mehdi alizadeh zarei

Children with special needs require extensive medical and rehabilitative interventions, which pose significant challenges for their families. The Family Functioning Questionnaire in Rehabilitation (FFQR) assesses family performance in this context.

This study aimed to evaluate the reliability, validity, and cultural adaptation of the Persian version of the FFQR among Iranian parents of children with special needs.

This observational cross-sectional study focused on psychometric validation and cultural adaptation of the Persian FFQR. Rigorous evaluations of face and content validity, criterion validity, internal consistency, test-retest reliability, and construct validity were conducted. Participants included 250 parents of children aged 3 to 18 with special needs, recruited from rehabilitation facilities in Tehran province.

The translation process, along with assessments of face and content validity, led to adjustments in questionnaire items. The Persian version of the FFQR demonstrated excellent internal consistency (Cronbach's alpha = 0.946) and high test-retest reliability (correlation coefficient (ICC) = 0.94). However, criterion validity with the Child Adjustment and Parent Efficacy Scale-developmental disability was not established. Confirmatory factor analysis supported the original factor structure of the FFQR, affirming its cross-cultural applicability. Model fit indices indicated reasonable fit, although the chi-square test suggested an imperfect fit (χ² = 2409.03, df = 1074, P < 0.001).

The Persian FFQR proved to be a reliable and culturally relevant tool for assessing family functioning in rehabilitation of Iranian children with special needs. These findings highlight the importance of employing culturally sensitive measurement tools in research and clinical applications.

This study investigated the efficacy of telerehabilitation (TR) in school-based Occupational Therapy (OT) for children with Specific Learning Disorder (SLD), focusing on occupational competence and parental satisfaction, aiming to contribute empirical insights to the discourse on the educational well-being of this population.

The study adopted a Randomized Controlled Trial (RCT) design involving 31 children diagnosed with SLD, implementing TR and in-person interventions alongside a control group. Outcome measures included the School Self-Concept Inventory, Child Occupational Self-Assessment (COSA), and Canadian Occupational Performance Measurement (COMP), analyzed using descriptive and inferential statistics (ANOVA, post hoc tests).

Both TR and in-person interventions exhibited significant enhancements in academic self-efficacy (F=23.96, p<0.001, Partial ȵ²=0.461), occupational competence (F=70.59, p<0.001, Partial ȵ²=0.716), and parent satisfaction (F=17.03, p<0.001, Partial ȵ²=0.378) compared to the control group. Notably, no significant differences emerged between the TR and in-person groups, emphasizing their comparable effectiveness in improving outcomes.

In conclusion, the study demonstrated the efficacy of TR and in-person interventions in school-based OT for children with SLD. The cohesive outcomes in academic self-efficacy, occupational competence, and parental satisfaction highlight TR as a versatile modality. This research, grounded in robust methodology, encourages further exploration of TR’s transformative role in enhancing the holistic well-being of children with SLDs.

 Handwriting is one of the most common reasons for referral to occupational therapy among children with specific learning disorders (SLDs). The Persian handwriting assessment tool (PHAT) is a valid assessment instrument. It is important to clarify the reliability of this assessment tool for the accuracy of results and certain clinical uses in Iranian children with SLDs.

 The present study aimed to investigate the internal consistency, test-retest, and inter-rater reliability of the PHAT in children with SLDs aged 10 to 12 years in the Iranian context.

 Thirty children (mean ± SD 132.33 ± 53.8 months) with SLDs, studying in grades 4 to 6, were recruited from special education schools and rehabilitation clinics from January to May 2022. Cronbach's alpha and intraclass correlation coefficient (ICC) were calculated to determine internal consistency, test-retest reliability, and inter-rater reliability, respectively. The standard error of measurement (SEM) and minimal detectable change (MDC) were computed to establish absolute reliability.

 Internal consistency was excellent (α = 0.98 to 0.99), as was inter-rater reliability (ICC = 0.95 to 1.00). Test-retest reliability was good to excellent (0.86 to 1.00). The SEM and MDC values for test-retest reliability were 0 to 0.47 and 0 to 1.29, respectively. Finally, the SEM (0 - 0.21) and MDC (0 - 0.57) values were acceptable for inter-rater reliability.

 The PHAT is a reliable assessment tool for Iranian children with SLDs aged 10 to 12 years. Further, clinicians can utilize this tool to identify handwriting difficulties in children with SLDs aged 10 to 12 years, which leads to more targeted interventions.

