فصلنامه آرشیو توانبخشی
سال چهاردهم شماره 6 (پیاپی 56، زمستان 1392)

Co-occupation is defined as engagement of two or more people in an occupation, who are acting within the same time and the nature of engagement. It involves shared physicality, shared emotionality, and shared intentionality, embedded in a shared meaning. This study was conducted in Iranian context to explore the co-occupations of mothers of children with cerebral palsy (CP) as experienced by children, mothers and occupational therapists (OT). This qualitative research is a part of a big Grounded Theory study. Three children, thirteen mothers and six OTs participated in the study. The data collected via in-depth semi- structured interviews and two observations at home and clinic and three video tapes and one diary. Participants were selected through purposeful sampling following by theoretical sampling. A qualitative content analysis approach was conducted to analyze data by using the constant comparative analysis. In total, 695 initial or open codes were extracted. The results were categorized in four central themes that were identified as; (1) facing with Self care problems, (2) effort to gain treatment follow-up, (3) coping challenges of educational care, and (4) parental limited personal leisure time. The concept of Co-occupation has extended our attitude to specific care for children with CP and has enhanced child care services and also greater awareness of barriers the mothers are faced to.

The aim of the study was to develop a valid and reliable Persian version of the Bayley Scales of Infant and Toddlers Development Screening Test. Forward and backward translation, face and content validity determination, and cultural and linguistic adaptations of the questionnaires were performed, consecutively. Clarity of items of the translated version of the scale were examined by a study that carried out on 45 Persian 1- to 42-month-old children, recruited by sampling in Tehran, during the year 2012. In order to determine the reliability; internal consistency, inter-rater and test-retest, 34 tests carried out. For determining the psychometric properties of the tests, later a representative sample of 260, 1- to 42-months-old children recruited through consecutive sampling from health -care centers in five main districts in Tehran. Performing cultural and lingual adaptations, our expert team made some inevitable changes to the test items. Almost in all age groups, cultural or linguistic changes were made in items in communication domains. The Cronbach alpha in cognitive, communication (receptive and expressive), fine and gross motor subtests were 0.96, 0.95. 0.95 and 0.94 respectively. The construct validity of the tests by factor analysis and comparison of mean scores in age groups was confirmed. The Persian version of the Bayley Scales of Infant and Toddlers Development Screening test is a valid and reliable tool.

The present study aimed to determine the effectiveness of attribution retraining group program on anxiety of students with learning disabilities. In this semi-experimental study pre-test and post-test design with control group was used. Two learning disorders centers were selected on purpose and conveniently in Tehran City in 2012-13 academic years. Thirty six students (9 girls and 27 boys who were educating in 2nd to 6th grade in elementary school) with learning disabilities selected in convenience. One center was considered as experimental group and the other one as control group randomly (each group consisted of 18 individuals). Experimental group was divided into three subgroups (each consisted of 6 individuals), and were participated in 11 intervention sessions (each lasts for 45 minutes; twice a week) and received attribution retraining program, but control group received no training. Spence Children Anxiety Scale (SCAS) was completed before and after the intervention by all subjects. Data were analyzed by independent t-test and analysis of covariance. The results of analysis of covariance showed that attribution retraining intervention did not influence the anxiety. There is no significant difference between the anxiety of experimental and control group (P=0.34). It was concluded that attribution retraining group program can not probably reduce anxiety symptoms of students with learning disabilities.

One of the problems of children with Down syndrome is their low performance on retention of information and recall of them from memory. The present study aimed to determine the efficacy of rehearsal strategy on auditory short-term memory of educable 5 to 8 years old children with Down syndrome. In this quasi-experimental study, 24 children (14 boys and 10 girls) were selected in convenience from Iranian Down Syndrome Charity Association and evaluated by Raven’s Intelligence Progressive Matrices. Then, children were assigned to experimental and control groups randomly (each group contains 12 individuals). Experimental group participated in 8 group sessions (two sessions per week, each lasting 30 minutes) and trained by rehearsal strategy. All subjects were evaluated by Expressive-Auditory Memory Sequence Test before and after intervention sessions. Data were analyzed by multiple analysis of covariance. The results of analysis of covariance showed that rehearsal strategy have led to increase of digit span, word span and auditory short-term memory (p<0.01) in experimental group compared to control group. It can be concluded that rehearsal strategy training is an effective method on promotion of digit span, word span and auditory short-term memory of children with Down syndrome and implies important consequences for their education.

