maryam mokhlesin

Children with cerebral palsy (CP) are at a heightened risk of developing feeding and swallowing disorders, which are influenced by a variety of medical, cultural, psychosocial, and nutritional factors. The prevalence rates of these disorders vary widely across different studies, highlighting the complexity and multifaceted nature of these challenges.

This study aimed to determine the prevalence of feeding and swallowing disorders and to explore the factors associated with the severity of swallowing issues in Iranian children with CP.

A cross-sectional study was conducted with a convenience sample of 111 Iranian children with CP. The study assessed feeding and swallowing problems through clinical evaluations and parental reports. Data analysis was performed using IBM SPSS version 20, utilizing chi-square and Spearman's correlation coefficient tests.

The study found that feeding and swallowing problems are common among Iranian children with CP, with 79.2% of children having feeding disorders and 78.3% experiencing swallowing difficulties. Of particular concern, 40.5% of the children showed issues during the pharyngeal phase of swallowing, and 12.6% exhibited unsafe swallowing patterns. There were significant correlations between the severity of swallowing issues and several factors: Malnutrition (P ≤ 0.001), gastroesophageal reflux disease (GERD) (P = 0.007), motor impairment (P ≤ 0.001), and caregiver concern (P ≤ 0.001). Malnutrition was found in 60% of the children, yet only 23% were receiving dietary supplements, and a mere 2.7% were using tube feeding.

Feeding and swallowing disorders, along with malnutrition, are highly prevalent in Iranian children with CP. The positive correlation between the severity of swallowing issues and malnutrition underscores the critical need for early, multidisciplinary interventions to address these challenges.

One of the dysarthria features is inaccurate articulation of consonants and vowels, which is the main cause of speech unintelligibility. However, it is not clear what acoustic measures are more related to speech intelligibility in dysarthria. On the other hand, the number of vowels, their articulation and acoustic characteristics are various in different languages. As far as we know, no study investigated vowels articulation in developmental dysarthria in Persian, so there is not enough information about movement details which make their inaccuracies articulation. Hence, the present study aimed to investigate some acoustic measures including vowel formants, vowel space area (VSA), formant centralization ratio (FCR) and vowel articulation index (VAI) and aim to study their correlation with speech intelligibility in Persian speaking children with dysarthria due to spastic cerebral palsy. In this cross-sectional study, 11 children with dysarthria aged 3-9 years and their healthy matched peers were selected through convenience sampling. For each of six Persian vowels, two monosyllable words were acoustically analyzed using PRAAT software. To determine intelligibility of words and vowels, the percentage of correct detected ones was calculated. Results showed a significant difference between the two groups in the third formant of the vowels /a/ and /u/ and the second formant of the vowel /o/. The vowel space area and intelligibility were significantly reduced in dysarthria. VAS was more correlated with intelligibility and is a good acoustic measurement to assess speech intelligibility in dysarthria. However all three studied acoustic indices had moderate significant correlation with intelligibility.

Some variables, such as age, gender, regional and dialectical differences influence speech tempo. Men and younger individuals speak faster than women and the elderly. Therefore, these variations should be considered when assessing speaking rate.

Since different accents influence speaking rates and there is no previous study investigated speech tempo with respect to regional and accent differences in Iran, and given that the elderly are more prone to problems influencing speaking rate, the present study was done to compare speech tempo and speaking rate in two different accents, namely Tehrani and Semnani, and to investigate some related factors.

This cross-sectional study was performed on 200 elderly women selected via convenience sampling method. Speech tempo, speaking rate, verbal fluency, and cognition scores were compared using an independent-samples t-test. Pearson’s correlation coefficient test was used to assess correlations between speaking rate and level of education, Montreal cognitive assessment (MoCA), and verbal fluency scores.

No significant difference was found in speech tempo between the studied accents (P = 0.13). Speaking rate was significantly slower in the Tehrani accent than the Semnani one (P = 0.04). The Tehrani elderly obtained significantly less scores in verbal fluency and MoCA ((P ≤ 0.001) and (P = 0.04), respectively. In both groups, speaking rate had a significant correlation with verbal fluency and MoCA scores but not with level of education.

