Archives of Rehabilitation (Journal of Rehabilitation)
Year:2013 | Volume:13 | Issue:5 (55) PEDIATRIC NEUROREHABILITATION|Papers Count:23

Objective: Today, there are several interpretations by therapists about the concept, implementation, and training aspects of handling of children with cerebral palsy (CP). This has created conflicts and differences in teaching handling for parents and caregivers. Moreover, handling is not clearly defined in the theoretical frameworks underlying occupational therapy (OT).Therefore, the main aim of this study was to provide an overview on handling in the children with CP.Materials & Methods: This study was a two- stage review of the national and international databases between 1990 and 2012. Out of the 2657 articles Obtained, we have studied 50 relevant full texts related to the topic.Discussion: Based on the exploration articles and documents, There are several different definitions about handling. It seems that, handling is a special care of children with CP in the occupational performance area and in the domains of self-care, mobility, and social function. Doing proper handling activities, not only is essential to improve the child health but also for parents. All sections of handling are placed on the activity and participation domain of ICF-CY in the domestic life chapter.Conclusion: Although, handling is the main component in the OT, there is no precise and comprehensive definition of the concept yet, and activities related to the handling and its position in the OT has not been clarified.

Objective: Sensor neural hearing impairments (SNHI) are not curable, and in the optimal situation, the most appropriate method is using hearing aids and aural habilitation. The main purpose of this paper is to investigate the ear symptoms and hearing aid’s complains and also to study the correlation between these two variables. We would like to encourage the therapists to pay more attention to the medical care follow-up and outcomes of aural habilitation.Materials & Methods: This is a descriptive analytic study. It was executed by a cross-sectional method on 95 SNHL children. Each case was examined by otolaryngologist and middle ears were assessed by Impedance Audiometry. Data were analyzed by Chi- square.Results: 38% of children who complained from their hearing aids had external otitis media. K Square showed a significant correlation (P=0.002) between external otitis and children’s complains about hearing aids.33% of children who complained from their ears, had abnormal tympanogram. Again K Square showed a significant correlation (P=0.005) between ear symptoms and abnormal tympanogram.Conclusion: External and middle ear infections in SNHL are as common as other normal hearing children. It can also be suggested as one of the important reasons in hearing aids dissatisfaction. So, regular otologic examination and audiometric evaluation in SNHL children are seriously recommended.

Objective: To determine the cross-cultural validation and test-retest and inter-rater reliability of the Persian translation of Parent version of the Gross Motor Function Classification System (GMFCS) for children with cerebral palsy (CP).Materials & Methods: Ninety Children (2 to 12 years, mean age 6.6 years; 57 boys and 33girls) with various types of CP were classified according to GMFCS by parents.After the forward and backward translation procedures, face and content validity and test–retest reliability between parents and inter-rater reliability between parents and therapists were assessed using the intra-class correlation coefficient (ICC) and the weighted kappa coefficient.Results: The ICC was 0.92 and showed excellent agreement and the weighted kappa coefficient was 0.61 and had good agreement. The interrater reliability was also high; the ICC was 0.88 with excellent agreement and the weighted kappa coefficient was 0.68, with good agreement.Conclusion: The Persian translation of Parent version of GMFCS is found to be valid and reliable, and is suggested to be appropriate for the assessment of gross motor function within the Iranian population.

Objective: The purposes of this study were: 1) Determination the correlation between gross motor function of children with cerebral palsy and their level in Gross motor function Classification System2) Evaluation and comparison of changes in gross motor function in children with cerebral palsy based on their severity Materials & Methods: In this longitudinal and in terventional study 30 children with CP (4-12 years) were recruited from some of Tehran rehabilitation clinics based on predetermined inclusion criteria. then this children based on their level in gross motor classification system were divided non randomly into three groups (mild, moderate and sever).For data collection demographic information questioner, Gross motor Classification system and Gross motor function measure were used. Data were collected before and after intervention.Intervention included two conventional occupational therapy sessions per week and lasted for three months. Data were analyzed by Spearman correlation coefficient, Wilcoxon, Man-whitney and Kruskal Wallis test.Results: There was inverse correlation between gross motor function level and gross motor function of children in pre & post occasion.in pretest occasion the mean of gross motor function in mild group was significantly higher than moderate & sever group and there was significant difference between moderate and sever group but in the post test occasion there was no significant difference between mean of gross motor function in moderate and mild group and the mean of gross motor function in moderate group was significantly higher than severe group. The most changes in gross motor function were seen in level 3 and 4.Conclusion: The highest increase in gross motor function after occupational therapy services was obtained by children in level 3 of gross motor classification system.