This study was aimed to determine the effective of pivotal response training (PRT) on behavioral problems of 4-6 years old children with autism. the present study was a quasi-experimental study with time-series design with two groups. Twelve individuals with autism (3 girls and 9 boys) who were attending in Beautiful Mind Clinic at Tehran in 2012 were selected in convenience and divided equally into experimental and control groups. Experimental group participated in 15 sessions (three times in a week) and received pivotal response training, but control group received mainstream programs (consists of applied behavioral analysis,and speech therapy) of the clinic. All children were evaluated by Giliam Autism Rating Scale (GARS) 3 times before and after intervention sessions. Data were analyzed by y analysis of covariance. the results of analysis of covariance showed that stereotyped behaviors and communication skills were reduced in experimental group, but there were no significant difference between experimental and control groups.(p=0.45). Also, findings showed that social interaction of experimental group improved compared to that of control group. . (p<0.001). We can conclude that pivotal response training program has a positive effect on social interaction of children with autism, but there was no significant effect according to stereotype behaviours and communication skills.

the present research aimed to determine the effect of reciprocal imitation training on social skills of children with Autism. This was a qusi-experimental study with repeated measures. Fourteen 5 to 7 years old children with high function autism (3 girls and 11 boys) were selected in convenience from who were referred to one private clinic at Tehran in 2012-2013. They were assigned randomly to experimental and control groups equally. Children were evaluated by Autism Social Skills Profile (Belini, 2006) 3 times before training sessions and 3 times after them. The experimental group were trained in 20 sessions (twice a week; each session lasts for one hour) and received reciprocal imitation. Data were analyzed by multivariate analysis of variance (MANOVA) with repeated measures. The results of MANOVA showed that reciprocal imitation training has increased significantly (p<0.05) social skills, social interaction and social participation of children with autism, but there was no significant difference according to their detrimental social behaviors (p>0.05). We can conclude that the reciprocal imitation training leads to improvement of social skills, social interaction and social participation of children with high function autism. It is recommended to use this program in educational and social settings for autistic children. Also, it is suggested as a part of family education programs or planned programs for preschool children with autism.

Early detection of children who are at risk for speech and language impairment and those at early stages of delay is crucial for provision of early intervention services. However, unfortunately in Iran, this disorder is not identified or referred for proper treatment and rehabilitation at early critical stages. This study was carried out in two phases. The first phase which was qualitative in nature was meant to identify all potentially affective factors through literature review as well as by acquiring the viewpoints of experts and families on this issue. Twelve experts and 9 parents of children with speech and language disorders participated in semi-structured in-depth interviews, thereby completing the first draft of potentially affective factors compiled through literature review. The completed list of factors finally led to the design of a questionnaire for identifying “factors affecting late referral in childhood speech and language impairment”. The questionnaire was approved for face and content validity. The cronbach’s alpha was determined to be 0.81. Two groups of parents were asked to complete the questionnaire: the parents of children who had attended speech and language clinics located on the west and central regions of Tehran city, after their child was 3 years old and those who had attended before their child was 3 years old, as the case and control group, respectively. According to the results, among the seven factors which showed significant difference between the two groups of children before definite diagnosis of speech and language disorders was arrived for the child, 3 factors were related to the type of guidance and consultation received by the family from physicians, 2 factors were related to parents’ lack of awareness and knowledge, and 2 factors were related to the screening services received. All six factors showing significant difference between the two groups after definite diagnosis of speech and language disorders was arrived for the child were somehow related to the parents’ misbeliefs and incorrect attitude towards the issue. We suggest that executive managers in the field of child health promote awareness programs for families in order to increase their knowledge and correct their beliefs and attitudes, and also to implement complementary training programs for pediatricians and other physicians related to the field of child health.