Although, our results showed no difference in speech tempo between the studied accents, the Tehrani elderly unexpectedly spoke more slowly meaning that they paused more while speaking. There was a relationship between faster speaking, better verbal fluency, and cognitive performance.

 Increasing the range of motion in joints is considered to be one of the most long term concerns in the treatment of cerebral palsy (CP).

 The purpose of this study was to investigate the effect of using whole body vibration (WBV) as a new therapeutic approach, with stretching exercises on the range of motion in lower extremities in children with CP.

 In this single-blind clinical trial, 20 children aged 4 to 12 years were enrolled. Participants were randomly divided into experimental and control groups. Control group received only passive static stretching exercise and experimental group received passive static stretching with WBV. Exercises were performed 3 times a week for 6 weeks. To collect data, Goniometry, modified Ashworth scale and 6 Minute Walk Test were used.

 The results of this study indicated that, stretching with WBV, increases active range of motion in hip flexion, abduction and ankle dorsal flexion and also can improve speed of walking in children with CP.

 According to the findings, the use of WBV can be considered as an effective treatment in increasing the range of motion and walking speed in CP children.

Increasing the range of motion in joints is considered to be one of the most long term concerns in the treatment of cerebral palsy (CP). The purpose of this study was to investigate the effect of using whole body vibration (WBV) as a new therapeutic approach, with stretching exercises on the range of motion in lower extremities in children with CP. In this single-blind clinical trial, 20 children aged 4 to 12 years were enrolled. Participants were randomly divided into experimental and control groups. Control group received only passive static stretching exercise and experimental group received passive static stretching with WBV. Exercises were performed 3 times a week for 6 weeks. To collect data, Goniometry, modified Ashworth scale and 6 MinuteWalk Test were used. The results of this study indicated that, stretching withWBV, increases active range of motion in hip flexion, abduction and ankle dorsal flexion and also can improve speed of walking in children with CP. According to the findings, the use of WBV can be considered as an effective treatment in increasing the range of motion and walking speed in CP children.

Many very‑preterm infants have difficulty in oral feeding during the first months of life after discharge. Since studies surveying the presence of feeding problems after the first year of life are limited and cultural/psychosocial differences can affect results, so the aim of this study was to compare scores of a feeding problems test between very‑preterm and full‑term born children at the age of 2 and study the relationship between obtained scores and explanatory variables. This is a retrospective descriptive‑analytic study conducted in 2014 in Semnan city of Iran. Thirty‑eight 2‑year‑old children with the history of very‑preterm birth were selected by census sampling method and 38 full‑term babies born in the same hospital were selected randomly. The Iranian version of Lewinhson Feeding Disorders questionnaire was used and the relationship between explanatory variables and the total score of the questionnaire was surveyed in each group by Mann‑Whitney and linear regression tests. Mean (SD) gestational age and weight of birth were 30.47 (1.63) weeks and 1630 (310) grams respectively in the very‑preterm group. Feeding scores were not significantly higher in very‑preterm babies, neither in total score (p 0.05) nor in subtests. A relationship was just found between total feeding score and female gender both in the exposed group (β = −0.36, p = 0.01) and non‑exposed group (β = −0.49, p = 0.002). Two‑year‑old children born very preterm did not have higher feeding problems scores than full‑term born peers. Male gender was related to more feeding problems at 2 years of age.

In addition to the child, disability also affects the family, especially the mothers. Since attention to maternal health is influential on family and community health and the level of satisfaction and quality of life of people is influenced by society and culture, this study evaluated the quality of life of mothers with a mentally retarded child and its related variables in the city Semnan (Iran).

This is a cross-sectional study. Census method was used to study mothers of intellectual disability children and 43 of them participated. Control group included 43 of mothers with normal children too. A demographic form and World health organization summery test of quality of life (WHOQOL-BREF) were used for data collection. Total score and each subtest were compared between the groups and correlations between scores and demographic data were studied.

