فصلنامه آرشیو توانبخشی
سال ششم شماره 2 (پیاپی 16، تابستان 1384)

Hearing loss (HL) is the most prevalent sensorineural defect in human. Mild to severly Profound HL occurs in about l.0 per 1000 births. Many previous studies have shown that about 50% of deafness is due to genetic factor and 50% is due to environmental and etiologically unknown. In this study, we are searching the causes of deafness at these families and introduce strategies for diagnosis and prevention. Questionaires were distributed in deaf schools, hearing loss and rehabilitation centers in Qom and Markazi provinces collecting done after filling by the parents. The criterias such as age, sex, number of deaf individuals in families their close relatives, the marriage type of the parents and etiology of disease (if it is genetic or environmental) were extracted from questionnaires and were analysed by SPSS software. Three hundred and fifty four (354) Questionnaires contained complete information from hearing loss families were collected. Age mean of proband individuals is 16.1±8.1. Sex distribution of 48.4% and 51.6% girls and boys, respectively. Parents were 59.3% and 36.7% of consanguineous and unfamilial marriage, respectively. The marriage type of were not determined in 4%. Mean of deaf individuals among these families was 1.8±1.4.By assessing the filled questionnaires and pedigrees. The deafness etiology in the studies population was categorized as genetic cause (70.9 %), environment factor (9%) and unknown etiology (20.1%). Genetic factor with and autosomal recessive inheritance pattern was the most common cause of hearing loss due to the high prevalence of consanguineous marriage which resulted and increased genetic causes in more than 50%. Multiplicity of offspring also shawn an increased in frequency of hearing loss in families that have deaf with genetic background of this disorder. In this study, environmental and unknown factors are second cause of HL. We may interestingly reduce frequency of HL in Iran with discouraging consanguineous marriage, health education, population regeneration control also genetic counseling especially for high risk families.

Objectve: Attention deficit with hyperactivity disorder is one of the most important mental disorders in childhood (ADHD). The American Psychiatric Associated has estimated it’s out bread between 3-5 Percent. On the other hand, writing is also one of the special needs in every Body’s life, and any disorders and difficulties in it, may lead to Many problems in making social communication and learning. In the study, using one of the most efficient Prehensioble tests, and furtherly analyzed the pre – writing skills in ADHD children. The goal of this study is to compare ADHD children with normal children in age group of 4-6 years of old. The present study is a cross-sectional&case-control Study on 21 boys of about 4-6 years of old, without any mental disease record, orthopedic disease in hand either out any other affected diseases, and without the application of any occupational therapy. 21 boys of the some age were chosen as a control group. Pre – writing skills were analyzed utilizing EDPA test, and in two sections of pencil grasp and drawing skills. Test score’s ranking valued “between” 1-4 in every question. The T test results showed that the Pencil grasps and drawing skills in ADHD Children and normal Children are different. According to the T test, the average scores in ADHD children in pencil grasp is lower than normal children. The T test also showed differences between the two groups in drawing skills. Generally, the results of this study showed ADHD children have weaker pre – writing skills than the normal children.

The purpose of this study was to assess the distribution of body weight force on toe and heel before and after exercise therapy and its effects on relaxation of children with spastic diplegia cerebral palsy. Ten children with spastic diplegia cerebral palsy between 8 to15 years of age participated in this study. Their mean weight and height were (30.8kg ± 5.7kg) and (1.35m±0.09m) respectively. Subjects underwent a 12 weeks of exercise therapy. A dynamic stability platform system (BIODEX) was used to measure the mean percentage of body weight pressure on toe and heal. The balance tests were repeated on stable, almost stable and unstable base of support as well as with and without shoes. Showed that the mean percentage of body weight pressure on toe and heal after exercise therapy was not significant (p>0.05). The mean percentage of body weight pressure on toe and heal was significantly decrease after exercise therapy in both with and without shoes (p<0.05). The greatest improvement achieved on almost stable and unstable conditions. Wearing shoes resulted in a balance percentage of body weight pressure on toe and heal on stable situation of stability platform the percentage of body weight pressure on toe and heal has no difference before and after exercise therapy. After exercise therapy strengthening the muscle of the ankle joint balance the percentage of body weight pressure on toe and heal. Wearing shoes decrease the muscle stretch and therefore balance the percentage of body weight pressure on toe and heal. The flexibility of spastic muscle and strengthening of the relax muscle must be perform. This result provides good information for physician in recognizing and therapy impacts on cerebral palsy children.

Survey on the effectiveness of drama therapy on increasing of motor skills and hearing skills of Male intellectual disabled with an I.Q between 55-70 in the Age Range of 10-15 years. The statistical community consisted of intellectual disabled students wich are the coverage exceptional training within an education organization in Tehran in school year of 2004-5 with an IQ between 55-70 in the age range of 10-15. Research sample that were selected randomly consisted of two groups, an experimental and a control group in number of 20 persons in each group. Research tool used in this study was Bruininks oseretsky motor perception skills test and along with hearing-oral memory reinforcement (sequence) tests. The averages obtained from the two experimental and control group were compared by the T test. Investigation of pretest scores and posttest scores in two experimental and control group showed a statistical significance difference. Results of this survey with a statistical significance at an alpha level of 0.05 and 95% reliability coefficient showed that drama therapy performance for the target group can cause the increased perception skills and hearing memory reinforcement.