Children with Cerebral Palsy (CP) need special long term care which is usually provided by their mothers. Providing such intensive cares can induce physical loads on mother's musculoskeletal system. The study aimed to assess the chronic musculoskeletal pains in mothers of children with cerebral palsy. This descriptive study was conducted in Tehran, 2011. Two groups of mothers having children aged 4 to 12 years, with and without CP, were selected via convenience sampling method and were enrolled in the study. To assess musculoskeletal pain Nordic questionnaire was used and the relation between variables was examined via Pierson correlation and independent t test. In this study, 60 mothers with CP children and 60 mothers with healthy children participated. The mean (±SD) age of mothers and their children was 33.79±6.02 years and 7.11±2.71, respectively. Depression, chronic musculoskeletal pain, and also pain in the lower back, shoulder, ankle and toes were significantly high in mothers of children with CP (p<0.05). Because of the high frequency of chronic musculoskeletal pain in mothers with CP children, they need physical & psychological support to diminish the adverse effects of care activities. It is recommended to train mothers about how to care themselves and their children correctly to reduce their physical and psychological problems.

This research is compromised emotional maturity in boys’ adolescents with Down syndrome (12-18) years that study in formal and exceptional schools. At first 15 boy’s students with DS that study in formal school matched with 15 students in Exceptional school (IQ,, age, family education and socioeconomic state were same). Then EMS (Emotional Maturity Scale) was tested by researchers. Adolescents with DS in formal schools are significantly different and have better scale in emotional maturity and their fields. (p<0.001). Emotional maturity in adolescents with DS in formal schools is positive and better than peers in Exceptional classs This result is helpful for improvement integrated education system..

Motor function in children with Down syndrome is similar to mentally retarded children. But the movements are slower and have lower quality. The purpose of this study was to identify weaknesses in motor function in children with Down syndrome, by using Bruininks Oseretsky Test of Motor Proficiency (BOTMP). In this cross-sectional study, thirty six children with intellectual disability, 18 girls with Down syndrome and 18 girls without Down syndrome, with chronological aged 8-13 years were investigated. The subjects of Down syndrome were selected by available sampling. The subjects of intellectual disability were selected by simple random sampling. Two groups of participants were matched for chronological age and IQ level. The measurement was BOTMP. Statistical analysis was performed using the Mann-Whitney U rank sum test and t-test. The children with Down syndrome scored significantly lower than the mentally retarded children in the areas of gross motor skill composite (p<0/014) balance (p<0/029), response time (p<0/034) and visual motor control (p<0/048), but the fine motor and overlay motor skill composite, and subtests of bilateral coordination, strength, upper limb coordination scores were no significantly different between two groups. Motor rehabilitation is appropriate for children with intellectual disability, especially for children with Down syndrome, in throughout their adolescence. Key words: Motor skill/ Intellectual Disability/ Down syndrome/ BOTMP

To gauge the gross and fine motor development of early treated phenylketonuria (ETPKU) in children in the age range of 1–4 years. A cross-sectional analytic study was conducted in PKU clinics (reference clinics for PKU follow-up), Tehran, Iran. Seventy children with ETPKU were selected as the case group for the study. ETPKU children were those with early and continuous treatment with a phenylalaninerestricted diet (the mean of blood phenylalanine level during the recent 6 months was 2–6 mg/dL or 120–360 mmol/L). Also, 100 healthy and normal children matched with the ETPKU group for age were randomly selected from 4 kindergartens in four parts of Tehran as a control group. The measurements consisted of a demographic questionnaire, Peabody Developmental Motor Scale-2 (PDMS-2), and pediatrician assessment. Motor quotients were determined by PDMS-2 and then compared in both groups by two independent samples t-test. The mean ages in case and control group were 28.5 (± 11.6) and 29.7 (±11.3) months, respectively. Comparison of the mean fine, gross, and total developmental motor quotients (DMQs) showed statistically significant differences between the two groups (p < 0.05). The fine and total DMQs of ETPKU children were also correlated with age. In addition, there was a negative correlation between the phenylalanine level and fine (p < 0.001) and total (p = 0.001) DMQs. It seems that ETPKU Iranian children, regardless of following a phenylalanine-restricted diet or not, have lower motor development. It is recommended to plan programs for early detection and intervention of developmental delays in these children.

The purpose of this study was to determine the impact of home adaptation on developmental level of 15-60 months old cerebral palsy children.

