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Objective Speech and language disorders, when happening during childhood will ultimately lead to important negative outcomes in the life of the child. The farther we move from this critical period, that is, the first 3 years of life, the less will be the positive effects of environmental stimuli on the development of speech and language. Early detection of children at risk for or in the preliminary phases of developmental delays and provision of early intervention services for them is of utmost importance. The objective of this research was to compile and produce protocols for early intervention in childhood speech and language developmental disorders in Iranian children. Materials & Methods This study was conducted in two main phases: review phase and qualitative phase. In the review phase, all accessible search engines and databases, especially those for systematic reviews and guidelines were searched. In the qualitative study phase, several focus group discussions and rounds of Delphi were carried out with 20 experts in 7 subgroups, who were selected purposively. Results The result of this study is presented as 7 intervention packages, including the following domains of disorders: prelingual lingual speech and language hearing impairment, speech sound, dysphagia, stuttering, and dysarthria Conclusion Most studies have confirmed the effectiveness and need for early interventions for children with speech and language impairment. However, most do not explain the details of these interventions. Before the present study, no systematic and evidence-based protocol existed for early intervention in childhood speech and language impairments, in Iran; and due to language differences, as well as possible differences in the speech and language developmental process of children of different communities, making direct use of non-Persian references was not possible and effective. Thus, there was a clear demand for the production of such a protocol.

Objective: This research was made to personal- social developmental screening of 4-60 months old children in Tehran city by DDST-II and ASQ and determining the agreement coefficient of two tests. Materials & Methods: In this study, the personal-social developmental status of 197 children 4-60 months old were screened by using ASQ and PDQ (93 girls and 104 boys). Convenient sampling was used. Data was analyzed by SPSS software. Results: By using DDST-II and ASQ personal- social developmental delay detected in 11% and 1.5% of children respectively. The estimated consistency coefficient between DDST-II and ASQ for Personal- social domain was 0.06. Conclusion: In this study personal- social developmental screening of children showed different results and kappa measure agreement of two tests was weak. For selecting a suitable tool we must consider the psychometric characteristics (sensitivity, specificity, positive and negative predicting power) of the tool. This study showed that the results of developmental screening of 4-60 months old children in Tehran by using ASQ and PDQ lead to different results. This finding emphasizes the need to comparing the results of screening tests with a diagnostic gold standard test.

Objective: 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. Materials & Methods: 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. Results: 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. Conclusion: The Persian version of the Bayley Scales of Infant and Toddlers Development Screening test is a valid and reliable tool.

Objective: Emotional intelligence has an important role on mental and social health of children and its defect prompts children for many problems. The aim of this study was to investigate the effectiveness of emotional intelligence training on reducing aggression and hyperactivity of girl students with physical disability. Materials & Methods: This study was experimental and؛ Pre-test post-test with control group was used. The samples were 40 physically disabled girl' 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. Results: The emotional intelligence training reduced the aggression and hyperactivity of students. The pre-testو post-test results by teachers (P

Objective: 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). Materials & Methods: 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. Results: The children with Down syndrome scored significantly lower than the mentally retarded children in the areas of gross motor skill composite (P

Objective: The present study aimed to determine the effectiveness of attribution retraining group program on anxiety of students with learning disabilities. Materials & Methods: 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. Results: 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). Conclusion: It was concluded that attribution retraining group program can not probably reduce anxiety symptoms of students with learning disabilities.

Objective: To gauge the gross and fine motor development of early treated phenylketonuria (ETPKU) in children in the age range of 1–4 years. Materials & Methods: 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. Results: 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

Objective: This Study aimed to investigate the level of personal-social developmental skills in 1-4 years old children with early treated phenylketonuria. Materials & Methods: This analytic, cross-sectional study has been done on 40 children 1-4 years old referred to clinics of phenylketonuria (PKU) who were diagnosed through screening at birth and were treated. The measurements were a demographic questionnaire, ASQ (Ages & Stages Questionnaire) and clinical assessment by pediatrician. Forty children were also selected randomly as control group from kindergartens of Tehran and completed the questionnaires. Data were analyzed by SPSS 19.0 software. Results: The mean age of Children was 30.7 (±10.5) months in the control group and 27.7 (±11.0) months in the case groups. There was no significant differences between two groups in terms of delivery type and the current and birth height, weight and head circumference. There was a significant difference between two groups regarding personal-social developmental skills (P

