Archives of Rehabilitation (Journal of Rehabilitation)
Year:2017 | Volume:18 | Issue:3|Papers Count:12

ObjectiveAutism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder that increases in its degree of prevalence on a day-to-day basis. Due to the many problems that the disorder brings to the table for children, families, and society as a whole, its early screening, early diagnosis, and preparing early intervention for this group of children is of extreme relevance. Although many countries have put to use tools designed to screen ASD, Iran has not standardized any tool for this important job. One of the most reliable tools in recent years designed to screen traits of ASD in toddlers is the Early Screening for Autistic Traits (ESAT). Therefore, the aim of the present study is to investigate the validity and reliability of the ESAT-Persian Version (ESAT-PV) among toddlers.Materials & MethodsThis research is a cross-sectional study that was conducted in order to standardize and validate the Persian version of ESAT. The population of the research included all children with ASD in the city of Isfahan. The sample included 72 toddlers selected using the convenience sampling method. After investigating and calculating the Content Validity Ratio (CVR) and Content Validity Index (CVI), like the developers of the main version of the questionnaire did, the mothers participating in the study were asked to answer ESAT-PV questions based on the characteristics of their own children at the age of 14 months. The construct validity was convergent and it was with the Modified Checklist for Autism in Toddlers (M-CHAT) and the Childhood Autism Rating Scale (CARS) and using the Spearman correlation coefficient. Criterion validity was tested by way of comparison of children with and without ASD. To determine the internal consistency of the scale, Cronbach's alpha coefficient was used, and to determine its test-retest reliability, the Intraclass Correlation Coefficient (ICC) was employed. The data were analyzed using SPSS-22.ResultsThe maximum and minimum of CVER were estimated to be 1 and 0.8, respectively, and CVI was 0.91.The correlation coefficient of Modified Checklist for Autism in Toddlers (M-CHAT) and ESAT-PV was 0.56 and that of Childhood Autism Rating Scale (CARS) and ESAT-PV was 0.61. In addition, there was a significant difference between the mean scores of ESAT-PV in the two groups of children with or without ASD (t=54.17 P=0.001). Cronbach's α coefficient was in the range of 0.73 to 0.77 for questions, and Cronbach's coefficientα for the total scale was 0.76. Intraclass Correlation Coefficient (ICC) was in the range of 0.93 to 0.77 for questions, and ICC for the total scale was 0.92.ConclusionThe results of the present study indicate that the ESAT-PV enjoys acceptable validity and reliability and can be applied as a clinical and research instrument for screening autism in toddlers. These results are important because through the investigating and approval psychometric properties of ESAT-PV, operation the concepts of early screening. Thereafter, interested researchers could use ESAT-PV in different groups for identification and screening of ADD. In addition, recommend to rehabilitation experts, psychologists and psychiatrists, with early screening characteristics of autism spectrum disorders in toddlers and acting for the development, implementation and evaluation of the results of early educational and rehabilitation interventions, and thus, be useful in reducing the cost of family and community.

