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Objectives: Massage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of wedish massage on abnormal reflexes in children with spastic cerebral palsy (CP).

Methods: This study was a single blind clinical trial conducted on forty children with spastic CP who were recruited from clinics of the University of Social Welfare & Rehabilitation Sciences. They were randomly assigned to intervention and control groups. The routine occupational therapy (OT) techniques were performed during a 3 month-period in both groups. The intervention group also received Swedish massage for 30 minutes before every OT session. Primary, spinal, brain stem, midbrain, cortical and automatic reflexes were evaluated at the beginning of the study and 3 months later. The data analysis was done by parametric and nonparametric tests.

Results: Finally, thirteen subjects in the intervention group and 14 subjects in the control group were remained and studied. The average ages in the intervention and control groups were 49.5 and 42.1 months respectively. There were no statistically significant differences in abnormal reflexes in the intervention group in comparison to the control (P>0.05).

Discussion: Adding Swedish massage to traditional OT techniques had no significant effects on abnormal reflexes in children with spastic cerebral palsy. Evidently more research is required in order to completely reject the effects of Swedish massage on abnormal reflexes of children with CP.

Objectives: This research was performed to compare the results of two parental-based developmental questionnaires.

Methods: In this study the developmental status of 196, 4-60 months old children were screened using Ages and Stages Questionnaires (ASQ) and prescreening developmental Questionnaire (PDQ) in 4 primary health care clinics in Tehran. Convenient sampling was used. Data was analyzed by SPSS software.

Results: Using ASQ 18% of children were detected as having developmental disorders. Developmental screening with PDQ showed that developmental delay or doubtful condition was seen in 20% and 19% of children respectively. The estimated consistency coefficient between PDQ II and ASQ for fine and gross motor domains was 0.05 and 0.24, and for language and personal-social issues were 0.18 and 0.06, respectively. Based on two different categorizing possibilities for questionable scores of PDQ-II, that is, "delayed" or "normal", the total agreement coefficient between two questionnaires were determined 0.30 and 0.20, respectively

Discussion: The process of developmental screening was changed in recent years and performing a correct and useful developmental screening is easier today. Several screening tools are available now. Recent studies showed that parental information about their child’s development have good accuracy. For selecting a suitable tool we must consider the validity, reliability, sensitivity, specificity and all other positive and negative points about the tool of the test. Conclusion: This study showed that the results of developmental screening of 4-60 months old children in Tehran using ASQ and PDQ lead to different results. This is necessary that the results of screening are compared with a diagnostic gold standard test.

Objectives: Cerebral palsy (CP) describes a group of disorders in the development of movement and posture in the developing brain. The main aim of this study was to determine the distribution of motor impairment and associated disorders in a population of children with CP.

Methods: This study was carried out in 2011 during three months, on 200 CP children. Multiple sources of ascertainment were used, including medical records of patients who access at the major rehabilitation and special educational centers in Tehran and examination by rehabilitation team. Children were grouped according to motor type, topographic pattern according to the Surveillance of Cerebral Palsy in Europe (SCPE) definitions and classifications, Manual Ability Classification System (MACS) and Gross Motor Function Classification System (GMFCS) scales. In this study we evaluate impairments such as seizure disorders, hearing and visual problems, and cognitive issues.

Results: During the study period, 200 CP child (103 males, 97 females) aged 4-12 years were seen, with a mean (SD) age of 7.7(2.4) years. In this study spastic CP was the most common type (80.5%) and more specifically, bilateral CP (62.5%) was more common than unilateral (18%). With respect to the MACS classification, level IV (23%), and to the GMFCS classification also level IV (30.5%) was the most common.

Discussion: Bilateral spastic CP was the most frequent type that had the worst motor problem, and difficult treatment, so it seems that the health care system should pay more attention to perinatal insults for prevention of CP in our population.

Objectives: The aim of this study was to determine the outcomes of receiving a master’s degree in “Rehabilitation Management” in Iran on the professional lives of graduates, as reported by them.

Methods: A questionnaire consisting of open and close-ended questions was e-mailed to 75 graduates and alumni of the course, graduated since the beginning of implementation of the course in Iran, from 1997 to 2003. The total response rate was 52.75.

