afsoon hassani mehraban

Cerebral palsy is one of the most prevalent physical disabilities in childhood. Children afflicted with this condition face a myriad of challenges and potential disabilities, which complicate treatment efforts. Integrating scales with other diagnostic instruments is increasingly crucial for accurately assessing these children and devising effective treatment strategies. This study primarily aims to review functional classification systems based on the International Classification of Functioning, Disability, and Health (ICF) for children with cerebral palsy and explore the relationships among these systems. This study was designed to review the ICF-based functional classification systems. A comprehensive search was conducted across multiple databases, including Google Scholar, PubMed, ERIC, OVID, ProQuest, Scopus, Web of Knowledge, and OTseeker. Search terms related to cerebral palsy and various aspects of body function, activity, and participation were utilized. The search was conducted until September 2022 to gather relevant literature for analysis. The analysis of the reviewed articles revealed the existence of five valid and reliable classification systems. In most studies, the correlation among these systems was moderate. Owing to their simplicity and comprehensiveness, these classification systems have significantly impacted the depiction of the functional status of children with cerebral palsy and the quality of their care. However, additional classification systems remain needed to address other overlooked functions and complete the overall description. The outcomes of this review indicated the development of classification systems for certain functions in children with cerebral palsy. In conjunction with the classifications above, creating additional new systems for overlooked functions could offer a comprehensive and integrated understanding of children with cerebral palsy's crucial functional capacities and performances.

Considering the prevalence of stroke, an economical and reliable questionnaire is needed for use in research and rehabilitation to measure the amount of burden on caregivers of stroke patients. True to our knowledge, there is no exclusive Persian language instrument for assessing the burden of stroke caregivers. The current study investigated the validity and reliability of the Burden Scale for Family Caregivers-short version (BSFC-s) for stroke patients’ caregivers.

In this cross-sectional study, 51 stroke patients and their caregivers were studied using the above-named questionnaire translated from English into Persian. Construct validity of the questionnaire was evaluated by Spearman and Eta correlation. Cronbach’s Alfa was used to assess internal consistency. Factorial structure was evaluated by exploratory analysis.

The test-retest reliability of the questionnaire was calculated to be 0.93, and the questionnaire’s internal consistency was 0.93. The construct validity of the questionnaire was acceptable.

In general, it can be said that this questionnaire has a good structure for assessing the burden of caregivers. In addition, by 10 items we can consider this questionnaire as an economically viable option in research and practice.

 The International Classification of Functioning, Disability, and Health (ICF) can identify body function, structure impairment, activity limitation, participation restriction, and contextual factors.

 Considering the importance of the role of environmental barriers in disability and function, this study aimed to investigate the environmental barriers affecting the function of individuals with multiple sclerosis (MS) based on the Comprehensive ICF Core Set for MS.

 This cross-sectional study was conducted on individuals with MS who are registered in the ICF Medical Commission. The participants completed the consent form, the Persian version of the Craig Hospital Inventory of Environmental Factors, Functional Independence Measure (FIM), and a demographic questionnaire based on the ICF Core Set for MS. The data were analyzed using SPSS software (version 25).

 A total of 140 individuals with MS (34 males and 106 females) participated in this study. The most frequently reported environmental barriers were structural and physical, and the least frequently reported barriers were related to work and school. The barriers related to attitudes and support were significantly associated with the motor function (P = 0.003) and total FIM score (P = 0.002). The variables of attitudes and support and policies were the main predictors of motor function (RS = 0.093, P < 0.001) and the total FIM score (RS = 0.109, P < 0.001), respectively. None of the barriers was significant and predictive of cognitive function.

 Since environmental barriers can affect the function of MS patients, authorities should implement the necessary strategies to eliminate these barriers and facilitate participation.

Clinical education is a bridge between theory and practice. The purpose of this study was to develop strategies to promote the quality of occupational therapy fieldwork education.  