Objective: Having a child with cerebral palsy affected all aspects of quality of life the mothers. This is a Quasi-experimental study which was carried out in order to determine the effects of applying supportive program health-centered on the quality of life of cerebral palsy children’s mothers. Materials & Methods: This study is a quasi-experimental research with two groups case (n=30) and control (n=30) who were selected by random sampling method. Supportive Programs health-centered for case group performed in three stages (assessment, protection and evaluation). Data collection tools include: demographic questionnaire and quality of life questionnaire. Data collected before and two months after intervention. Statistical analysis was done by spss16 software. Results: Data analysis with Chi-square showed that demographic data were similar in both groups (P>0.05). Comparison of quality of life after intervention by independent samples t-test was significant in two groups (P0.05). Paired t-test showed that there is a significant difference between mean scores of eight dimensions of QOL and whole QOL before and after study in experimental group (P0.05).meams difference of whole QOL was significant in Both groups (P

Objective: This research was designed to evaluate the developmental status of children aged 4–60 months in Tehran city by two developmental screening tests, Denver Developmental Screening Test II (DDST II) and Ages and Stages Questionnaires (ASQ) and also to determine the consistency coefficient between these two tests. Materials & Methods: In this cross–sectional study, DDST II and ASQ were performed on 197 children (104 boys, 93 girls), aged 4–60 months (Mean=23.5 months), at four health centers in Tehran city. Evaluation of 15% of children was repeated by Developmental Pediatricians who were blinded to the screening results. Results: Developmental disorders were observed in 37% and 18% of children who were examined by DDST II and ASQ tests, respectively. Considering those children who were healthy but their parents were concerned about their developmental status, these figures changed to 38% and 43%, respectively. The estimated consistency coefficient between DDST II and ASQ was 0.21 which is weak (P=0.002) (for gross motor 0.24, language 0.18, personal-social 0.06 and fine motor 0.05). The consistency coefficient between the physicians’ examination with DDST II and ASQ were 0.17 (P=0.099) and 0.47 (P=0.003), respectively. Conclusion: A weak consistency coefficient was found between DDST II and ASQ tests. Therefore, the results of these two screening tools should be compared with a developmental diagnostic test in order to choose an appropriate screening tool.

Objective: Cerebral palsy is a nonprogressive disorder in body posture and movement, due to different etiologies. Different medical and rehabilitation interventions include massage have been used in these children. This study has been done to determine the effect of adding massage to occupational therapy on muscle tone of children with spastic cerebral palsy. Materials & Methods: This study was a double blind clinical trial. The children were recruited from clinics of University of Welfare & Rehabilitation Sciences. The individuals were divided to intervention and control groups. The routine rehabilitation techniques were done in 3 months in both groups. The intervention group received massage for 30 minutes before rehabilitation. Muscle tonicity was evaluated at the beginning of the study and 3 months later by Ashworth test. The data analysis was done by parametric (t test, paired t test) and nonparametric (Mann Whitney, Wilcoxon) tests. Results: Thirteen subjects of case (intervention) group and 14 subjects of control group were studied. The average age in case group and control group was 49.5, and 42.1 months respectively. There were no statistically significant differences in Tonicity of upper and lower limbs, trunk and neck between intervention group and control group (P>0/05). Conclusion: In general based on the results of this study, adding massage to occupational therapy had no effect on tonicity of spastic cerebral palsied children. Regarding to some effects of massage mentioned in different articles on physical abilities of children with C.P. as well as executive limitations in this research, it is not possible to reject the effects of homeopathy on physical abilities of children with C.P.

