محمدرضا راه چمنی

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.

To study the knowledge, attitude and practice in breast feeding mothers in the field of physical activities and related factors on exercises. Tow hundred breast feeding mothers referring health and treatment centers of Tehran have been random selected from five centers through the questionnaire and their knowledge, attitude and related factors on exercise were studied. Regarding practice, Global physical activity questionnaire from World Health organization was used evaluating the three fields of work, exercise, leisure time, going from one place to another, level of physical activity. Data were analyzed using SPSS Statistical software after being collected. According to the data from this research, 74.5% of mothers were highly aware while 80.5% had positive attitude toward exercising during lactation. In term of physical exercise only 14% were performing some type of sport activity. Regarding physical activity, 58% of the subjects had average physical activity among the total activities in all three fields. As well the study showed that the average physical activity among lactating mothers in the field of work was 38 min per day, going from one place to another using bicycle or walking for 15 min per day and 5 min per day of exercise in the field of sport activities.Among the most important factors of having no sport activity the reasons were having no enough time, having small children, giving no importance to sport activities and lack of exercise space for women respectively. However most of breast feeding mothers in this study had high knowledge and positive attitude toward the benefits of exercises during lactation, their activity level was so limited. So it is recommended that health employees, especially those in health and treatment centers should encourage mothers to perform and follow both health behaviors, namely exercise and breast feeding and arrange short term exercise plans for lactating mothers in post labor and lactation care services. Further researches on the effects of health training models on exercises in lactating mothers seem to be necessary.