The qualitative content analysis was used to identify the promoting strategies of fieldwork quality in occupational therapy from students' and fieldwork educators’ perspectives during the 2019–2020 academic sessions. Participants were 12 fieldwork educators (mean age=39.33 yr, Male=5, female 7) and 14 students (mean age=23.28 yr, Male=7, female 7) in the code extraction phase and 16 fieldwork educators (12 of them were in code extraction phase too) in actions of strategies scoring phase.  

Following the content analysis of the data, the prompting strategies categorized into 4 major categories and 10 subcategories: factors related to Fieldwork educators (Improving clinical teaching skills, Enhancing fieldwork management skills, Motivating fieldwork educators, and Fostering coordination between fieldwork educators), related to Educational Planning (Modifying clinical fieldwork planning, Revising curriculums), related to Students (Empowering students, Motivating students) and related to Fieldwork settings ( Improving the social environment, Improving physical environment ). Based on the qualitative content analysis and 3 expert panels. Finally, the 23 promoting actions were identified.  

Improving the quality of fieldwork education in occupational therapy needs a systematic collaboration between educators, students, and educational planners. Doing the promoting actions on fieldwork education process in occupational therapy may improve the quality of fieldwork education process.

Action Observation Therapy (AOT) is a top-down approach that has been recently introduced in the rehabilitation of neurological disorders mainly after stroke. The main goal of this study was to investigate the effects and feasibility of a new technique in AOT procedure (called self-AOT) following periods of no treatment and routine AOT intervention on upper limb motor function, occupational performance and neurophysiological changes in a stroke patient.

A single-subject A-B-A-C design was used and a 58-year-old woman with a 3-year history of left hemiplegia poststroke participated in this study. In the baseline (A1, A2) phases, the patient received no treatment. In the first intervention (B phase), she received a 4-week AOT, and in the second intervention (C phase), a 4 week of Self-AOT was practiced. In all phases, upper limb motor recovery as a target outcome was evaluated on 4 occasions using the Fugl-Meyer assessment. Upper limb function, dexterity and spasticity were assessed using Action Research Arm Test, Box-Block Test and Modified Modified Ashworth Scale respectively. Occupational Performance/Satisfaction was assessed with Canadian Occupational Performance Measure and to assess neuroplasticity, Motor Evoked Potential was recorded by Transcranial Magnetic Stimulation. Visual analysis, slope, and percentage of non-overlapping data were used for assessing the changes between phases.

Percentage of non-overlapping data and slopes indicated that motor recovery had clinically relevant improvements after both interventions compared to baselines. Other outcomes also showed improvements except for spasticity of wrist/elbow flexors and Motor Evoked Potential of opponens indicis.

Self-AOT may be as effective as other procedures of AOT for improving upper limb motor function, occupational performance/satisfaction, and cortical excitability post-stroke.

This study was conducted to determine the construct validity and reliability of the Children Participation Assessment Scale in activities outside of School–Child version (CPAS-C) in 6-12-year-old children with physical disabilities (PDs).

In this methodological study, participants were 100 children with PDs, recruited from a school for exceptional children with physical-motor disabilities and 100 normally developing children. For assessing the test-retest reliability (ICC), 40 children with PDs completed CPAS-Cwithin a two-week interval, and for assessing the internal consistency (Cronbach’s alpha) and construct validity, 100 children with PDs separately completed the Vinland Adaptive Behavioral Scale (VABS) and CPAS-C.

The majority of participants were children with CP, among whom the highest and lowest ratios were related to diplegia (32%) and dystonia (1%), respectively. The results showed that CPAS-C had acceptable reliability (ICC: 0.6-0.99). Cronbach’s α score was between weak to moderate (α = 0.25-0.75). The difference in the score of participation between the two groups (normally developing children and children with physical disabilities) was significant in all areas (P<0.001).

The CPAS-C had acceptable psychometric properties; it can be used as a valid and reliable tool for assessing the participation of 6-12-yearold children with PDs in school activities

Clinical education is a vital factor in the process of learning in medical sciences universities. The aim of the present study was to explore the perspectives of fieldwork educators and students concerning barriers to occupational therapy fieldwork education in Iran.