Total score of the test and also psychological and environmental subtest scores were significantly lower in the study group. Among studied variables (age, sex, communication and appearance of children, number of children and family`s income also mother`s education and outside working), just mother`s education and family’s income had a significant weak negative correlation with quality of life (z=-0.3).

Mothers of mental retarded children were less satisfied. There was a negative correlation between such dissatisfaction and mother`s educational level and family income which can be due to more expectations of such mothers from the child. So mothers of mental retarded children especially with more education need supports and consultations to improve their quality of

Sucking behaviors may have negative effects on occlusion and thus the production of specific speech sounds. The main purpose of this research is the study of the relationship between the behaviors of sucking and speech sound disorders in children 3 to 5 years old.
This research is a retrospective descriptive analysis which 60 children between 3 to 5 years old from kindergartens of Semnan City were assessed. Data collection tools included a self-administered questionnaire and Farsi version of phonological test, which contained 5 subtests of diagnostic, phonetic, phonological, oral motor and instability. Correspondingly, Chi-square test was used for the analysis of data.
There was not any statistically significant relationship between sucking behaviors (breast feeding, bottle feeding, sucking pacifier and sucking finger) and speech sound disorder. There was not also any statistically significant relationship between the duration of these behaviors and speech sound disorders.
The results of this study may reduce some of the parent’s concerns about the negative effects of sucking behaviors on speech mechanism. Further research with a greater sample size and also consideration of some other factors such as the frequency and duration of sucking behaviors during a typical day is necessary for making a better decision about the impact of these behaviors on speech

Rate of speech as a supra-segmental feature, directly affects the speech fluency and Intelligibility. Studies have shown some factors such as gender, age, living place, and accent can influence on speaking rate. So, it is important to consider norms of each language during assessment and diagnosis. Since studies to determine the standards for speaking rate is very limited in Farsi language, this survey was done to compare speaking rate and articulation rate in young and elderly Farsi speakers who live in Tehran city.
52 young and elderly men and women participated in this cross sectional study and convenience sampling approach was used for this selection. Two different speaking samples were recorded for each participant including a reading text sample and a 3 minute spontaneous speech sample. Speaking rate was determined and articulation rate in reading and spontaneous speech were considered after excluding filled and empty pauses.
The highest rate belonged to articulation during speaking, articulation during reading and spontaneous speech respectively. Both of speaking rate and articulation rates were significantly less in elderly than youth and also more in men than women.
Age, gender and task affect on speaking rate. Hence, such factors are important to be considered by speech and language pathologists during diagnosing and assessing the fluency problems

Language impairment is a primary characteristic of children with autism spectrum disorder (ASD). However, findings of language deficits in these children have been inconclusive, and many researchers believe that in such children the pattern of language profiles is different from normal children. To determine this pattern, comprehension and expression of syntax were examined in 10 Persian speaking children at ages 6-9. Children with autism were compared to normal groups on the basis of their age and language.
Material and In this study, research data were collected of 10 children with autism and 20 normal cases (10 age-matched and 10 language-matched). Gilliam Autism Rating Scale- 2 and the Autism Spectrum Screening Questionnaire were used for diagnosis of children with autism, and test of language development was used to determine their language scores. Afterward, reception of syntactic structures was assessed using the Persian syntax comprehension test, and expression of it was also evaluated using a Persian photographic grammar expression test. Finally, the data were analyzed by Kolmogorov–Smirnov, Mann–Whitney, and Wilcoxon tests.
Comparing the total scores shows that in normal groups, there was a significant difference between receptive and expressive of syntax both in terms of the number of correct tasks and number of correct structures. However, in the study group, such a difference was only seen in the number of correct tasks. Comparison of reception and expression of different structures in all groups showed that there was a significant difference between receptive and expressive tasks of subject relative clause in children with autism and language-matched group. However, in age-matched group, such a difference was not noticed. As to the grammatical relations such as aspect, tense and superlative adjectives, there were no significant differences between receptive and expressive tasks of any groups. Finally, there was a significant difference in terms of using of independent pronouns just in group of children with autism.
Overall, it can be concluded that comparing total scores of difference between reception and expression does not suffice for making a hypothesis that in ASD comprehension of all structures is more difficult than their expression because their performance in different structures of syntax is variant.