Results: Results overall indicated that 67% of graduates believed attending the Rehabilitation Management post-graduate course was worth the costs and 87% mentioned it as ‘very effective’ or ‘relatively effective’ on their present quality of job performance.

Discussion: Findings could serve as a baseline for periodic evaluations and revisions of the Rehabilitation Management curriculum in the future and also for comparisons with other management courses.

Objectives: The aim of present study was determining the level of satisfaction and its relative factors among parents of mentally retarded children using the services of private rehabilitation centers.

Methods: This was a descriptive-analytical study that was conducted on parents of 150 mentally retarded children, who were selected by quota sampling from eight private rehabilitation centers in Tehran. Questionnaires were used to collect data, and correlation tests, independent t-test, and one-way analysis of variance were utilized to analyze data.

Results: Upon the results, overall 88% of participants expressed their satisfaction. The major related factors were the behavior of managers and employees, receiving training for follow-up rehabilitation and education programs for the child at home, and the child's progress. The factors related to dissatisfaction included nutrition services, physical condition of the center and lack of parental participation in decision- making on matters related to the child. A significant relationship was found between parental satisfaction and family size, father's job, and the number of other disabled people in the family.

Discussion: According to the findings, it seems that patient satisfaction is also affected by the behavioral aspects of care, in addition to the technical aspects. Considering the humans’ need for respect and compassion and the sense of being valuable, this finding could be anticipated. The managers of private rehabilitation centers, for attracting and retain clients, need to pay attention to the factors which have impact on service users’ satisfaction.

Objectives: Speech and language development is one of the main aspects of evolution in humans and is one of the most complex brain functions such that it is referred to as one of the highest cortical functions such as thinking, reading and writing. Speech and language disorders are considered as a major public health problem because they cause many secondary complications in the childhood and adulthood period which affect one’s socioeconomic status overall.

Methods: This study was conducted in two phases. The first phase was to identify all potential factors influencing delay in referral of children with speech and language disorders for receiving rehabilitation services, based on literature as well as the families’ and experts’ points of view. In the second phase of the study which was designed in a case-control manner, actual factors influencing the time of referral were compared between two groups of participants.

Results: Parental knowledge of their children's problems related to speech and language had no significant impact on the on-time referral for treatment for children with speech and language disorders. After the child definite diagnosis of speech and language disorders, parents’ information about the consequences of speech and language disorders, had a significant influence on early referral for speech and language pathology services.

Discussion: In this study family structure plays an important role in the early identification of children with developmental disorders. Two-parent families had access to more resources than single-parent families. In addition, single-parent families may be more involved in the work and business of life.

Objectives: Quality of life, when referring to an individual’s health, is called health-related quality of life. The purpose of this study is to assess self-perceived hearing loss related quality of life of adolescents with hearing loss and its relationship with sex, age sub-groups or school settings with domains of quality of life.

Methods: A school based survey was conducted in Tehran city. Using stratified sampling, 255 7^th to 12th grade students with hearing loss, aged 11-19 years, studying in main streaming and special school sitting, were participated in the study by completing the health-related quality of life adolescent’s questionnaire. Physical, Emotional and Social health-related quality of life domain scores as well as Total health-related quality of life scores was calculated in a 0-100 scoring system.

Results: As a whole, health-related quality of life of adolescents calculated to be 64.7±16.5. Students with milder hearing loss reported their quality of life (physical, emotional and social domains, as well as total quality of life) better than those with more severe hearing loss. Girls reported their physical and total health-related quality of life better than boys, and adolescents who were studied in mainstreaming reported better physical, social and total health-related quality of life. No significant differences were seen between reported health-related quality of life in early, mid or late adolescent age sub-groups. Nevertheless the power of tests was not enough to exclude differences between groups.

Discussion: Findings of this study could be readily used to focus interventions on domains with more weakness in each group of adolescents. Beyond that the results could be helpful as a base line for detecting effectiveness of interventions in future.

Objectives: Regarding the type of service receivers as well as the technicality of the services provided, these services often bear high complexity and difficulty which can eventually lead to job burnout and shortage of motivation in the staffIn this study, the factors affecting job motivation from the viewpoints of staff and managers of Semnan Welfare Organization have been identified and possible differences have been analyzed.