Impairment in the way of sensory information by the central nervous system can cause functional problems in all areas of an adolescent’s activities, including education, self-care, social participation, and leisure. Therefore, in the presence of problems in such activities, it is necessary to evaluate and screen for sensory processing. In the present study, the sensory processing assessment tools that cover the adolescent age group were investigated.

In this review, PubMed, Science Direct, Google, OTseeker, and Google Scholar databases were searched, and articles published between 2000 and 2022 on sensory processing assessment tools in adolescents and their psychometrics were selected. Keywords used included sensory integration dysfunction (SID), sensory processing disorder (SPD), adolescence, adolescent, assessment, measurement, reliability, validity, psychometry, environment, scale, and instrument.

The assessment tools identified to evaluate sensory processing in the adolescent age group include the “adolescent/adult sensory profile” (AASP), “Glasgow sensory questionnaire” (GSQ), “sensory processing measure (SPM)”, “sensory response in autism spectrum” (SR-AS) questionnaire, “sensory processing scale” (SPS), and “SPM-second edition” (SPM-2).

The environment was considered as a factor that needs to be evaluated only in the second version of the SPM among the selected tools. The results of this review also showed that the only tool available in Persian in this field is the AASP, which does not seem to be a suitable tool for use in adolescence because the population studied in the psychometric evaluation of the Persian version was elderly people with dementia. Therefore, it seems necessary to prepare the Persian version and psychometric evaluation of an appropriate assessment tool for evaluating the sensory processing of Iranian adolescents.

According to DSM-5, sensory processing problems are among diagnostic criteria in children with autism spectrum disorder (ASD). Various studies have shown that games, as the main occupation of children, can be helpful in performing sensory interventions. Solving sensory problems isoneof themostcommondemandsof families with children withASD. Children’s families play a key role in the implementation of occupational therapeutic interventions.

This randomized clinical trial investigated the effectiveness of sensory play activities performed by parents at home on the sensory patterns of children with ASD.

Fifty-one children with ASD, aged 3 to 6 years, were divided into the intervention and control groups. All participants attended 16 sessions of in-person individualized sensory integration therapy (SIT) in a clinic for 8 weeks. In the intervention group, children received 8 sessions of a sensory play activity intervention performed by parents at home. Data collection instruments included the Gilliam Autism Rating Scale-2 and the sensory profile 2. Parametric (independent and paired t-test) and non-parametric (Mann-Whitney and Wilcoxon tests) were used for statistical analysis to compare between-group and within-group mean differences.

The resultsshowedthat althoughall four sensory processing patterns improved significantly in both groups (P< 0.05) (i.e., the within-group effect), children in the intervention group showed significant improvements in three sensory patterns, including sensory avoiding, sensory sensitivity, and sensory registration (P< 0.01). There was no significant difference in the mean score of the sensory seeking pattern between the 2 groups (P > 0.05).

Sensory integration therapy improved dysfunctional sensory processing patterns in ASD children, an effect that was enhanced by the simultaneous implementation of sensory play interventions.

Individuals should have good sensory processing ability to function appropriately and participate in daily activities. This investigation aimed to evaluate the sensory processing characteristics of children aged under 14 years.

This is a descriptive cross-sectional study. The study population comprised all children aged >14 years referred to child’s developmental centers and elementary and middle schools in Tehran City, Iran. After considering the inclusion criteria, 1272 children were selected using multistage cluster sampling. The research tool was sensory profile-2, completed by children’s caregivers and teachers. Their sensory processing characteristics were measured according to the cut-off scores of the separate questionnaires of Sensory profile-2 in the section, school, and quadrant factors. 

The research samples scored just like the majority of others on most sensory processing areas, with only two quadrants, one sensory section, and one school factor score indicating “less than others” or “more than others.”

According to the findings, a high sensory sensitivity leads to intolerance of children in schools. Also, the low level of sensory seeking in toddlers is associated with less than other scores in movement items.

The difficulties to perform self-care or basic activities of daily life are among the concerns of families, and rehabilitation professionals. In this issue, culturally adapted assessment tools help in the accurate assessment and treatment planning in rehabilitation.

The present study aimed to survey the validity, and reliability of Activities of Daily Living Inventory for Children with Disabilities (ADLIC-D) in preschool children with autism spectrum disorder (ASD), cerebral palsy (CP), intellectual disability (ID), and typical children.