Although movement disorders and abnormal postural are the main features of children with cerebral palsy but many of them have sensory problems too, so the purpose of this study was to investigate the relationship between sensory process and motor skills in children with cerebral palsy.
In this descriptive-analytic study, 56 children with cerebral palsy aged 5 to 10 were studied. The gross motor function was assessed using the gross motor function classification system, manual ability was assessed using manual ability classification system, intensity of spasticity was evaluated using modified ashworth scale and sensory process was assessed by sensory profile questionnaire.
The results of this study showed that the gross motor function and manual ability of children with cerebral palsy are related to low muscle tone and tolerance, poor sensory registration, and sedentary, significantly. Findings also demonstrated a significant relationship between manual ability and oral sensory sensitive in children with cerebral palsy (p According to the significant relationship between motor skills and sensory processing in children with cerebral palsy, it is recommended to evaluate both motor and sensory skills during the management and rehabilitation of these patients

in regard to previous various studies, the role and importance of phonology is clear in ability to read. However, studies have shown different outcomes in understanding the relationship between memory, language and phonological awarness. Considering the different characteristics of Persian script and the lack of phonology and related cognitive processing in Farsi, the present study seemed to be necessary. Also because of the relationship between phonological memory and reading, in this study we expected to find the power of language proficiency and memory in predicting children's reading skill. The present study assessed the statistical correlation between the memory, language and phonology in Persian language preschoolers.
This cross-sectional study included 40 normal preschoolers from Tehran. Phonological working memory tests (Digits Recall and Non-word Repetition: NWR), phonological awareness and language development tests were used.
There was a strong positive correlation between phonological working memory (Digits Recall and NWR) and the phonological awareness total score. Also there was a correlation between phonological awareness and language development scores. In spite of positive correlation between language development and Digits Recall, there wasn’t any relationship between language proficiency and NWR.
Results showed positive statistical correlation between phonological awareness, phonological working memory and language proficiency in normal Persian speaking children. And also language skills and memory can work as predictors for reading skills in children.

Working memory is the capacity to store and control information for a short period of time. This memory is closely related to reading and other academic skills such as spelling, comprehension and mathematics. This study aimed to compare working memory in normal versus dyslexic children. This was a descriptive-analytic study. Dyslexic group included 30 children randomly selected from the Learning Disability Center of Semnan Department of Education. The control group consisted of 60 primary school students without any academic failure and intellectual problems. Phonological working memories such as Word Recall, Digits Recall and Non-word Repetition were used for assessments. The experimental and control groups were not different in two factors of age (P=0.880) and sex (P=0.552). Control group scores in word recall, digits recall (forward), and non-word repetition tasks were highly dominated (P <0.001) over dyslexic children. The findings showed that children with dyslexia have lower performance in subtests of phonological working memory. This study indicates the need to raise the awareness of teachers and speech and language therapists to plan designing and implementing educational and interventional programs based on activities related to the working memory for children with dyslexia and other learning disabilities

Some studies, which are engaging with the mechanisms of word procession in the brain, are interested in the brain activity responses to the emotional content of the words. There are also some studies which have focused on how lexico-semantic features affect word processing by controlling the affective dimensions. To perform such studies we need a list of affective words in Farsi language and culture. The present study aims to make a list of such words to be used in probable future neural processing studies of Persian words. In this study 150 Farsi speaking college students, with the average of 22 years of age, scored 300 Farsi words based on their valence, being evocable, familiarity, age of acquisition and being imaginable, by using Likert scale. Information about the frequency, objectivity and class of words were also added to each word by researchers. Within 294 studied words with clear valence, there were 237 nouns, 47 adjectives and 10 verbs. There were also 158 positive, 79 negative and 63 neutral words in this study. Data gathered for each word based on scores were recorded in tables for future references. The provided list of words and related scores in this study can be useful in order to control or study the factors contributing to word processing in Persian youth for future studies. The reason for different scoring paradigm in this study with other patterns was the difference in culture and sociolinguistic backgrounds with other cultures and languages.