A qualitative research was conducted from May 2019 to April 2020 to address the study objectives. The data analysis was performed using conventional content analysis based on Graneheim and Lundman’s approach. Purposive sampling was used to enroll 12 educators and 14 students of various backgrounds (physical disabilities‑adult, physical disabilities‑pediatrics, psychosocial‑adult, and psychosocial‑pediatrics) in the study.

The findings indicated that the main themes were related to fieldwork educators, fieldwork settings, educational planning, students, and educational regulation.

It can be concluded that the perspectives of students and occupational therapy educators regarding the field of clinical education are not only important but also useful for the attainment of effective clinical education and the development of knowledge related to rehabilitation nursing education. Therefore, educational planners should develop effective programs based on these themes.

Multiple Sclerosis (MS) is a neurodegenerative disorder. The progressive and unpredictable nature of MS indicates the patients’ need for long-term care as well as the increased burden of their primary caregivers’ care and occupational challenges that emerge in their daily life activities.

The current study aimed to explore the occupational challenges caused by engaging in the care process for the caregivers of people with MS

This qualitative study was conducted on 21 caregivers of MS patients using a content analysis approach. Data were collected through semi-structured face-to-face interviews.

Three main themes emerged: Time limitations in occupation implementation, care needs in occupation implementation, and emotional reactions affecting occupations.

According to the results, the caregivers of people with MS were faced with a variety of occupational challenges. The time limitations for performing routine occupations and desired activities, unmet patient care-facilitating needs, and the occurrence of psychosocial reactions and behaviors were contributed to these challenges and their exacerbation. Identifying these challenges is both useful for designing interventional programs and to help caregivers to successfully perform their desired occupations in spite of challenges in the care process.

 Fatigue is one of the most debilitating conditions associated with cancer and anticancer therapy. The purpose of this study was to translate the fatigue questionnaire in Persian for developing an appropriate instrument to evaluate the effect of rehabilitation and other interventions on fatigue in intended patients. 

 The present study was analytical and descriptive. Thirty experts and 15 children with cancer who were treated at Mahak Hospital and their parents were asked to participate in the study through convenience sampling. For content validity, CVI (content validity index) has been calculated as an aggregation of concessions for each item that has earned "Relevant but Needed to Review" and "Completely Related" points divided by the total number of specialists. To determine the CVR (content validity ratio), experts were asked to check each item based on the three-part spectrum. To assess the face validity of the scales, forms for rating and explaining the scoring for questionnaires of all three scales were given to 15 participants, and they were asked to answer each question scale based on the three concepts of relevance, clarity and simplicity on the 4-point graph. Scores higher than 0.79 indicated the suitability of the items for further analysis. 

 The translated questionnaire was completed by the participants. In the content validity section, according to the critical point of the Lawshe table, CVR was acceptable at 0.49. The translation of items by CVI less than 0.79 was modified. Finally, CVIs of all items were averaged, and the final score was determined as the CVI level. In the face validity section, scores higher than 0.79 indicated the suitability of items for further analysis. 

 The Persian version of fatigue scale can be considered as one of the suitable instruments in measuring the influence of fatigue on activities of daily living.

The benefits of play-based occupational therapy for hospitalized children with cancer warrant further exploration. Pediatric cancer disease symptoms, complications from treatment, and multiple and prolonged hospitalizations restrict participation in the daily activities of a child’s life. However, occupational therapy services in pediatric oncology are limited because of the disease nature, treatment complications, hospital environment, and unclear play-based occupational therapy frame. For this purpose, we decided to introduce the process of occupational therapy in such children, using the play-based approach by reviewing the current literature. Considering limitations and problems in hospitalized children with cancer, it seems that controlling symptoms, facilitating independent doing of daily activities, improving the Quality of Life (QoL), and making hospital environment more acceptable are more accessible, using the play-based approach compared with other traditional interventions.