Methods: In the present study, based on Herzberg’s model of job motivation and considering several assessment tools produced according to this model, a draft of a researcher-designed questionnaire was prepared in order to determine the factors affecting job motivation in the staff and managers of the State Welfare Organization in Semnan province. The content and face validity of the questionnaire was determined and approved by 10 experts, 5 managers and 15 staff members of the Semnan Welfare Organization who were selected purposefully, using the Lawsche’s method. The reliability of the questionnaire was assessed and approved by test-retest correlation coefficient determination. After informed consent was obtained, all staff and managers conforming to the inclusion criteria were invited to participate in the study and to complete the questionnaire.

Results: In contrast to Herzberg’s theory which considers intrinsic factors as more important than extrinsic factors in causing motivation, our results demonstrated that staff and managers of Semnan Welfare Organization believed extrinsic factors provoked higher motivation.

Discussion: The major motivation factors for staff and managers of Semnan Welfare province were somehow related to management practices of managers and staff, both of which are categorized as extrinsic factors.

Objectives: The aim of this research was to assess the level of awareness of rehabilitation professionals employed in academic rehabilitation centers in Tehran with reference to Tele-rehabilitation technology.

Methods: In this study, a descriptive cross-sectional research method was used. The research was implemented by using a researcher-designed questionnaire which was developed by the integration and cultural adaptation of different tools collected in the field of tele-health implementation feasibility. The content and face validity of the questionnaire was determined and approved by Lawsche’s method. The reliability of the questionnaire was assessed by test-retest correlation coefficient determinations. After considering the inclusion and exclusion criteria, informed consent was obtained, and the questionnaires were distributed among the study sample, which comprised of 141 rehabilitation professionals.

Results: The findings show that a desirable level  of awareness does not exist among rehabilitation professionals with regards to this technology. Based upon the results, only 8% of the participants had basic knowledge of this technology required in case of implementation.

Discussion: Since rehabilitation professionals’ awareness and knowledge can be a major key to a better implementation and application of this technology, it seems that there is a need for some developmental and training programs, such as informative educational workshops and seminars, to help them improve their level of knowledge and awareness.

Objectives: There are various developmental screening tools that are different in terms of psychometric characteristics and choosing the best one is challenging for the pediatrician. This research was designed to identify the validity and reliability of Parents Evaluation of Developmental Status, a developmental screening questionnaire, in 4-60 months-old children in the city of Tehran.

Methods: In order to validate the Parents Evaluation of Developmental Status, a precise translation of the questionnaire was performed by the research team. A Persian version was back-translated by three English language experts who were unfamiliar with the Parents Evaluation of Developmental Status. The back-translated version was compared with the original version. The content validity of the finalized Persian version was verified by three pediatricians. The questionnaire was performed on 648 children ranging from 4 to 60 months old in healthcare clinics. A test-retest method with 2-3 weeks interval and Cronbach’s & alpha were used in order to determine the reliability of the questionnaire.

Results: All of the questions in Parents Evaluation of Developmental Status had desirable content validity and there was no need to change them. The total Cronbach’s &alpha coefficient was 0.63, which, when considering the low number of items in Parents Evaluation of Developmental Status, is acceptable. The test-retest correlation coefficient was determined to be 0.87, which is desirable. The estimated Kappa measure agreement between Parents Evaluation of Developmental Status and Ages and Stages Questionnaires was 0.30. Due to the rather large sample size and similarity of the screening results by both questionnaires in 71.5% of cases, it is possible to conclude that this measure is an acceptable one. 

Discussion: This research showed that Parents Evaluation of Developmental Status has a good content validity and reliability and can be used for developmental screening of children in Tehran city. Because the test is brief, using it can lead to saving time and resources.

Development is a dynamic and continuous phenomenon  that is under the influence of various factors forming a complicated multidimensional system together. Any impairment in these factors can lead to impaired development in children, which is one of the most common problems in children. Therefore, this study provides a brief overview of these factors and the way they affect early childhood development. A brief review was performed in databases including Google scholar, PUBMED, Proquest, SID, Magiran, Iranmedex, Irandoc with following keywords: child  development, income, occupation, education, employment, boy, girl,  gender, sex, social class, Race and Ethnicity. All of article was reviewed then categorized based on WHO model. Among the papers reviewed, most of the studies were about employment, education, and income and most of them investigated these risk factors in terms of socioeconomic status. Structural factors of social determinants of health had a close relationship with each other, and they  had affected development through each other. Given that, only few studies on structural factors, except for socioeconomic factors, have been conducted and little attention has been paid to the way these factors affect child development, further studies in this area are required to propose a model in order to better understand the interaction between these factors.