The face validity examined by 60 parents of children with disabilities. Content validity studied by 10 occupational therapists. The sample included 205 (70 normal, 45 ASD, 45 CP, and 45 ID) children aged 3 - 6 years whose parents completed ADLIC-D. Face and content validity, convergent validity with the Pediatric Evaluation of Disability Inventory (PEDI), discriminant validity, testretest reliability, and the internal consistency of instrument were examined.

Intra-class correlations coefficient for test-retest reliability was excellent (above 0.9). Cronbach’s alpha for all items was excellent (0.977). The ADLIC-D had convergent validity with the PEDI (r = 0.95). The discriminant validity demonstrated that the measure distinguishes between normal and disabled groups. In addition, the number of final items on the new scale grew from 73 in the original to 76.

ADLIC-D had validity, and reliability for children with ASD, CP, and ID. It measured the desired construct, i.e., the activities of daily living in children with the disabilities and differentiated between normal groups, and groups with disabilities.

Sensory processing patterns can be related to children's preferences for various activities. Still, our understanding of how different sensory processing patterns are related to children's participation in leisure activities is fairly limited. Therefore, this study aimed to investigate the association between sensory processing patterns and children's participation in leisure activities.

In this systematic review, the PRISMA (The Preferred Reporting Items For Systematic Reviews And Meta-Analyses) Guidelines were followed. We searched PubMed, Google Scholar, Springer, ProQuest, Scopus, Cochrane Library, Medline, OT Seeker, SID, and Healio databases using the following keywords: “Participation”, “leisure”, “play”, “sensory processing”, “sensory integration”, “sensorimotor”, “sensory”, and “children”. A total of 5040 articles were found, of which 5027 were eliminated after the review, and finally, 13 articles were included in the study based on the inclusion criteria; 6 of them entered the meta-analysis process. The meta-analysis was performed using CMA software. 

The meta-analysis of 6 studies illustrated a significant correlation between the energy level and desire to participate in leisure activities, the auditory-visual sensitivity and willingness to participate in leisure activities, the sensory processing patterns and the intensity of involvement in leisure activities, the general sensory processing and desire to participate in leisure activities, the sensory processing patterns and desire to participate in informal activities, the olfactory sensitivity and desire to participate in leisure activities, the auditory filtering and desire to participate in leisure activities, the sensory processing patterns and enjoyment of participation in leisure activities, and finally sensory processing patterns and desire to participate in recreational activities. 

The evidence in articles on sensory processing patterns and participation in play and leisure activities is inadequate. The only conclusion drawn from all patterns of sensory processing is the significant relationship between these patterns and the preference to participate in recreational activities (which is just one of the several leisure activities).

Iran, like many other countries, has committed to providing universal and equal access to health care and rehabilitation for people with disabilities by joining the Convention on the Rights of People with Disabilities. Thus, this study aimed to examine the availability of rehabilitation facilities on national and sub-national levels.

This cross-sectional study was conducted between May and December 2019. The data of rehabilitation facilities including infrastructure and rehabilitation workforce in health system settings were obtained using rehabilitation master list. The data were collected from the Vice-Chancellor for the Treatment Ministry of Health and Medical Education, the Rehabilitation of the State Welfare Organization, and Licensing and Planning the Medical Council in the 32 provinces of Iran and analyzed using Excel version 2016.

On the national level, the following situation was found: in inpatient settings: 1.1 beds per million population; in outpatient settings: physiotherapy 42.6, optometry 16.4, audiology 10.5,occupational therapy 8.2, speech therapy 8.1, orthotic & prosthetic 4.5, physical medicine & rehabilitation 3.8 centers; day-care centers 11.7 and rehabilitation centers 1.3 centers, community-based rehabilitation (CBR): 15.9 units, rehabilitation home care 2 centers, rehabilitation nursing home care 1.6 centers and medical rehabilitation home care 0.3; Long-term care centers: residential care 4.1 centers per million population. Regarding rehabilitation work force: physiotherapists 84, speech therapists 34.8, occupational therapists 32.5, optometrists 31.2, audiologists 27.9, prosthetists and orthotists 10.3 therapists and physical medicine & rehabilitation 5.1 specialists per million populations. On the sub-national level, there were no outpatient rehabilitation centers in 12 of the provinces and the distribution of day rehabilitation centers in the rich provinces was 10 times higher. The number of CBR units, rehabilitation home care and rehabilitation nursing home were 40, 22, and 23 times higher in rich provinces than in poor provinces, respectively and there were no medical rehabilitation home care centers in 21 provinces. Regarding long-term care, the residential care centers in the richest province were 8 times higher.