For children with Attention Deficit Hyperactivity Disorder (ADHD), different types of play therapy may have different effects. This study aimed to compare the effect of two play therapy intervention methods including a child-parents therapy named as Filial Therapy (FT) and a child therapist therapy known as Adlerian Therapy (AT) on attention and hyperactivity of these children.

In this randomized clinical trial which lasted from February 20 to May 5 of 2014, 51 boys and girls aged 6-12 years with ADHD were selected and allocated randomly by blocked blocks to three groups of 17 subjects in each one. From three groups, two ones received FT and AT intervention and one group remained as a control group. Participation’s parents in the FT group received one session training play therapy per week for 10 weeks and played with their children at home every day during this time. The AT group acquired three sessions play therapy for 10 weeks in the clinics. Attention and hyperactivity of the subjects were gathered in pre and post-test and three months after that as a fallow-up time by Child Symptom Inventory-4 (CSI-4) and Test of Everyday Attention for Children (TEA-Ch). The Mean, standard deviation and frequency were used as descriptive statistics and the Chi-squared, one-way ANOVA, Man-Whitney, Kruskal-Wallis tests, and Generalized Estimating Equation (GEE) were utilized as analytical statistics in the SPSS version of 22. The alpha of 0.05 considered as the significant level.

50 percent of the subjects were male and the mean ± SD of the age of the subjects were 8±2 years old. The mean ± SD of hyperactivity in the FT group were 23.94 ± 13.44, 20.82 ± 11.64, and 20.76±11.13, in the AT group were 17.70 ± 3.70, 15.20 ± 3.33 and 15±3.50, and in the control group were 24.25 ± 10.32, 25.38 ± 11.48 and 24.81±11.96,  respectively. The mean ± SD of attention in the FT group were 8.47 ± 5.33, 15.60 ± 2.79 and 15.80±2.50, in the AT group were 6.71± 5.31, 12.24± 3.33 and 12.90±3.12, and in control group were 9.71± 5.36, 10.41± 3.24 and 9.92±4.89,  respectively. As the result showed, hyperactivity of the subjects had significantly decreased in the intervention groups (p <0.05) compared with the control group. Also, the attention of the subjects had significantly increased in the intervention groups (p <0.05) compared with the control ones.

Although both methods reduced the severity of hyperactivity and increased the attentional performance of the subjects, but the effectiveness of FT method was more enormous. The founding indicated that participating of parents in the treatment process could exceed the rehabilitation procedure of children with ADHD.

Clinical education is a vital part of occupational therapy education process. High clinical education quality in fieldwork settings leads to higher clinical competency and occupational proficiency. One of the most effective clinical education methods in equalizing the conditions of clinical education to students is the correct use of educational models related to each field of medical sciences. In the field of clinical education, various models have been designed with a specific subject. However, limited research has been done on the introduction of the usability of these models in occupational therapy settings. This study was conducted to determine which models have the potential to be used as clinical education models in occupational therapy.

A scoping review was conducted and studies published in English between 2000 and 2018 that examined clinical education models were selected.

A total of 8 articles were entered in the review, and a central theme of implementing clinical education models in occupational therapy was determined by thematic analysis. This central theme consisted of 3 categories: (1) evaluative models, (2) acting models, and (3) evaluative/acting models.

Occupational therapists, especially who work as educators should be aware of the different types of clinical education models and try to use these models in clinical education process and minimize the variation of teaching methods in fieldwork settings to promote the clinical education quality.  However, more research should be done to improve evidence-based occupational therapy practice in clinical education.

Gait analysis through using modern technology for detection of Alzheimer's disease has found special attention by researchers over the last decade. In this study, skeletal data recorded with a Kinect camera, were used to analyze gait for the purpose of detecting Alzheimer's disease in elders.

In this applied-developmental experimental study, using a Kinect camera, data were collected for 12 elderly women with Alzheimer's disease and 12 healthy elderly women walking in an oval path. After extracting various features of gait, descriptive analysis was performed to compare the features between the healthy and patient groups. Then, a support vector machine classifier was designed to detect elderly people with Alzheimer's disease.