Objectives: One of the problems in the process of assessment and evaluation, especially of clinical training in rehabilitation disciplines, is the lack of an instrument with objective criteria for evaluation. Considering the effects of appropriate evaluation on quality assurance of clinical training, the aim of the present study was to design a valid and reliable tool for general evaluation of clinical training in rehabilitation disciplines.

Methods: This study was a methodological research. Initially by literature review and also by holding a focus group discussion with professors of clinical training of rehabilitation disciplines who were recruited by convenient purposive sampling, the main indicators for evaluation of clinical education in those fields were determined. Then, after classification of the indicators and first evaluation tool was developed. The face validity and content validity of the tool were determined with the Lawasche's method and its reliability was determined with the test- retest method and Cronbakh's alpha coefficient in SPSS-19.

Results: Content analysis of the focus group discussion resulted in 57 indices, classified in 5 categories (including: the educator, the Trainees, Administration of clinical training, field of clinical training and Evaluation of clinical training). Finally, the final tool was adjusted in two separate questionnaires. The correlation coefficient for the questionnaire of the clinical educators was 0.9, its Cronbakh's alpha coefficient was 0.88 and its content validity coefficient was 0.84. The correlation coefficient for the questionnaire of the students, was 0.7, its Cronbakh's alpha was 0.92 and its content validity coefficient was 0.81.

Discussion: The tool designed for the evaluation of clinical training in rehabilitation disciplines has appropriate and acceptable validity and reliability.

Objectives: Autism Spectrum Disorder (ASD) is a group of neurodevelopment syndromes with impairments in social communications and restrictive or repetitive behaviors. Neurofeedback is a new method that may regulate neuro and metabolic function in brain. This study is semi-experimental, with pre and post test. 
Methods: In 26 children with ASD, 40 sessions of Neurofeedback were done. Brain waves were recorded before and after intervention by EEG/ERP 19 channels. 
Results: The average of Theta (low frequency) power decreased, but there was no difference in the Gamma of Gamma waves (High frequency). 
Discussion: Our findings showed that the implementation of Neurofeedback sessions improved Theta, which leads to better social communication.

Objectives: To assess the relationship between visual rehabilitation with the quality of life and visual status in children who had been diagnosed with amblyopia in the national amblyopia screening program.
Methods: Information was gathered from optometric centers in the cities of Nowshahr, Chalus, and Kelardasht, or in case it was not available, from parents of participating children. The KINDL Health-Related Quality of Life Questionnaire for Children was also completed by the children. Children were examined regarding visual acuity, stereopsis, strabismus, and refractive errors. Statistical tests such as one way ANOVA and Pearson correlation coefficient were used via SPSS software version 22.
Results: Overall, the researchers obtained the records of 90 children with amblyopia, of which 76 were included in the study based on the inclusion criteria. The amblyopic children who did not have an early and timely start of treatment aid and did not complete treatment were the most prevalent group (38.2%). The lowest frequency (13.2%) pertained to those who did not have a timely start of treatment but experienced a completed treatment process. The highest proportion of children with entirely uncorrected amblyopia was those who had a timely start of treatment but did not complete the treatment. The majority of amblyopic children who had a completely corrected amblyopia had strictly acted in accordance with their therapist’s prescription. In contrast, the majority of those children whose amblyopia was left completely untreated had not acted in accordance with the therapist’s prescription. The children who had started treatment early but had not completed it obtained the lowest score on quality of life. The highest mean score was observed in the children who had completed their treatment process, either with or without an early start of the treatment.
Discussion: The completion of treatment seemed to be of higher importance in the correction of amblyopia and increased the quality of life than the early start of treatment. Therefore, the authorities and therapists are recommended to pay more attention to follow-ups for completion of the treatment process and its important impact on improving eyesight and children’s quality of life.