The present research determines the level of peer acceptance of students with physical disabilities in inclusive and non-inclusive schools. A number of studies which have sought to identify the influential factors in the success of inclusive education, have pointed out the acceptance of special need student by his/her regular peers to be a significant variable. This is a descriptive investigation. The instrument utilized was the Acceptance Scale (Voelts, 1980). The upper elementary level version that we were used consists of 34 items, two are general friendship items, two are veridicalite items, and the remaining items are acceptance items.Three response options are provided for each item,I agree, I disagree, and maybe. For such reliability, a Spearman-Brown corrected split-half reliability index of +.82 was reported, as well as an alpha coefficient of +.77. A test –retest stability coefficient of. 68 was obtained by retesting a sample of 101 children on two occasions separated by three weeks. In Iran, with test retest on 72 students we got Reliability coefficient of. 83. The sample includes 179 student boys and girls in grades three to five who had classmates with physical disability in their elementary schools in Tehran. This sample was randomly selected from each of the five different regions in the city of Tehran. In addition, for the purpose of comparison, a sample of fifty-five students in similar grades was studied in regular schools. The effect of gender and type of school (inclusive vs. non-inclusive) on students’ acceptance of a peer with physical disability all were assessed. Results indicated that acceptance level is similar in boys and in girls in inclusive schools. The girl and boy students in inclusive schools demonstrated a significantly higher level of peer acceptance than their pupils in non-inclusive schools. This difference was much more noticeable in boy students. The lowest level of acceptance was found in the group of boy students in non-inclusive schools. As the results indicate, students with physical disabilities are much highly accepted by their peers in inclusive schools as compared with those in regular schools. This greater level of acceptance in inclusive schools could be reflective of the reality that the experience of contact and familiarity with a child who has a special need may encourage his/her feeling of being accepted by regular students. The limitations of this investigation and the overall scarcity of research in this area (in our country) points out more needs for further researches, specially in regard to appropriate interventions for enhancement of peer acceptance.

In recent years a variety of system models for providing community based health care services to the elderly has been envisioned and implemented in the developed countries which meet the special care needs of different groups of elders. In Iran due to lack of these systems development, implementation and evaluation of these care system models from aspects of effectiveness and efficiency seems to be necessary. In this study a model of social and health care system for community dwelling frail elders was implemented on 36 such elders for approximately six months and their respective expected outcomes were evaluated. The model has been developed in another study using a qualitative inquiry approach with named methodological triangulation (i.e. comprehensive literature review, panel of experts and ethnography on elders’ life styles and health practices). Implementation of Comprehensive Geriatric Assessment Tool, staff meetings for care planning, adopting an interdisciplinary approach with collaboration among all team members and case management rather than disease management were the most significant characters of this care delivery system. Investigation of Pretest scores and posttest score in two experimental and control group showed a statistical significance differences. The preliminary results of employing this care system and examination of expected outcomes such as enhancing quality of life and hope in elders reflects the efficiency of this system, although further complementary studies and particularly cost benefit analysis are strongly recommended.

Evaluation of nasalance is one of the important factors of instrumental evaluation of voice in persons susceptible to resonance disorder. There are different factors which can affect nasalance score. One of the most important factors is phonetic context of words and the other is sentences. We studied some effects of this important factor on nasalance score in normal Farsi speakers. This study is a cross-sectional and descriptive-analytic study of nasalance scores of words in 62 male and 60 female normal and Farsi speakers aged 18-27 years old. Subjects were selected from students of rehabilitation college which hadn’t any auditory, articulatory, fluency, and resonance problem. They hadn’t cold, or any other disease which could affect their voice. Twelve printed words (6 words with and 6 words without nasal consonants) were read by each of subjects, and nasalance of them were calculated by Nasal View, and then, the gathered data were analysed. Mean Nasalance scores of words without nasal consonants in ascending order are for words /dâd/, /bâl/, /dærd/, /bur/, /did/, and /bil/ SDs are nearly follow this order. Mean Nasalance scores of words with nasal consonants in ascending order are for words /mâl/, /nærd/, /dân/, /mur/, /mil/, and /din/ SDs are nearly follow this order. Maximum nasalance score in nasal words is for /din/, and minimum is for /mâl/. Maximum nasalance score in nonnasal words is for /bil/, and minimum is for /dâd/. Mean nasalance scores of males and females are compared with each other. Findings of this study prepared useful information about nasalance score in adult Farsi speakers wich can be a good start for access to standardized data for different aspects of voice. In addition, it shows that mean nasalance score of words can be significantly changed with these factors: different vowels, presence or absence of nasal consonants, and gender. This study shows the necessity of investigating about the effect of different phonetic contexts, manner and placement of articulation too.

After two decades of nomber expansion of universities of medical sciences and increasing the number of students as one of the most attainable solutions for the problem of substandard status of Iranian community health, recently, the quality-based policies in medical education have taken priority over most of the national health plans. The goal is determine differences in the field of education between schools providing rehabilitation sciences programs in Iran by stratifying their educational services. To measure the educational performance of rehabilitation sciences programs nationwide, a benchmarking tool, consisting of aboute 50 indicators, was devised. Their values were defined through consensus developing methods. Each school was asked to introduce a representative who would complete a questionnaire, which was designed to collect schools’ information. In the next step, all the divisions were visited by one of the project’s members and the school’s representative. Then, data retrieval was performed and verified at the project’s office. Finally, a special computer software was exploited to perform the final analysis. Schools providing rehabilitation sciences programs were stratified based on their individual scores. Furthermore, all schools were also ranked in each indicator. Among schools providing bachelor’s rehabilitation sciences programs, University of Social Welfare and Rehabilitation Sciences gained the first rank, with the score of 73.41 out of 100 Iran Rehabilitation School was the second with the score of 70.91 and Tehran Rehabilitation School gained the third rank with the score of 68.91. This study defines the educational strengths and weaknesses of rehabilitation sciences programs in Iran that could be used as a measure for authorities to devise practical strategies for qualitative and quantitative improvement.