According to the WHO report and the rehabilitation expert panel, it was concluded that the number of rehabilitation facilities including rehabilitation centers and workforce was limited in Iran and that the available centers were also poorly distributed in the provinces of the country. This made it difficult for people to have fair access to rehabilitation services. It appears that health policymakers should pay special attention to further developing rehabilitation facilities.

 Despite their high effectiveness, rehabilitation therapies can reduce the number of families with children with autism spectrum disorder (ASD) visiting clinics due to the number of treatment sessions and the long duration of treatment. The use of technological methods, such as transcranial direct current stimulation (tDCS) as one of the therapeutic interventions to improve cognitive function in rehabilitation clinics, can help reduce the duration of treatment for these children.

 The present study was carried out to examine the effectiveness of tDCS in behavioral and cognitive aspects of executive functions in children with ASD.

 A pretest and posttest design with follow-up were used in this study. The subjects were children with high-functioning ASD aged 8 - 11 years who were selected by the convenience sampling method from occupational therapy clinics in Tehran, Iran. A total of 20 eligible candidates were included in the study according to inclusion and exclusion criteria. The subjects were randomly divided into two groups (10 subjects in each group). The intervention group received tDCS during 12 sessions of 20 minutes in the dorsolateral prefrontal cortex area, with an electrode size of 35 cm2 for 3 weeks (four sessions per week). The control group received common cognitive interventions used in occupational therapy clinics in 12 sessions of 60 minutes (one hour) for 6 weeks (two sessions per week). Follow-up was performed one month after the end of the interventions. The research instruments included the Behavior Rating Inventory of Executive Function and computer-based tests, such as the Tower of London, Wisconsin Card Sorting Test, and Stroop test.

 The results demonstrated that tDCS, similar to cognitive rehabilitation, could affect the cognitive functions of the brain, such as executive functions, and several basic cognitive processes, such as inhibitory control, cognitive flexibility, and mental planning.

 The findings recommended using tDCS as a new intervention method to improve the cognitive function of individuals with ASD. This is due to the lasting effect of the results of this intervention as a technological instrument with faster results than other clinical interventions.

Objective:

 Despite the evidence that rehabilitation interventions are effective for spinal cord injury (SCI) patients, these interventions usually impose costs on the health system. Therefore, it is necessary to examine the cost-effectiveness of these interventions for the health system of countries through economic evaluation. In this study, we examined the cost-effectiveness and net financial benefits of rehabilitation services in treating spinal cord injuries in Iran.

Materials & Methods:

 Considering that this research is the first economic evaluation study related to spinal cord injury rehabilitation, the first stage of the economic evaluation was dedicated to designing an economic evaluation model. The model was designed based on disease groups, the natural course of the disease, the details of rehabilitation interventions for spinal cord injury patients in different disease groups, clinical outcomes, probability of occurrence of outcomes, and related costs. The structure of the economic evaluation model of this study is based on the design of a lifetime Markov model with a 1-year cycle length for each strategy and two groups of patients (paraplegia and tetraplegia). In this study, we also used the incremental cost-effectiveness ratio (ICER) to determine the cost of the most effective strategy. All findings were analyzed using Excel 2016 and TreeAge 2011 software.

Results:

 According to the annual incidence of spinal cord injury patients in need of rehabilitation services in the country, which is about 2000 people, based on public sector tariffs, the total annual cost of SCI rehabilitation in Iran in the paraplegia group ranges from 32997 to 40200 million Iranian Rials (IRR) and in the tetraplegia group from 25476 to 26119 million IRR in mild to very severe conditions. Also, the total rehabilitation costs of SCI patients based on public sector tariffs in one year were calculated to equal 256847 million IRR. Similarly, based on private sector tariffs, the total annual costs of SCI rehabilitation in the paraplegia group were estimated from 86374 to 103122 million IRR and in the tetraplegia group from 67509 to 68997 million IRR in mild to very severe cases. Meanwhile, the total rehabilitation costs of SCI patients were calculated based on private sector tariffs in one year, equivalent to 668847 million IRR. Also, the average lifetime of SCI patients undergoing rehabilitation is lower compared to non-rehabilitation and also has higher QALY (The quality-adjusted life year) values, which indicates the dominance of the rehabilitation strategy. The amount of ICER, in this case, is estimated based on public sector tariffs equal to negative 674 million IRR and based on private sector tariffs equal to negative 629 million IRR per QALY unit. Possible sensitivity analysis of the results and Monte Carlo simulation in both scenarios confirmed the initial analysis findings with high probability. Based on the public sector tariff, the net amount of incremental financial benefits of rehabilitation for the total annual incidence is estimated at 8991 billion IRR. These amounts were calculated based on private sector tariffs of 8579 billion IRR.