Objective: Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. One of the effective therapies for ADHD is positive parenting program (Triple-P) mixed with medication. The purpose was to determine the effectiveness of group training positive parenting program on ADHD symptoms of 4-10 years old children.Materials & Methods: In this pre-experimental study, pretest and post-test design with single group used and 25 mothers of ADHD children who had attended in Akhavan and Rofeide Clinics selected in convenience. They participated in 8 sessions (one session, 2 hours weekly) and trained with positive parenting program. Mothers completed Conner’s Parents Rating Scale Revised before and after training sessions. Data analyzed by using one-way analysis of variance with repeated measures and Bonfroni post-hoc test.Results: one- way analysis of variance with repeated measures showed that group training positive parenting program has led to significant reduction (P<0.001) in ADHD index, hyperactivity, oppositional behaviors, cognitive and attention problems in ADHD children. Posthoc Bonfroni test indicated that there is significant differences (P<0.05) between the means of hyperactivity with oppositional behaviors and cognitive and attention problems, hyperactivity/attention deficit index with oppositional behavior, cognitive and attention problems with hyperactivity respectively. But, there is no significant difference between the means of cognitive and attention problems with oppositional behavior.Conclusion: Group training positive parenting program lead to improvement of ADHD symptoms and it causes positive outcomes in combination with medication.

Objectives: This research was made for screening the motor developmental status) fine and gross) of 4-60 months old children in Tehran city through Denver Developmental Screening Test II (DDST-II) and Ages and Stages Questionnaires (ASQ), comparing the results of two tests and determining their agreement coefficient.Materials & Methods: In this analytical study the gross and fine motor developmental status of 197 children 4-60 months old were screened by using ASQ and DDST-II in 4 primary health care clinics in north, south, east and west areas of Tehran. Convenient sampling was used. Data was analyzed and consistency coefficient of two tests was determined.Results: By using ASQ and DDST-II fine motor developmental delay suspected in %5 and %11.7 of children and gross motor developmental delay suspected in %3.6 and %11.2 respectively. The estimated consistency coefficient between DDST-II and ASQ for fine motor domain was 0.05 and 0.24for gross motor domain.Conclusion: In this study motor developmental screening of children showed different results and kappa measure agreement of two tests was weak. For selecting a suitable tool it is necessary to compare the developmental screening results with a gold standard diagnostic test results of motor developmental screening be compared with a diagnostic gold standard test.

Objective: The aim of the present research was to compare General Health, Self-Esteem and Social Skills in Siblings of Educable mentally retarded (EMR) and normal students in yazd.Materials & Methods: In this a case-control studies.80 girls and boys with EMR Siblings and 83 girls and boys with normal Siblings were chosen with the method of cluster random sampling.GHQ, RSS, MESSY questionnaires were given to Siblings. Data were analyzed by pearsonian correlation coefficient, kolmogroffsmirnoff and independent T test Results: The result of this study indicated that girls with EMR Siblings in comparison to girls with normal Siblings, had significant difference in social skills, for example: fear of relationship with peers (P<0.001) and altruistic behaviors with other groups (P<0.024). There were no significant difference between other groups.Conclusion: The result of the present research indicated that: fear of relationship with peers and altruistic behaviors were more in girls with EMR Siblings than the other group. Influence of EMR children in family, having sufficient information about EMR child and adjustment of EMR children are important factors for girls & boys in relationship with their EMR Siblings and general health, social skills and selfesteem of them.

Objective: Because of the necessity for more and different follow-ups in children with developmental disorders in the early years of life, determination of contributing, factors especially those related to pregnancy is important in any community. This study was performed to reveal a correlation of anemia in mothers during childbirth with developmental status of 12-month infants.Materials & Methods: This study was performed through designing descriptive correlation on 250 mothers and their 12-month infants who visited to health services centers affiliated to Qazvin University of Medical Sciences and Health-Treatment Services in 1390 in multistage sampling method. Data collection tool included informational forms, Ages and Stages Questionnaire. Thereafter, the data was statistically analyzed with and Chi-square, Independent T, Mann-Whitney and Logistic regression tests.Results: The prevalence of iron-deficiency anemia in the studied community was 12% and the prevalence of developmental delay of children was 22.4%. Anemia had a significant correlation with developmental status of infants and its communicational domain (P<0.05).In the logistics model, hemoglobin showed significant correlation with developmental status of infants (P=0.02 and OR=0.31).66.7% out of all infants in anemic group and 55% in non-anemic group were male boys.Also the male gender had a ratio close to significance level (P=0.55 and OR=0.052). Other variables showed no correlations.Conclusion: Mother’s Iran Deficiency anemia showed to be in possible attribution with infants’ Developmental delay and it is compatible with the crucial role of Iran for central nervous system development.