Objective: Sensory processing refers to reception, adjustment, and integration of sensory information sequentially and generates adaptive responses. People need to have appropriate sensory processing abilities for functioning adequately in the environment and be able to participate in activities of daily living. Dunn' s sensory processing model consists of two constructions. The first construction involves neurological thresholds, and the second construction concerns self-regulation. When the two continuums are connected, four basic patterns of sensory processing appear. The four models are: sensation seeking (including representation of high thresholds and active self-regulation strategy), sensory avoiding (including representation of low thresholds and active self-regulation strategy), sensory sensitivity (including representation of low thresholds and passive self-regulation strategy), and low registration (including representation of high thresholds and passive self-regulation strategy). Sensory processing patterns can be seen in each age group from infancy to adulthood. These patterns are different for people with disabilities such as autism, attention deficit disorder/ hyperactivity disorder, schizophrenia, Asperger syndrome, developmental disorders, and learning disabilities compared to those without disability. Dunn sensory profile school companion is provided to assess sensory processing patterns in children. As sensory processing plays an important role in the daily life of people, the purpose of this study was to determine the validity and reliability of Dunn's sensory profile school companion in children and students in the age group of 3-11 years.Materials & Methods: The study was a descriptive-analytical one. The population consisted of all children and students aged between 3 and 11 years and studying in Tehran schools in the academic year 94-95 and those who attended preschools. The sample consisted of 384 children and students who were selected through multi-stage cluster sampling. Dunn's sensory profile companion was used to collect data. Dunn' s sensory profile companion is a standardized measurement tool for assessing sensory processing abilities of children and students in the classroom and school and preschool environment. This tool was built by Winne Dunn. This profile are using for age range from 3 years to 11 years and 11 months and be completed by teachers and educators. Descriptive statistics such as mean and standard deviation were used for data analysis and confirmatory factor analysis, and Cronbach's alpha was used to draw inferences from the data.Results: Confirmatory factor analysis was used to assess the validity of the sensory processing profile school companion. The results showed that sensory processing profiles are school companion and four factors had construct validity (P<0.001). Internal consistency (Cronbach's alpha) was used to evaluate the reliability. Cronbach’s alpha for the entire questionnaire was 0.879, and for sensory registration, sensation seeking sensory sensitivity and sensory avoiding was 0.818, 0.885, 0.825, 0.812 respectively.Thus, this confirms that the sensory processing profile school companion and four factors are reliable.Conclusion: The results showed that Dunn's sensory profile has good reliability and validity. Dunn's sensory profile is a useful tool for assessing sensory processing patterns in school and kindergarten settings, and can be used by occupational therapists in clinical environments and by psychologists in educational environments.Information obtained from this profile can have diagnostic value and could also be used for the design of curriculum and classroom space.

Objective: The present study tries to examine the effective factors contributing to the acceptance of people with disability in the society.Materials & MethodsThe study included 4058 disabled persons supported by Welfare Organization of Shahrekord (2474 motional-physical, 673 eyesight, and 911 hearing disability). According to quota sampling method, the statistical sample was 352, which consisted of 58 blind, 80 deaf and 214 motionalphysical people with disability. A researcher-made questionnaire was used for gathering the data. Face validity method and Cronbach’s alpha test were used for determining the validity and reliability of the questionnaire. The questionnaire was affirmed by advisor and experienced professor and by using Cronbach’s alpha method for variables of social acceptance of people with disability, social capital, family support, manner of spending leisure, presenting rehabilitation services, transportation facilities, mass media programs, personality characteristics and training, which were found to be 82%, 86%, 94%, 82%, 93%, 85%, 79%, 92% and 87%, respectively.Results: Results of Pearson correlation coefficient showed that there was a significant relationship among variables such as social capital, transportation facilities, manner of spending the leisure, presenting rehabilitation services, training and entrepreneur, social media programs, personality characteristics, family support and acceptance of people with disability (P<0.001). There was no relationship between variables such as type (P=0.108), history (P=0.531) and reason of disability (P=0.427) and acceptance of people with disability in the society. According to the results of variance analysis and t-test in terms of demographic characteristics of people with disability, there was no significant difference between gender (P=0.071) and age (P=0.498) and acceptance of people with disability. But, there was a significant difference between education level, occupation of people with disability, and their societal acceptance (P<0.001). People with disability who were highly educated had a higher acceptance in the society.Also, there was a significant difference between marital status (P=0.032) and education level of spouse (P=0.046) and acceptance of people with disability.The most important effective factors on acceptance of people with a disability include social capital (B=0.240), family (B=0.198), type of disability (B=0.164), social media programs (B=0.163), transportation facilities (B=0.159), and entrepreneur and training (B=0.129).Conclusion: Acceptance of people with disability is necessary for their presence in the society and their social relations. We should provide the opportunity for their presence in the society and improve their life through creating proper conditions and possibilities.

Objective: Increase in the normal sagittal curvature (hyper kyphosis) may occur in individuals after skeletal maturity due to the poor postural habits and muscular weaknesses. Failure of changing these postural habits or strengthening the postural muscles may lead to deformities that cause pain and discomfort.The current study aims at determining the effect of a novel mechanical reminder “Kypho-remainder Orthosis” on the intensity of the curvature in individuals with postural hyper-kyphosis.Materials & Methods: Fifteen adult participants (9 female, mean age: 26.44 years; 6 male, mean age: 25.66 years) whose X-rays reported over 45 degrees of kyphosis were included in the trial. After the initial evaluations and assessments, each individual was asked to wear the kypho-remainder 8 hours a day for 6 weeks. The kyphosis curvature was measured before and after the trial period by the inclinometer.The quality of life of the participants was evaluated by SF-36 questionnaire.Results: The study represented that wearing the orthosis had a significant effect on the angle of hyperkyphosis curve index (P=0.000) and the quality of life (P=0.028) of the participants. Age, gender, occupation, and BMI variables did not have any impact on the effectiveness of orthosis in decreasing the hyper-kyphosis curvature.Conclusion: Considering the importance of maintaining a proper posture to optimize the muscles activity in preventing deformity and orthosis with a bio-feedback mechanism may be the solution. The longterm effect of using a bio-feedback orthosis indicated that kypho-remainder orthosis can significantly improve the kyphosis curve in individuals with postural hyper-kyphosis.