Conclusion :

Generally, the results of this economic evaluation showed that the rehabilitation of spinal cord injury patients in Iran, based on public and private sector tariffs, is quite cost-effective and has significant net positive financial benefits. The results of the sensitivity analysis also confirmed this finding.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders characterized by poor attention and subsequently lower learning abilities than normal children. This study aimed to compare the effectiveness of neurofeedback and perceptual-motor exercises as two common nonpharmacological treatments for visual attention.

A total of 40 combined medicated ADHD children (aged 5-12 years) were randomly allocated into two groups: neurofeedback training and perceptual-motor exercises. Visual attention and motor proficiency were assessed before and after the treatment by continuous performance test (CPT) and Bruininks-Oseretsky Test (BOT), respectively.

According to repeated measures analysis of variance (ANOVA), both groups showed significant improvement in three attention-related areas of CPT, including reaction time, omission, and commission errors (P<0.001), while the difference between the two groups was not significant (P>0.05). However, in the perceptual-motor exercises group, motor proficiency improved significantly (P<0.01).

Neurofeedback training intervention, as well as perceptual-motor exercises, are effective in improving ADHD symptoms, and given the similar effect of both interventions and their lack of side effects, perceptual-motor exercises appear to be the more appropriate option for reducing symptoms of ADHD, because of its additional effect on motor proficiency, rich content of purposeful activities, and social interactions.

COVID‑19 virus is on the rise globally, and people with the disease experience a variety of physical and mental problems. According to studies, depression can be a complication of the virus. So far, limited measures have been taken to prevent and treat emotional–psychological complications of COVID‑19. The aim of this study was to evaluate the effect of online cognitive behavioral therapy (CBT) on depressive symptoms in recovered patients with COVID‑19.

This study was conducted in a quasi‑experimental design. A sample of 150 recovered patients with COVID‑19 who referred to Imam Reza Hospital in Tabriz city, were selected by random sampling method. The patients’ emotional–psychological status was assessed by the Beck Depression Inventory, and they entered the treatment process according to the inclusion criteria. As a therapeutic intervention, a scientific and valid approach called CBT was implemented, which two occupational therapists performed in eight treatment sessions in the context of a social communication application. Paired sample t‑test was used to analyze the time sequence of quantitative data due to its normality.

After the last session of the intervention, the effect of this therapeutic approach on reducing the depressive symptoms of patients was evaluated. According to the findings, the Beck score of the participants decreased significantly after the intervention (MD = ‒45/9, P < 0/001).

Therefore, in order to promote the recovery of patients with COVID‑19 and help health authorities to develop preventive measures and effective treatment of emotional–psychological problems caused by this virus, it is recommended to use the online CBT approach.

The COVID-19 pandemic may have destructive effects on patients’ mental health and quality of life (QoL).

This study aimed to assess the relationship between QoL and coping strategies in hospitalized patients with COVID-19.

This cross sectional descriptive-analytical study was performed at Imam Reza Hospital in Tabriz City for 2 months. Seventy hospitalized patients with COVID-19 were recruited by convenience sampling. The patients completed the adapted version of the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) and the Coping Strategies Questionnaire (CSQ). We indicated a critical value of 60 as the optimal cut-off point to assess perceived QoL. Also, low, moderate, and high coping strategies are dedicated to 0 - 66, 66 - 110, and > 110, respectively. Data were analyzed using the Pearson correlation coefficient in SPSS version 21.

Seventy patients were enrolled, including 35 males and 35 females with a mean age of 39.69 ± 11.31 years. QoL’s social and physical dimensions had the highest and lowest mean scores (65.18 ± 18.99 and 41.40 ± 17.22, respectively). The results showed that 3 out of 5 dimensions had a mean score of < 60. Regarding CSQ, the mean scores of problem- and emotional-oriented coping strategies were 87.27 ± 15.45 and 85.05 ± 12.47, respectively. Most participants had moderate problem- and emotional-oriented coping strategies (85.5% and 92.8%, respectively).