In this experimental single-blinded study, forty children with cerebral palsy (15-60 months old) were recruited from some of Tehran public or private rehabilitation clinics based on pre-determined inclusion criteria, and after matching for child age, type of clinic referred to (public or private), type of cerebral palsy, IQ score, GMFCS level and number of occupational treatment sessions already provided at the rehabilitation clinic, the children were divided randomly in to two groups: intervention and control. For data collection, a Demographic Information Questionnaire and Ages & Stages Questionnaires (ASQ) Test were used. Data were collected on two occasions: before the intervention and 3 months after intervention. For intervention, researcher went to the intervention group home and explained educations related to handling for caregivers and adapted home in a 4-hour session. During 3 months, researcher would follow up to implement the intervention.Finally data were analyzed.

there were significant differences in developmental level in total of two groups in 3 months after intervention than before intervention (p<0.015). but there were no significant differences in average relation (0.713), gross motor (0.2), fine motor (0.329) and problem solving(0.981) improvement of two groups in 3 months after intervention. But there were significant differences in average socio - personal improvement between two groups (p<0.001) and this was greater in the intervention group.

In this study it is concluded that home adaptation and handling training on caregivers in home improves developmental level in 15 -60 months old cerebral palsy children.

The aim of this study is to determine validity and reliability of Persian version of Life Habits questionnaire) LIFE-H (in children 5-13 year old with cerebral palsy (CP). LIFE-H is a tool for measuring participation in children with disabilities. In this study which is a tool making and validation instrument; 101 caregivers of children with CP aged 5-13, completed the LIFE-H and a demographic questionnaire. Then the discriminant validity of the items was calculated by using Spearman's test. To evaluate test-retest, 22 of participants completed the questionnaire for the second time with a two weeks interval. Also, face validity of the questionnaire was done in two stages by professionals and caregivers of children, and content validity was verified by Lawshe’s method with 13 occupational therapists. Most people have reported good face validity of the questionnaire. Content validity of the Persian version of LIFE-H achieved (except for two items), acceptable score. All items correlate in average to appropriate levels with its own subscale (r> 0.39). Also, all subscales showed a higher correlation with total scores (r >0/50). I CC values ​​ for all subscales were obtained more than 0.6 and for the questionnaire was 0.78. Results showed that the Persian version of the LIFE_H in the children with cerebral palsy has good validity and reliability. Therefore, it is appropriate assessment to measure participation of children for both research studies and clinical evaluations.

Febrile seizure (FS) occurs between 6 months and 6 years of age. Febrile seizure is a common disease in pediatrics. Some patients are retarded with recurrent febrile seizure. For example Drawet syndrome was started with febrile seizure and progress into the intractable seizure and finally are retarded. This article is the clinical trial study. Population in this study are 86 children whit febrile seizure refer to pediatrics’ medical central. This study was carried out in 2013. In this study evaluated patients with febrile seizure’s criteria and included in the population. Children statistics with febrile seizure refer to pediatrics’ medical center registered and compared with other statistics. Data enter the SPSS program 18 version (SPSS Inc, Chicago, USA) and used analysis statistical tests and also T-test, Chi Square tests. Finally evaluated total parameters by MIN+SD and reported significant difference (P-value<0.05). Numbers of patients determined according to previous study. In this study 46 patients with complex febrile seizure and early initiation of treatment were not retarded and haven’t any complications. Early initiation of treatment in the patient whit febrile seizure very important to prophylaxis of developmental delay and developmental regression.

Emotional intelligence has an important role on mental and social health of children and its disorders may predispose them to many behavioral and psychological malfunctions. The aim of the study was to investigate the effectiveness of emotional intelligence training on reducing aggression and hyperactivity of female students with physical disability. Study was experimental and the Pre-test/ post-test comparison with control group was used. The samples were 40 physically disabled students with behavior disorders whom were in3rd, 4th and 5th grades. The instrument Rutter behavioral questionnaires (the teacher and parent forms) was used to measure behavior problems. SPSS was used for data analysis. The emotional intelligence training reduced the aggression and hyperactivity of students. The pre-test post-test results by teachers (p<0.001, f=15.04)) and parents (p<0.001, f=21.15) Forms have shown a significant differences between the two groups of students in aggression and hyperactivity. It was shown that training of emotional intelligence to physically disabled students with aggression and hyperactivity can help them to improve their behavioral status.