The comparison of extracted features from skeletal data of gait using Kinect camera in this study indicate that the results are matched with previous findings from systems based on other types of sensors. The accuracy, sensitivity, precision and specificity of system designed in the present study for classifying elders with Alzheimer's disease and healthy elders were 91.25%, 93.4484%, 90.5945% and 93.581% respectively.

In addition to descriptive analysis of gait, by using machine learning methods such as support vector machine classifier, elderly people with Alzheimer's disease can be detected based on features extracted from skeletal data of Elderly people.

 Older people are at risk of falling and its complications more than other age groups. Evaluation of environmental hazards requires time and money. So it seems necessary to design a self-report questionnaire for initial screening. This study aims to develop a self-report tool for falling risk assessment in Iranian older people.

 After approval of the Ethics Committee of Iran University of Medical Sciences, an expert group prepared and wrote the study items using simple words and fluent structure. The reliability of the questionnaire was evaluated through test-retest method and its validity through content validity method. The elders were residents in their homes and had the appropriate level of consciousness to understand and respond to Persian sentences correctly. Information was collected through questionnaires and observations. Statistical evaluation was performed by SPSS version 16, and the retest test reliability of the questionnaire was determined by intra-class correlation coefficient.

In terms of content validity, Content Validity Ratio (CVR) formula was used, and the agreement between the experts was significant, so the questionnaire has good content validity. Test-retest reliability was calculated by Standard Error of Mean (SEM), and relative and absolute repeatability coefficients showed excellent reliability of this questionnaire. The validity of the questionnaire was calculated based on the Spearman correlation coefficient of 0.95 and P value less than 0.001. The questionnaire contained 15 main questions and 75 sub-questions about the dangers of the home environment.

The results of this study showed high validity and reliability of this questionnaire, so it can be used as a practical tool for identifying the risks of falling at home.

Stroke is one of the main causes of disability and mortality worldwide. Most survivors experience impairments in their upper limb motor function. This experimental study was performed as a clinical trial on 30 chronic stroke patients who experienced stroke from 6 to 96 months ago. Patients were non-randomly divided into the intervention (Virtual Reality besides conventional occupational therapy) and control (conventional occupational therapy) groups. Each treatment session lasted for one hour which was divided into conducting conventional occupational therapy techniques and Virtual Reality (VR) for the intervention group, and routine techniques for the control group. The intervention effectiveness was evaluated by the Fugl-Meyer Upper Extremity Scale, Stroke Impact Scale, Chedoke Arm and Hand Activity Inventory, Motricity Index, Modified Ashworth Scale and goniometer. Results were analyzed by SPSS and one-sample Kolmogorov-Smirnov, Shapiro-Wilk test, Independent Samples t-test and Mann Whitney U test were applied to assess the normality of data and to detect significant differences between study variables. The results suggested that investigated parameters such as upper limb motor function, muscle tone and the range of motion were significantly different in the intervention group, compared to control group; however, there was no significant changes in none of the group’s daily living activities.  VR-based computer games in combination with routine occupational therapy interventions could improve upper extremities functional impairments in chronic stroke patients. However, it seems the mechanisms behind the effectiveness of video games and their impact on brain cortex as well as upper limbs function need to be further investigated.

  Virtual reality is a new technology that has been recently used for different purposes in the rehabilitation of children. This study aimed to investigate the effectiveness of this method in balance rehabilitation of children with Cerebral Palsy (CP). This was an A-B-A design single subject study in which 3 children with hemiplegic CP participated. The baseline phase and intervention phase, lasted 2 and 4 weeks, respectively. Then, the secondary evaluation phase was held at an evaluation session. Intervention sessions as the baseline phase were repeated 3 times a week. In each session, children performed different computer games with displacement of the center of pressure in frontal and sagittal planes (for 21 min). The secondary evaluation phase of this study was held 2 to 3 months after the completion of the intervention phase. The changes made in this study were evaluated by assessment tools of Pediatric Reach Test (PRT), Single Limb Stance (SLS), Plate sensitive to pressure of Biometrics Ltd E-LINK force plate, and Activity Scale for Kids (ASK). Finally, the results were evaluated by C static and the visual analysis method. Comparison of the results of PRT, ASK and the evaluation of planes sensitive to pressure of Biometrics Ltd E-LINK in all 3 phases revealed the significant improvement of dynamic balance and the enhancement of the independence performance of children in daily living activities and the sustainability of the recovery in the secondary evaluation phase. Although, the SLS test results and data of force Plate indicated no significant improvements in the static balance of patients. The study results suggest that weight shift exercises with the use of virtual reality can effectively improve the dynamic balance of children with CP. However, it fails to make a significant change in the static balance of these children.