Objective: Some individuals with Chronic Ankle Instability (CAI) termed as functional ankle instability (FAI) suffer from repetitive ankle giving way and feeling of ankle joint instability during dynamic activities like walking. Walking, as a postural task, requires some central attention to integrate sensory inputs, estimate, and plan and produce proper motor outputs. Attention demanding cognitive task has the ability to influence walking control and may increase the risk of giving way and ankle sprain. The purpose of this study was to investigate the effect of dual-tasking on dynamic balance in people with FAI.Materials & Methods: Twelve physically active with clinically diagnosed FAI and 12 matched controls completed trials of normal walking in isolation or with a concurrent cognitive task, which is repeatedly subtracting seven from a randomly selected number (between 200 and 250) and the same cognitive task while sitting. Spatiotemporal parameters (measured by a seven-camera motion capture system) were calculated by visual3D during gait cycles. Gait velocity, step time, step length, stance time, and swing time were calculated. Independent t-test was used to compare the data for FAI and control groups, and comparisons between the single and dual task conditions were made using the paired t-test. Step time variability was calculated using Intraclass Correlation (ICC).Results: The results indicated that step velocity was decreased and that stance, swing, and step time were increased significantly during dual task walking in FAI people (P<0.05). FAI people demonstrated greater step time variability during single and dual tasks compared to the control group.Conclusion: The athletes with FAI demonstrated different movement strategies during the dual-task condition compared to control group. Cognitive load may increase the risk of ankle instability in individuals with FAI.

Objective: The social adjustments decrease with increasing age, which can have a major impact on the lives of the elderly. According to different studies, using different trainings can increase social adjustment in the elderly group. Therefore, the purpose of the current research is to study the effectiveness of social skills training on social adjustment of elderly.Materials & Methods: The current research is experimental with pre-test and post-test patterns and a control group. The statistical population in this study includes 60 elderly people (36 women and 24 men) of the Elderly Cultural Center in Tehran who were chosen randomly. They were grouped into intervention and control groups. Social skills instruction program was done for all groups undergoing experiments in 8 sessions each with 90 min duration for evaluating the social adjustment of participants before the first session and after the last session. Social adjustment bell (1961) and demographic surveys were filled by participants. Valid and reliable Bell compatibility questionnaire 1378 was measured by Naqshbandi. Reliability coefficient of 0.93 was obtained for the total adjustment, 0.86 for social adjustment, 0.77 for physical health, 0.88 for family harmony, 0.70 for job is emotional adjustment, and 0.85 for compatibility. Bell further validated the construct validity. For data analysis, software SPSS version 16 was used, and descriptive statistics like average, frequency variance, and deductional statistics including U-man Whitney, Leven, Kolmogorov–Smirnov and independent (t) and Dependent (t) and covariance (ANCOVA) examination were used.Results: The result of this research showed that considerable difference can be found between ultimate total social adjustment and each of its subscales, including compatibility of family, emotional, occupational, social and physical health before and after social skills training (P<0.05). Significant differences were found between total and subscales of social adjustment among trained and untrained (P<0.05) people.Conclusion: According to the results of this study, it can be said that holding social skills instruction social work group on social adjustment method is effective among the elderly. The wider use of this type of intervention by specialists in the field of aging can affect well-being and mental health of this group.