The current study showed that the QoL score was less than 60 in most of the QoL dimensions in COVID-19 patients. Moreover, most of the participants used coping strategies moderately. Therefore, it is recommended to perform further studies to compare the impact of coping strategies on QoL in patients and the control group.

Activities of Daily Living (ADL), as an ultimate goal of rehabilitation, rely on cultural and environmental factors. This study aimed to develop a questionnaire based on the occupational therapy practice frame to accurately evaluate Iranian children’s occupational performance.

This scale was developed in two phases of planning and construction. The planning phase involved a literature review and a collection of the available evaluation tools in the area. The advice of two expert panels was used to develop a preliminary 87-item questionnaire. In the construction phase, 40 parents were surveyed to assess the popularity of the activities in Iran. After a face to content validation, the final version of the questionnaire was prepared with 93 items.

The final 93-item questionnaire was used to assess the ADL of 3-6-year-old children. The 93 items, selected according to criteria found in the literature and the panel of experts, were categorized into six ranges of occupational therapy practice framework (bathing/washing/personal hygiene, toileting, dressing, eating/feeding, functional mobility, and others).

The ADL in Iranian children is a practical and culturally relevant tool for measuring the occupational performance of Iranian children. It can be used in clinical and population-based research.

Autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders in children and causes defects in social functions, behaviors, and limited and repetitive interests.One of the symptoms of ASD is a disturbance in sensory function, which can disturb the social participation of affected people. Therefore, the present study was done to determine the relationship between the sensory processing pattern and social participation in children with autism aged 6 to 12 years.

This applied research was carried out in 2022 using a cross-sectional descriptive and analytical method. The research population included 6-12-year-old children with ASD in Tehran. A total of 54 children participated in this study, of whom 49 cases were included in the study after meeting the inclusion criteria. Data collection tools included the Gilliam autism rating scale-3, the children participation assessment scale-parent version (CPAS-P), and sensory profile-2. Finally, the data were analyzed by descriptive and analytical statistics using SPSS software, version 26.

The overall score of autism in the studied children was 76.22±33.82. Among the variables of sensory processing, the highest mean score was related to low registration (51.17±18.55) and the lowest was related to sensation seeking (40.16±93.92). No significant relationship was observed between most variables of sensory processing patterns and social participation in CPAS-P. However, there was an inverse and significant statistical relationship between social participation and sensory-seeking pattern.

The results showed that sensory seeking is related to social participation in children with autism. There is an inverse and significant statistical relationship between social participation and sensory search pattern and no relation with the others. Therefore, more severe sensory problems in these children are associated with more prominent social problems.

participation in meaningful activities are important aspects of development in children with developmental disorder such as autism spectrum disorder. The purpose of this study was to assess the correlation of school participation with motor proficiency and executive function in children with Autism Spectrum Disorder.

In this cross-sectional (descriptive-analytic) study, 52 students aged 6 to 12 years old with ASD were selected through the convenience sampling method. The GARS-2 scale was used to confirm ASD diagnosis. Other psychiatric comorbidities such as ADHA were studied by the CSI-4 tool, and students with comorbidities were excluded. Data were collected using SFA, BOTMP-2, and BRIEF questionnaires. It should be noted that in the BRIEF questionnaire, a higher score indicates a more severe disability.

Our findings showed that motor proficiency and its components had a significant direct correlation with school participation in childrenwith ASD (P ≤0.001). On the other hand, school participation was inversely and significantly correlated with the behavioral regulation and metacognition monitoring indices of the executive function dimension (P <0.05).

Based on the findings of this research, the development of motor proficiency and improvements in the behavioral regulation andmetacognition monitoring of students with ASD will boost their participation in school activities. Motor proficiency was significantly correlated with school participation in children with ASD. More attention should be paid to perceptual motor interventions and cognitive rehabilitation programs (with a focus on monitoring metacognition and shifting behavioral regulation) to increase the participation of children with ASD in school activities.

The purpose of the present study was to establish the item analysis and internal consistency of the Persian version of the Child Sensory Profile 2 in 2 groups of typical and atypical children (autism spectrum disorder and learning disabilities) aged 3 to 14 years.

