty volunteers with normal hearing (10 male, 10 female), with ages ranging from 18 - 24 years were enrolled in this study. First, audiometric Bing test was performed in frequencies of 250, 500, 750 and 1000 Hz. Then in real ear measurement, subjects were instructed to vocalize /â/ and /i/ for 5 seconds. Probe microphone was recorded the sound pressure in the ear canals. The degrees of occlusion effect unit were obtained for further analysis.
Results: The means of occlusion effect were present in all subjects. There was no correlation between the results of audiometric Bing test and real-ear measurement. No significant difference was obtained between genders and monaural or binaural occlusion in real-ear measurement. But in audiometric Bing test, the difference between monaural or binaural occlusion was significant(p<0.05).
Conclusion: The peak of occlusion effect varies significantly among hearing aid users, so the hearing aid must be tuned. Probe- microphone measures will assist in determination how much gain is enough, and where frequency- specific adjustments are needed.

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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 aid users complain about a phenomenon called "occlusion effect". The aim of this study was to compare the occlusion effect in normal hearing individuals and those with slight and mild sensory neural hearing loss via Real Ear Measurement.
Methods: Sixty volunteers (30 male, 30 female) aged 18-55 years were enrolled in this study. Subjects were instructed to vocalize /e/ and /i/ for 5 seconds. Sound pressure level was measured by a probe- microphone and recorded in the ear canal. Occlusion effect and the frequency in which maximum occlusion effect occurs were obtained for each individuals for further analysis.
Results: The peak of occlusion effect for /e/ was 10.25 dB and 9.77 dB respectively in 751.9 Hz and 542.98 Hz frequencies in female and male individuals. The maximum occlusion effect occurred with 19.03 dB and 19.10 dB for /i/ and in 518.88 Hz and 440.28 Hz in female and male individuals, in respect. In addition, no significant difference was seen among hearing levels and between genders.
Conclusion: The peak of occlusion effect varies significantly among hearing aid users so that the hearing aid must be tuned. Probe-microphone measures will assist in determination where frequency- specific adjustments are needed.

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Background and Aim: Subjective tinnitus etiology has not been fully understood. Recently, in normal hearing subject one of the tinnitus theories, more specifically the medial olivocochlear tract, is related to the dysfunction of the efferent auditory system. The aim of this study was to determine the potential contribution of a defective cochlear efferent innervations to the chronic tinnitus in patients with normal hearing and determine the relation between tinnitus loudness and the amount of suppression of the transient evoked otoacoustic emission. Methods: This study was conducted on 20 tinnitus patients aged between 20-45 years and 20 controls matched for age and gender in School of Rehabilitation, Tehran University of Medical Sciences. Transient otoacoustic emission testing without and with contralateral white noise at 55 and 65 dB was performed on each subject. Results: The amplitudes of the emissions in the two groups was significantly different (p=0.001), but no correlation between tinnitus loudness and the amplitudes of the emissions in the presence (p=0.3) and absence (p=0.06) of contralateral noise. Conclusion: The suppression of the transient evoked otoacoustic emission by contralateral white noise did not reach statistically significant levels in tinnitus patients while the amplitude in control group reduced significantly.

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Background and Aim: While most of the people with tinnitus have some degrees of hearing impairment, a small percent of patients admitted to ear, nose and throat clinics or hearing evaluation centers are those who complain of tinnitus despite having normal hearing thresholds. This study was performed to better understanding of the reasons of probable causes of tinnitus and to investigate possible changes in the auditory brainstem function in normal-hearing patients with chronic tinnitus.

Methods: In this comparative cross-sectional, descriptive and analytic study, 52 ears (26 with and 26 without tinnitus) were examined. Components of the auditory brainstem response (ABR) including wave latencies and wave amplitudes were determined in the two groups and analyzed using appropriate statistical methods.

Results: The mean differences between the absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that was not statistically significant. Also, the interpeak latency values of waves I-III, III-V and I-V in both groups had no significant difference. Only, the V/I amplitude ratio in the tinnitus group was significantly higher (p=0.04).

Conclusion: The changes observed in amplitude of waves, especially in the latter ones, can be considered as an indication of plastic changes in neuronal activity and its possible role in generation of tinnitus in normal-hearing patients.

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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.