Objective: High risk infants are those who have a history of one or more risk factors in prenatal, perinatal or postnatal period in their developmental period, shown as developmental delay (DD). The incidence of DD in these infants is higher than normal. This study is done in order to determine the incidence of motor developmental delay (MDD) and effective risk factors in developing of it in high risk infants who have been refered to developmental disorders center of SABA. Materials & Methods: Study is a descriptive (incidence determination) and analytic case – control type (Effective high risk factors determination). The samples include 403 referred infants from health centers and pediatric clinics of Tehran that have the history of one or more risk factors. The infants with MDD defined as cases and infants who had refered to SABA center for other reasons as controls. Results: The incidence of MDD in high risk infants was 30% that was significantly higher that of normal values. The most effective risk factors were prematurity (25.6), low birth weight (19%), neonatal seizures (7.4%), hyaline membrane disease (6.6%) systemic infections of mothers in pregnancy (5.7%) and severe neonatal hyperbilirubinemia (4.9%) in sequence. Conclusion: Regarding to effect of above risk factors in developing of MDD necessary and suitable attempts should be done for prevention of these factors in order to decreasing the incidence of DD. Developmental delayed infants also should be diagnosed early in order to early intervention rehabilitation & therapy in order to achieve a better results.

The baby's first words producing is one of the most important index of development. Development of talking is through a complex process that is influenced by both neuromaturation and human relationships (environment). It is not an imitative function in which children learn to repeat what they hear, but also it is a creative process through which children master a rule based, symbolic system. Talking development can be evaluated in 5 important dimensions: phonology, semantics, morphology, syntax and pragmatic. The receptive and expressive abilities of the child must be evaluated also. This paper discusses about the epidemiology, etiology and pathogenesis, clinical manifestations, how to assessment and make early diagnosis, differential diagnosis, management (treatment and rehabilitation) and prognosis of delayed or atypical talking in addition to above definitions. This paper also emphasizes on early intervention for children who develop significant behavior problems secondary to their communication difficulties and for whom long-term problems in social development are a major concern.

This disorder is too rare that about 100 patients have been reported in the world. In this condition a liver enzyme (methylmalonyl CoA mutase) which should carry out one of many thousands of chemical processes that turn protein into energy or body tissues is defective. Clinical presentation of this disorder in first months of life may be failure to thrive, lethargy, poor feeding, mental retardation and seizures. Late-onset manifestations include other neurologic findings e.g. dementia, myelopathy and gait disorder. Increases in levels of plasma methylmalonic acid and homocystine confirm the diagnosis. Unlike patients with classic homocystinuria, plasma level of methionine is normal in these patients. The patient was 13.5 years old girl that presented to us due to convulsion, losing the ability to walk, loosing appetite, developing urinary incontinence and showing intellectual regression. In a number of investigations, there was severe increasing in urinary and plasma levels of methylmalonic acid and homocysitine. The patient has commenced on treatment with high doses of vitamin B12, Betaine and Carbamazepine and also physiotherapy. Following the treatment marked improvement in neurologic and mental state appeared and also Methylmalonic acidemia and homocystinuria was controlled.

The term “fragile X syndrome” is named after a constriction recognizable on chromosome (at Xq 27.3) cultured at chromosome media without folic acid. The unstable part includes repetition of 3 nucleotides which is intensified at subsequent generation (DNA amplification) and gives rise to a more severe phenotype in the individual. About 20% of males have normal fragile X syndrome. The daughters of these individuals have abnormal chromosomes (carrier) and their grandchildren will be marked. In typical syndrome, the boys will suffer from mental retardation, macrocephalia, large or protruding ears, elongated face, and macroorchidism. In terms of behavioral comorbidity, symptoms are similar to pervasive developmental disorder such as autism and attention deficit/hyperactivity disorder. The impairments in cognitive abilities are manifested as learning difficulties to severe problems. Our patients were 2 boys (6 and 7 years old) referred due to their hyperactivity. In physical examination, attention deficit/hyperactivity disorder as well as fragile X syndrome were confirmed. In chromosome culture test, the constriction at Xq 27.3 was specified.