Emotion have an important role in brain`s cognitive functions and information processing such as visual words` recognition rate. Emotion is considered to have two different dimensions: Valence and Arousal. Only a few studies have considered both of these aspects and it is not yet clear if they are either separated aspects or have correlation with each other. On the other hand, word`s recognition speed is influenced by some lexico-semantic features too. Finding correlation between affective dimensions and lexico-semantic features is important in studying the distinctiveness of affective dimensions. 100 university students scored to 300 words in the questionnaire related to affective dimensions and lexico-semantic features, based on Likert rating scale. Then data correlation was studied by linear and quadratic regression tests. There was a strong positive correlation between valence and arousal as valence was increased by arousal increments. Negative words were significantly more arousal than the positive ones. There was a moderate positive correlation between the valence and the familiarity of the words. Also, there was an equal week correlation between the imaginability and valence and the imaginability and arousal, which means words with higher arousal or valence, are more imaginable. In spite of significant correlation between the arousal and valence, they are distinct variables; since the sense of arousal was different for positive and negative words, while, each emotional dimension correlated with different lexico-semantic feature. This independency should be considered in future studies. The Persian affective words` list, which was used in this study and rated for both lexico-semantic and emotional dimensions, could also be used as a primary tool in future studies

The high number of cerebral palsy, the severe disability of this disorder, depression in disabilities, and long lasting effects of the child`s disability on the family especially mothers are the common issues. The purpose of this study was investigating the level of depression in mothers with cerebral palsy children and its related factors. This caused comparative study was carried out in Tehran, in 2011. Two groups of mothers with 4 to 12 years old healthy and cerebral palsy children were randomly selected to participate in this study. Beck questionnaire was used to evaluate mothers’ depression level. The relationship between variables was investigated by independent T- test and Pearson’s correlation. Sixty mothers with cerebral palsy children and sixty mothers with normal children as control group were participated in the study. Mean and standard deviation of age were 33.79± 6.02 in mothers and 7.11± 2.71 in children. Depression of mothers with cerebral palsy child was significantly higher than control group and there was a significant correlation between depression of mothers with cerebral palsy children, and increasing caring time, dependency in activity of daily living and children`s gross and fine movements ability. Although depression was higher in mothers with cerebral palsy children, the depression level of these mothers was affected by some factors related to the child issue. In order to decrease undesirable effects of having a cerebral palsy child, it is necessary to emphasize on children`s abilities to achieve maximum evolution potential and provide physical and mental protections for their mothers.

Stuttering is potentially a socio communicational problem, which has negative effects on individuals’ mental and emotional health and other aspects of life. Recognizing the quality of life (QOL) dimensions in adults who stutter can be useful in treatment planning and preventing later mental, emotional and social disorders.

This study aimed to investigate the QOL and its relationship with stuttering severity in adults who stutter.

This analytic-descriptive study was performed on 78 adults (61 males and 17 females) who stuttered and 78 normal control cases in Mashhad City, Iran. Short-form 36 (SF-36) questionnaire of QOL was used to collect data and the percentage of syllables stuttered (%SS) was determined in a spontaneous speech sample as a frequency measurement tool. Mann-Whitney test was used to compare data between the groups and ANOVA test was also used to evaluate the correlation between stuttering severity and QOL dimensions.

This study showed a significant difference between the groups in mean scores of QOL, general and emotional health, social and physical functions, vitality and role limitations made by physical and emotional problems (P < 0.05). No significant difference was found in pain between the groups and there was no significant relation between %SS and dimensions of QOL (P > 0.05).

Stuttering has negative effects on different dimensions of QOL among individuals. Thus, it is necessary to pay special attention to its prevention and treatment before it is developed into a completed and progressive condition.