Objective Female-headed households are one of the minority groups of women in Iran and other countries, grappling with many problems. This group normally face with too many obstacles in their personal, family and social life. So much difficult tasks assigned to these women, put unbearable pressure and tensions on them, and gradually makes them susceptible to a variety of mental disorders. Considering the wide range of issues, problems, limitations and vulnerability of female-headed households and their being as one of the target groups of social workers; it is important to provide professional services by social workers with the aim of psychosocial empowerment of this group. Thus the present study aimed to investigate the effectiveness of group social work intervention with developmental approach on psychosocial empowerment of female-headed households.Materials & Methods: This research was quasi-experimental with pretest/posttest design and control group. The study population consisted all female-headed households living in Tehran. The sample of women heads of households were randomly chosen from the Guide Institute of Imam Ali (AS). The inclusion criteria were the ability to read and write, aged 20 to 45 years, and willingness to participate in the study. Finally, a total of 60 women heads of households were selected and randomly divided into two intervention and control groups. Group social work intervention with developmental approach was taught in eight 90-minute sessions to the experimental group. The control group did not receive intervention. In order to assess the psychosocial empowerment of women heads of household before the first session and after the last session, social demographic data and psychological empowerment questionnaire were distributed among the participants and were filled by them. In this study, questionnaires on demographic information and Moradi (2010) sociopsychological empowerment questionnaire were used. Construct validity and reliability of the questionnaires have been approved. Also the validity and reliability of the questionnaire was assessed by the investigator again. The Cronbach α of the questionnaire was equal to 0.79. The content and face validity of the questionnaire were confirmed by the University of Welfare and Rehabilitation Sciences. The data were analyzed by SPSS 22. The analyses were performed by descriptive statistics such as mean, frequency, standard deviation and inferential statistics, including Levine, KS, paired t test, and covariance.Results: The results showed a significant difference between psychological empowerment of women headed households, before and after the intervention. This significant difference was observed in the scales of psychological empowerment, including self-esteem, self-efficacy, intellectual independence and sense of power (P<0.001) and subscales of social empowerment, including participation in social activities and pluralism (P<0.001). Also there were significant differences (P<0.001) between trained and untrained people in psychological empowerment with the scales of self-esteem, self-efficacy, intellectual independence, sense of power and in social empowerment with the scales of participation in social activities and pluralism.Conclusion: According to the study results, group social work intervention sessions with psychosocial developmental approach to empowering female-headed households is effective. The wider use of this type of intervention by professionals can empower and improve the lives of this group of people.

Objective: Cerebral palsy is an example of a physical disorder that causes multiple impairments that affect function and physical performance. Hemiplegia is a physical impairment, which can affect children. One of the most debilitating symptoms of hemiplegia is unilaterally impaired hand and arm function. Treatment options comprise physical or occupational therapy, conductive education, neurodevelopmental therapy, peripheral splinting and casting, pharmacotherapy (e.g., botulinum toxin type A), and operation. However, the success rate of such treatments is low. Thus, the study aimed at evaluating and determining the effective rehabilitation approaches on upper limb function of children with hemiplegia.Materials & Methods: A literature review was carried out. All evidences that were located in the first, second and third levels of evidence based on evidence-based practice classification and have explored the effect of any form of forced use, constraint induced movement therapy, hand-arm bimanual intensive therapy, and traditional treatments were included in this review. Patients with hemiplegic cerebral palsy and aged between 0-19 years and the researches on the treatment of the upper limbs were included in the study.Results: In this literature review, 19 articles were gathered from certain databases such as PubMed, Cochrane Library, Scopus, MeSH, and Index Medicus with key words like hemiplegic cerebral palsy, types of treatment approach, and upper limb dysfunction. Twelve articles in first level, six in second level, and one in third level were included in this study; most of these included articles were on the constraint-induced movement therapy.Conclusion: Based on the positive results of all these studies, constraint-induced therapy, forced use and handarm bimanual intensive therapy seemed to show effectiveness as interventions to improve involved hand and arm function in children with hemiplegia. Nevertheless, we needed to conduct researches with level 1 of evidence for each of the above treatment methods, particularly hand-arm bimanual intensive therapy for use in medical centers. Forced use was started with animal studies and then was continued on human studies of stroke patients and eventually expanded to children with hemiplegic cerebral palsy. Further research based on principles of motor learning and neuroplasticity promoted the use of forced use and developed constraintinduced movement therapy. Finally, the hand-arm bimanual intensive therapy was developed to remove constraints and difficulties of intervention in constraint induced movement therapy. Each of these interventions may be useful for hemiplegia. Comparative studies between these interventions are suggested to study their effects on the target behaviors.