The sample of this study included 120 typical and atypical children aged 3 to 14 years who referred to schools and rehabilitation centers in Tehran were selected using multistage sampling method. To collect data, the Child Sensory Profile 2 questionnaire was used, which is a set of questionnaires of the Sensory Profile 2. To analyze the data, the discrimination index was used to determine the discriminant validity of the Child Sensory Profile 2, and the Cronbach's alpha coefficient was used to determine the reliability in terms of internal consistency.

Discrimination index was satisfactory for all the items of the Child Sensory Profile 2. The values of Cronbach's alpha ranged from 0.795-0.919 in typical children and 0.617-0.901 in autistic children, and 0.792-0.920 in children with learning disabilities.

The Persian version of the child sensory profile 2 is a valid (discrimination with vulnerable populations) and reliable (internal consistency) tool for assessing sensory processing.

The first and most basic area of occupational performance is the activities of daily living. These activities of life highly depend on the contextual and ecological (environmental) factors. Cultural values, parental expectations, social routines, and physical environment influence acquisition time of a child’s daily activities. At present, there is no comprehensive and adapted-culturally tool to evaluate the daily life activities of Iranian children aged 3 - 6 years.

This study aimed to investigate the factor structure, construct validity, and reliability of the Activities of Daily Living in Iranian Children (ADLIC) scale.

The participants were 470 Iranian parents of children among the ages from 3 to 6. Exploratory factor analysis, internal consistency, and test-retest reliability were conducted for data analysis. Convergent validity was measured by correlation to the Pediatric Evaluation of Disability Inventory (PEDI).

The results indicated that ADLIC has excellent reliability due to internal consistency (Cronbach’s alpha 0.96). Furthermore, the temporal stability of ADLIC was supported using the Intra-class correlations coefficient, which ranged between 0.95 and 0.98. Convergent validity between the ADLIC and two subscales of PEDI, including self-care (0.88) andmobility (0.80), was good. The ADLIC scale showed a clear factor structure with five main components and ten factors based on the findings.

ADLIC has excellent psychometric properties, including internal consistency and temporal stability, and can be used as a reliable and valid measure to assess the daily living activities of children aged 3 - 6 years.

Generally, spinal cord injuries can lead to functional limitations and restrict participation in different areas of occupations. One of the areas of occupations that are less considered is rest and sleep. The aim of this study was to investigate the relationships between physiological, emotional status and daily activities, and sleep quality in patients with spinal cord injury.

The present study was a cross-sectional analytical study that was conducted in 2019-2020. The statistical population of this study was patients with spinal cord injury referring to the occupational therapy clinics in Tehran and Karaj as well as hospitalized patients and daily patients referring to the Kahrizak care unit in Alborz province. The sample size was considered 100 spinal cord injury patients who were randomly selected. Data were collected using Pittsburgh Sleep Quality Questionnaire, STOP-BANG Respiratory Apnea Probability Questionnaire, Beck Anxiety and Depression Questionnaire, Pain Scale, and Barthel Questionnaire.

The results showed that there was a significant relationship between the risk factors of respiratory apnea, anxiety, depression, pain, the time elapsed after the accident and functional mobility, and sleep quality (P≤0.05).

Sleep quality in patients with spinal cord injury is low and is significantly associated with factors, such as the likelihood of respiratory apnea, pain, mood factors anxiety and depression, muscle tone, functional mobility, and independence in daily activities

Studies indicate that balance disorder, motor development problems, and weak postural control are likely to occur in children with severe to profound hearing deficits. Children with hearing deficits also indicate behavioral problems related to impulse control, distraction, and disability to maintain attention in the visual modality.

The present study, therefore, aimed to investigate the effect of balance exercises on balance performance, motor coordination, and attention in children with hearing deficits.

In this experimental study, 36 children aged 7 to 12 years with severe to profound hearing deficits were randomly divided into two control and experimental groups using permuted block randomization. The experimental group performed a 12-session balance and vestibular sensory, motor exercise program. Assessments were performed as pretest and posttest by four subtests of the Bruininks-Oseretsky test of Motor Proficiency and Continuous Performance test. Then, the mean scores were compared between the pretest and posttest phases and between control and experimental groups by the paired t-test, Wilcoxon signed-rank test, two-sample t-test, and Mann-Whitney U test.

The results indicated a significant difference between the control and experimental groups in the pretest and posttest scores of balance (P = 0.000), upper limb coordination (P = 0.000), bilateral coordination (P = 0.004), and visual-motor control (P = 0.023) subtests of Bruininks-Oseretsky test and Continuous Performance test (P = 0.017) in children with hearing deficits.