The ICF (the international classification of functioning, disability, and health) is a globally agreed framework and classification to define the spectrum of problems in the functioning of patients. ICF tools were developed based on ICF Core Set (ICF-CS) for the clinical application of ICF and patient management in the rehabilitation process. The current case report aimed at using ICF-based documentation tools in the occupational therapy process in a patient with chronic stroke. The case was a male who had a stroke 6 months prior to the study. The occupational therapy provided to this patient included 5 patient management components (examination, evaluation, prognosis, diagnosis, and intervention) using the ICF-based documentation tool. After one month, improvement in balance and mobility, going up and down the stairs without help, independent upper and lower body dressing achieved. The ICF was clinically applied to the occupational therapy practice in this case report. Because of the close relationship of ICF tools with the concept of occupational therapy, particularly client-centered approach and holistic evaluation of patients, occupational therapists can use ICF in clinical practice to have a more comprehensive view toward patients’ recovery.

ObjectiveEvidence has shown that because of the multiplicity and diversity of the symptoms of cerebral palsy, integration between different specialists in evaluating the function of this population does not exist. Comprehensive ICF Core Set of cerebral palsy including a set of functions of these children and the aim of this study was to determine the validity of this version based on Iranian Occupational Therapists’ perspectives.
Materials & MethodsThis study was a qualitative study using expert panels and Delphi survey. Experts were the academic staff of the universities that were selected through convenience sampling. Content validity was done by them. Then a Delphi survey was used for generating consensus on the final version. Participants were 50 clinical Occupational Therapists who were invited via email from across the country. An agreement of 75% was considered as the cut-off for inclusion of each code-category.
ResultsAfter expert panels and rounds of Delphi, 60% of the code–categories of comprehensive version of ICF Core Set of cerebral palsy approved by Occupational Therapists. In the final version, 82 code-categories were listed that included 21 code-categories for Body Functions, 40 for Activity/Participation, and 21 for Environmental Factors. This indicates that Occupational Therapists pay more attention to the activity/ participation component.
ConclusionThe validity of the Iranian ICF Core Set for children with CP aged 0–6 years was supported by Iranian Occupational Therapists. It could be the basis for evaluation of this population in Occupational Therapy.

 Informal caregivers who give regular care to their relative, needing help for a time, are at risk of many difficulties such as financial dependency, anger, wandering, social problems and communication problems. The purpose of our study is to translate and validate a Persian version of “burden scale for family caregivers-short (BSFC-s)” to measure the burden of informal caregivers.

 The BSFC-s was translated into Farsi by the world health organization (WHO) method. Content validity was evaluated by 15 experts in the field of occupational therapy and physical therapy using Lawshe’s method. A total of 11 caregivers of stroke families’ patients scored each item for face validity.

 The results indicated that BSFC-s has good face validity. The impact factor was between 2.94 and 4.14. No item had a content validity index (CVI) below 0.79 and based on the Lawshe’s method, the items’ content validity ratio (CVR) was above 0.49.

 The BSFC-s was translated into Persian and its face as well as content validity were acceptable. Nevertheless, further studies are needed to evaluate its reliability and validity.