Phonological awareness and working memory are two important factors in literacy acquisition. Since auditory system plays an essential role in phonological processing, we investigated such skills in deaf population in the present study. Twenty deaf children with severe and profound bilateral sensory-neural hearing loss and twenty healthy control subjects were examined in this cross-sectional study. Children were students in second grade of public elementary schools in Karaj city (Iran). All participants were given phonological awareness, reading comprehension, visual working memory and auditory-verbal memory tests. Between-groups data analysis was processed and the relationship between task scores was investigated in the deaf group. Deaf children had significantly less scores in all tasks (p˂0.001) compared to their normal peers except for the visual working memory test. There was a positive correlation between reading comprehension and both the visual working memory and phonological awareness in the deaf group. Nevertheless no relationship was found between reading comprehension and auditory-verbal memory. Deaf children used both their phonological awareness and orthographic knowledge In the reading activity, requiring a good visual working memory. Although it seems that such children are reliant on their visual ability and not their auditory or kinetic senses in phonological acquisition

It is difficult to determine the effect of hearing loss pathologic factors on the vocal features rather than other parts of speech, due to the complication of nature of voice, its vast range of changes, and lack of necessary standards and criteria.

The current study aimed to evaluate the effect of hearing loss on acoustic properties of voice through acoustic analysis of some vocal parameters in two groups of children with moderately severe or deep hearing loss, and normal children of the same age and gender.

The current study was a comparative cross-sectional descriptive analysis of primary school students with severe to deep hearing loss disorder (n = 17) and normal students (n = 17) of the same age and gender. Data were collected using Speech Studio software and Laryngograph apparatus. To compare parameters between the two groups T-test (P < 0.05) was performed.

The mean of fundamental frequency for the hearing loss children and the control group were 323.04 Hz and 267.53 Hz, jitter 10.05% and 1.52%, shimmer 17.24 and 5.07, silence duration 29.40% and 17.02%, friction duration 17.55% and 34.52% and vocalization duration 14.71% and 28.65%, and vocal cords contact quality index 39.93% and 47.77%, respectively.

Significant difference in the fundamental frequency, jitter, shimmer, silence duration, friction duration, vocalization duration, and vocal cords contact quality index between the two groups was observed (P < 0.01).

Children with speech and language disorders have a reduced diadochokinesis rates.. The purpose of this study was to compare the oral diadochokinesis with rate of speech and reading in normal students. One hundred of fifth grade female students were participated in this descriptive - comparative study. All subjects were native speakers of persion who passed an informal screening test of articulation and speech. None of subjects had a history of speech, hearing, behavioral and neurological disorders. The subjects were asked to read a text of their book, tell a story and perform some oral diadochokinesis tasks (flecher`s criterion).The time was measured by Cool Edit. Descriptive statistics and compared t-test were used for analysis. the syllable / tâ /had the highest rate of diadochokinesis, while the syllables /pa/ and / kâ/ were in the next orders (3.96,4.01, 4.52).The rate of reading was higher than the rate of talking. There was a significant relationship between the reading rate and diadochokinesis in / kâ / (P=0.02) and / pâtâkâ / (P=0.02) the results indicate that there is no relation between the rate of speech and diadochokinesis but there is a significant relation between Reading rate and diadochokinesis in some tasks.

Since some children with speech and language disorders have a reduced diadochokinesis rates, some researchers have concluded that there is a relation between diadochokinitic and rate of speech but some rejected it. The purpose of this study was to compare the oral diadochokinesis with rate of speech and reading in normal student. In this descriptive - comparative study, one hundred of second grade female students participated. The subjects were asked to read a text of their book, tell a story, and perform some oral diadochokinesis tasks. The time was measured by Cool Edit. Descriptive statistics and compaired t-test were used for analysis. Time taking of diadochokinesis tasks /tâ/, /pa/ and /kâ/ were in the orders 4.10, 4.15 and 4.74. The rate of reading was 3.1 syllable per second and rate of talking was 2.8 syllable per second. There was no relationship between the rate of speech and diadochokinesis but there was a significant correlation between the reading rate and diadochokinesis in /kâ/(p=0.03) and /pâtâkâ/(p=0.00). We can use the relevant diadochokinetic tasks for improving the rate of reading. Reading rate was higher than talking rate and the rate of bilabial diadochokinesis is the highest rate that we can expect in our treatments.