Objective: The purpose of this study was to translate "Cerebral Palsy Quality of Life" (CPQOL) questionnaire into Farsi and to determine its validity and reliability.Materials & Methods: In this cross-sectional study, CPQOL was first translated into Farsi through 5 stages, and then its validity and reliability.200 parents of children with cerebral palsy aged 4-12 years were recruited from 8 selected rehabilitation center and 3 special education schools. Reliability (internal consistency and test-retest within a 3-week interval) and construct validity with Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS).Results: Spearman's correlation coefficient was used to asses the relationship between CPQOL and GMFCS- E & R (0.18-0.32), and between CPQOL and MACS (0.13-0.40). Item discriminant validity was shown by %75 of items. Cranach’s alpha (0.61-0.87), SEM (4/8-15.27), interaclass correlation (0.47-0.84) showed high reliability of Farsi CPQOL questionnaire.Conclusion: Farsi version of CPQOL has acceptable validity and reliability rates. It is now useful enough to be used for clinical as well as research purposes.

Objective: The aim of study was developing a valid hearing loss-related quality of life scale for hearing impaired adolescents.Materials & Methods: The first draft of the questionnaire, answering and scoring systems was produced based on literature review. The viewpoints of 14 experts were gathered to assess the questionnaire’s face and content validity. In order to assess clarity of items, construct validity and test-retest reliability, the questionnaire was completed by 12-18 year- old hearing impaired students of secondary and high schools with mainstreaming and those with exceptional settings in the year 2011 in Tehran city, The adolescents were chosen by stratified sampling and the sample sizes were 28, 255 and 117 respectively. Lawashe Method was used to calculate Content Validity Index. Construct validity was analyzed using factor analysis.Results: The questionnaire was constructed in 3 domains and 38 items with a set of 3 to 5-answer choices for each question. The total score of the questionnaire and scores of each domain were developed on a 0-100 scale in which the higher scores indicated better QOL. The face validity and content validity (CVI=0.79) was confirmed satisfactory. Test-retest correlation of scores was 0.85 for the total score and 0.81, 0.68, 0.78 for the physical, emotional and social domains, respectively.Conclusion: The Adolescents' Hearing Loss-Related Quality Of Life Questionnaire has been shown to be a valid and reliable tool and can be used for assessing consequences of hearing impairment, and the effects of rehabilitation programs on quality of life of Iranian adolescents with hearing loss.

Objective: Following diagnosed as hearing impaired many children are referred for auditory training as a part of rehabilitation program. The aim of the study was to explore the issueof discharging of hearing impaired children from auditory training program.Materials & Methods: This qualitative study was carried out in Tehran city using semi-structured deep interviews with experienced audiologists. A combination of purposive and snowball sampling techniques were used to reach audiologists experienced in auditory training. Interviews were continued to the point of data saturation, which occurred after interviewing the 8th interviewee. Transcripts based on interviewer’s notes of important points during the interviews and audiotapes were analyzed. Meanings were generated during a code-and-retrieve process and codes grouped together under larger themes and clusters.Results: Some interviewee did not perceive ‘listening abilities development’ and ‘receiving auditory training services’ as different entities. It seems that willingness of family and their limitations’were the only well determined and agreed-upon criteria for ending the auditory training sessions. Results cleared that most participants did not believe that auditory training programs should necessarily come to an end. However participants who believe in necessity of defining a point for termination of training sessions, referred to current assessment tools for children’s auditory skills as inefficient for use in discharge decision making.Conclusion: Non agreement of audiologists on the necessity of planned discharge from the auditory training and inefficiency of auditory skills assessment tools, could be challenging dilemma in national neonatal hearing screening program in terms of rehabilitation management.

Objective: The purpose of the present research was investigation of the effectiveness of social competence instruction on the adaptation behavior in male students of 12-14 years old with intellectual disability in Tehran province.Materials & Methods: This research was quasi -experimental with pre-test and post-test design with control group. The study population was included of boy students of 12-14 years old with intellectual disability in Tehran province.The participants were chosen by cluster sampling method from two districts of Tehran province (Shahr Rey and Eslamshahr).Then, one School was selected in each district and 20 male students were randomly chosen at each school. Participants were divided in experimental and control group. For experimental group were used social competence instruction in the 10 instructional sessions but the control group did not receive none of instruction. The instruments consisted of Riven intelligence test, Vineland adaptive behavior scale and social competence instructional program. Data were analyzed through MANCOVA.Results: Findings showed that there was significant increase in adaptive behavior scores of experimental group in comparison with control group (P<0.001). Also adaptive behavior scores of experimental group was significantly in communication skill, life skill and social skill (P<0.001), But was not significantly in kinetic (P=0.269).Conclusion: The social competence instruction program led to improvement of in the adaptive behavior, communication skill, life skills and social skills of students with intellectual disability. Therefore, planning for providing social competence instruction would be of particular importance.