Clinical reasoning is at the heart of clinical work; it is affected by different field factors. A clear understanding of the reasoning process could solve practitioner's problems on how to make their underlying theories, assumptions and values more explicit. The aim of this research is to understand how clinical reasoning process is formed in the context of occupational therapists working in different clinical settings in Iran.
A purposeful and theoretical sampling of 15 occupational therapists working in clinical settings was performed through semi-structured interviews. All the data were recorded, transcribed, and analyzed using Strauss and Corbin’s (2008) grounded theory approach and constant comparative analyses.
Conceptual model was developed to explain the relationships among the main categories extracted through the grounded theory. Achieve an observable change emerged as the core category. Other important categories linked to the core category were, performing the continuum of clinical reasoning, context of clinical reasoning, and effective factors in clinical reasoning.
Findings showed that achieving an observable change in the client was the main consequence of the action/interaction strategies. Some facilitating factors related to the therapist, helped to process reasoning with a holistic and client-centered view, while also helping to develop the self-belief and professional identity. The dominance of medical views and a lack of health insurance were two intervening factors that constrained the dynamics of clinical reasoning within the context of practice.

Participation in daily life activities is an essential aspect of health, which can facilitate a child’s development. Children with cancer are at risk of functional limitations and participation restrictions. The present study aims to investigate participation of children with cancer in daily life activities compared to healthy peers.
This was a comparative cross-sectional study. In the first phase, we assessed the test-retest reliability of the Iranian Children Participation Assessment Scale in 30 children (6-12 years of age) diagnosed with cancer and their parents (child and parent versions). The second phase of the study included a comparison of daily life activities as measured by the Iranian Children Participation Assessment Scale between the children with cancer (diagnosed at least 4 months prior and currently receiving active treatment) and their age- and gender-matched healthy peers.
The child version had excellent reliability according to Cronbach’s alpha in diversity of activities (0.97), intensity of participation (0.95), with whom they participated (0.95), and enjoyment of daily activities (0.94). The parent version had excellent reliability (Cronbach’s alpha) as follows: 0.99 for diversity, 0.97 for intensity, 0.97 for with whom, 0.98 for enjoyment, and 0.98 for parents’ satisfaction. The coefficients of agreement were 0.77 (total scores of diversity), 0.63 (intensity), 0.60 (with whom), and 0.91 (enjoyment). The child version indicated that children with cancer had significantly lower scores in daily life activities items of diversity (P=0.000), intensity (P=0.000), with whom (P=0.000), and enjoyment (P=0.000) compared to healthy children. Based on the total scores in the parent version, children with cancer showed significantly lower scores in diversity (P=0.001), intensity (P=0.000), with whom (P=0.001), enjoyment (P=0.002), and satisfaction (P=0.000) compared to the healthy group.
The findings of the present study show that cancer diagnosis and treatment can restrict children’s participation in daily life activities. Early planning and intervention to facilitate participation in these activities can minimize negative consequences and may mitigate or prevent adverse long-term functional effects of childhood cancer.

Although the effect of educational methods on executive function (EF) is well known, training this function by a playful method is debatable. The current study aimed at investigating if a play-based intervention is effective on metacognitive and behavioral skills of EF in students with specific learning disabilities.
In the current randomized, clinical trial, 49 subjects within the age range of 7 to 11 years with specific learning disabilities were randomly assigned into the intervention (25 subjects; mean age 8.5±1.33 years) and control (24 subjects; mean age 8.7±1.03 years) groups. Subjects in the intervention group received EF group training based on playing activities; subjects in the control group received no intervention. The behavior rating inventory of executive function (BRIEF) was administered to evaluate the behavioral and cognitive aspects of EF. The duration of the intervention was 6 hours per week for 9 weeks. Multivariate analysis of covariance was used to compare mean changes (before and after) in the BRIEF scores between the groups.
The assumptions of multivariate analysis of covariance were examined. After controlling pre-test conditions, the intervention and control groups scored significantly differently on both the metacognition (P=0.002; effect size=0.20) and behavior regulation indices (P=0.01; effect size=0.12) of BRIEF.
Play-based therapy is effective on the metacognitive and behavioral aspects of EF in students with specific learning disabilities. Professionals can use play-based therapy rather than educational approaches in clinical practice to enhance EF skills.

There is no valid and reliable Persian tool to exclusively assess all of the components of attention.
The aim of this study was to define content validity and reliability of the Test of everyday attention for children (TEA-Ch) in Iranian normal children aged 8 - 11 years. In addition, we defined the construct validity of TEA-Ch with four subtests of Wechsler intelligence scale for children.
Ninety-six 8 - 11 year old students in Tehran filled the first version of TEA-Ch (A) and four subscales of Wechsler’s intelligence scale for children. Thirty- five students were simultaneously scored by two raters. Moreover, the second version of the test (B) was administered on 18 students within two weeks after the first version. The intraclass correlation coefficient was calculated for test-retest and inter-rater reliability of the raw scores in each of the TEA-Ch subtests. Discriminate validity between the TEA-Ch and the four subscales of the Wechsler’s intelligence scale for children-fourth edition (WISC-IV) was assessed, using Pearson’s correlation of SPSS Version 16.
The experts confirmed the content validity of the TEA-Ch after translating some items and modifying them based on Iranian language and culture. The moderate to good test-retest reliability was indicated with the ICC from 0.40 to 0.82. Moreover, the relationship between the scores of the two raters in TEA-Ch was 0.78 to 1, indicating excellent inter-rater reliability. Only five subtests of TEA-Ch were correlated with Wechsler’s subscales (r = -0.314 to 0.339).
According to the results, the test is valid and reliable and can be used for normal Iranian children. Furthermore, attention needs to be assessed by special tools and the results revealed that TEA-Ch is designed to achieve this goal.

Virtual reality is a novel technology which creates attractive environment using computer hardware and software. In these virtual realities people can actively participate and use their motor and cognitive abilities. Current study aimed at investigating effect of virtual reality on the balance of children with cerebral palsy.
Material and This research is a single subject study with ABA design conducted on three children with cerebral palsy (GMFCSΙ level). Basic phase and intervention phase of investigation lasted for 2 and 4 weeks, respectively. Intervention sessions were repeated 3 times per week like base line phase. In each intervention session, children performed different computer games for 21 minutes. These games require center of pressure displacement in the frontal and sagittal planes. Follow-up phase was implemented 2 to 3 months after completion of intervention phase. Changes were measured using following measurement tools: pediatric reach test (PRT), Timed Up and Go (TUG), 10-meter walking (10MW) and subtest of balance and lower limb strength test, including Bruininks-Oseretsky of Motor Proficiency (BOMP). Finally results were investigated using visual analysis and C Statistics.
Comparison of PRT tests and subtest of balance and lower limb strength test, including BOMP suggested significant improvement in static balance (P=0.000), jumping ability, and dynamic balance of children participating in the research and durability of this improvement in follow-up phase, though investigation of TUG and 10MW test results showed no significant improvement.
Results in this research showed that using virtual reality can improve balance in children with cerebral palsy.

One consequence of aging is decline of executive functions. Different, factors such as exercise, have effects on executive function. The aim of tthe present study was to answer the question whether the individuals who are consistently engaged in occupations of sport and reading have better executive functions.
The current retrospective study was performed on 100 participants aged between 50-95 years old. Cluster layer sampling was conducted in four districts of Tehran. Initially, participants were included in four groups of only reading, only sports, both, and none according to demographic questionnaire. Next, they performed three tests of Stroop, Tower of London, and Wisconsin for evaluating the executive functions. To examine the difference between the average scores of executive functions in the four groups, one-way analysis of variance and to examine the difference between groups, paired t-test with Bonferroni correction were run.
The results of the present study showed that there is a significant difference between people who have no continuous occupations (sports and reading) from adolescence to the present and the other three groups in executive function tests. But no significant difference was observed between the other groups.
People who are doing one of the occupations of sport, reading, or both have better executive functions compared with those who do not do any of these occupations. It seems that early enagagement in sport and reading in younger years and continuing it until aging could prevent a sharp drop in executive functions in aging. But further longitudinal studies are needed to investigate this theory.