Objective: The aim of the study was to assess the impact of social skills training on daily living skills for girls with Down syndrome.Materials & Methods: This was a quasi-experimental study. Forty female children with Down syndrome, aged 8-12 years, were enrolled by simple sampling and randomly assigned to intervention and control groups (20 children in each group). The intervention group received social skills training for 10 sessions (1 hour per session) during 2 months. For data collection, the Vineland scale adjusting behaviors was used as pre-test, post-test and follow-up test in the two groups. Repeated measurement analysis of variance was used for data analysis.Results: There was significant difference in the daily living skills scores between the two groups. Follow-up study also showed that the effect has been maintained after the end of intervention (P<0.001).Conclusion: It seems that social skills training can improve the daily living skills of children with Down syndrome.

Objective: The purpose of this study was to investigate the effects of nonnutritive sucking on the time needed for achievement of independent oral feeding and weight gaining in 26-32 week gestational ages preterm infants in kamali NICU hospital.Materials & Methods: Randomized clinical trial design was used. The population of study was 22 preterm infant with 26-32 weeks gestational ages, that were admitted in kamali’s NICU. After choosing infants based on inclusion and exclusion criteria, the researcher divided them into two groups (control and nonnutritive sucking program) randomly.The researcher implemented this program in 10 consecutive days for each infant during first 5 minutes of gavage feeding (3 times in a day) in experimental group. Infants in control group did not receive any stimulation except routine nursing care. The testers were investigated for gestational age during various oral feeding times and discharge time from NICU and also their weight measured during first, second week after birth and discharge time from NICU and then the results of two groups, were compared.Results: In nonnutritive sucking group, mean of gestational age at discharge times, was 33.97±0.69 weeks (mean ±SD) and in control group was 34.32±1.33 weeks, which is not statistically significant (P=0.4).In NNS group Average weight at discharge time was 1654.54±133.29 grams and in control group was a 1472.72±94.34 gram. In NNS group, weight at discharge from NICU was significantly more than the control group (P=0.001).Conclusion: Use of NNS, significantly increased weight gain.Although there was no statistically significant effect on oral feeding criterion, but clinically improved oral feeding in preterm infants and decreased hospitalization time in NICU, were seen.

Objective: The purpose of this study was to comparing executive functions in children with autistic and normal and relationship with math and reading ability.Materials & Methods: Present descriptive-comparative study consisted of 132 students (16 autistic and 116 normal). Normal students had been selected by convenient sampling. Because the statistical population was limited, the whole individuals were recruited in the study. Two groups also were match. Cooldige and cornoldy, Key-Math and reading level scales were orderly used to assess executive functions, math and reading ability. Data were analyzed by multi-vitiates analyses of variance.Results: The results showed that autistic children have weaker executive functions than healthy children. Also the results showed that organizing and planning-decision making are more influential in predicting mathematics ability and inhibition. Moreover active memory and inhibition are more influential in predicting reading ability.Conclusion: Based on these findings, it can conclude that executive functions are disabled in autistic children and these disabilities are correlated with their weakness in mathematics and reading ability.

Objective: The aim of this study was to determine the effectiveness of ball skills training on adaptive behaviors of children with high functioning autism.Materials & Methods: In this quasi-experimental study, (12 boys and 2 girls) aged 4-7 years old were selected by convenient simple sampling. The study was designed in two phases: In phase I, the effectiveness of current therapeutic program and in phase II the effectiveness of ball skills training (totally 10 sessions, 3 sessions per week and each session took 45 minutes) along with current therapeutic program was measured and mean difference were compared with each other in both phases. Vineland Adaptive Behavior Scale and Autism Treatment Evaluation Checklist were used to assess adaptive behavior and severity of autism respectively. To describe the data, descriptive statistics index such as mean and standard deviation and to analysis of data; repeated measures analysis of variance and Tukey test were used.Results: There were significant difference of mean in subtests of Vineland including verbal communication (P=0.040), socialization (P=0.003) and activity of daily living (P£0.001) in phase II as compare with phase I. Also, there was significant difference of mean on ATEC score in both phases.Conclusion: Results of the study indicated that ball skills training along with current treatment caused adaptive behaviors improvement in children with high functioning autism. It could reduce the severity of symptoms as well.