Balance training including vestibular sensory and motor exercise program can simultaneously affect balance performance, motor coordination, and attention in children with hearing deficits.

One of the executive functions affected by autism spectrum disorder is set-shifting. Set-shifting leads to adaptive behaviors in different life situations, including school function.

Accordingly, this study aimed to examine the relationship between set-shifting and school function in children with autism spectrum disorder.

In this cross-sectional (descriptive-analytic) study, a total of 52 students aged between 7 and 12 years old with autism spectrum disorder were selected through convenient sampling technique in schools specifically for the autistic children in Tehran, Iran (2017 - 2018). The required data were collected using school function assessment (SFA) and behavior rating inventory of executive function (BRIEF) and were analyzed using the Pearson correlation coefficient and regression analysis.

The results showed that the shifting subscale of BRIEF has a significant reverse relationship with school function (P < 0.5). It should be noted that in BRIEF, the higher score indicates further damage. Also, the results of regression analysis revealed a predictive role for set-shifting in the school function of children with autism spectrum disorder (β = -0.67, P < 0.05).

Set-shifting is associated with the school function of children with autism spectrum disorders. Furthermore, setshifting can predict the school function and autistic children with problems in set-shifting are expected to have a weak school function.

Executive functions (EF) impairments are considered as central deficits in autism spectrum disorder (ASD). The purpose of this study was to determine the effectiveness of cognitive rehabilitation therapy (CRT) on EFs of children with high-functioning ASD (HFA).

This was a quasi-experimental study with a pretest-posttest design and control group. The study population included all children with HFA referred to the comprehensive Arman Shayan Rehabilitation Center in Tehran, Iran. Using the high-functioning Autism Spectrum Screening Questionnaire (ASSQ) and clinical diagnostic interviews by two clinical psychologists, 24 children with HFA were selected purposefully and were randomly assigned to experimental or control groups. Subjects in both groups completed the Behavior Rating Inventory of Executive Function (BRIEF) in pretest and posttest. The experimental group received 1-2 sessions (1 hour) per week of CRT for 6 months. Data analysis was performed using analysis of covariance (ANCOVA) in SPSS.

Data analysis showed that the use of CRT resulted in a significant difference between groups in terms of the total EFs score, which was 88.5%, as well as the components of inhibition (57%), orientation (46%), emotional control (42%), initiate (43%), working memory (55%), planning (56%), organizing (36%),and monitoring (36%).

CRT, as an evidence-based intervention, seems to be effective in improving neuropsychological functions in children with HFA.

  Cerebral palsy is a non-progressive disorder in the growing brain that disrupts movement and ultimately limits the individual’s performance and participation in a variety of areas, such as everyday life, play, and school activities. Individualized occupational interventions help these children receive appropriate services and supports based on their needs, abilities, and disabilities. Current research aimed at investigating effect of individualized occupational therapy interventions on mobility in children with cerebral palsy in the schools.

This is a Single-blind randomized clinical trial, in which 18 children with cerebral palsy at ages 6-12 were selected using convenience method, and were divided into control and intervention groups using block randomization method. During the research period, the control group like before the research received the conventional occupational therapy interventions for 5 weeks and 12 sessions. The intervention group received occupational interventions based on the individualized appropriate goals. Both groups were assessed by School Function Assessment (SFA).

The average age of participants was 10.17 years old. Of these children, 52% used wheelchair .Difference in changes of mobility variables was significant between control and intervention group (P<0.05).

The results showed that individual occupational therapy based on participation of children with cerebral palsy in exceptional schools had significant impact on mobility of children in non-academic activities of the school, which requires further studies.

The current study aimed to develop a tool to assess the performance skills of Iranian children aged 5 to 7 years in order to evaluate their school competency based on the occupational therapy practice framework and to determine its validity.
Performance skills are the cornerstone of the tool. The eight-step design process of Devellis was used to develop the tool. To analyze the content validity, the content validity index, and the content validity ratio were used. Following administration of the tool in 100 children (5 to 7 years) in the pilot study, the items were analyzed. After applying the tool to 400 children aged 5 to 7 years, the construct validity of the tool was determined with confirmatory and exploratory factor analysis and differential, convergent, and divergent validity.
The primary item pool included 212 items which was reduced to 112 items after administrating content validity and item analysis. Based on exploratory factor analyses, Kaiser-Meyer-Olkin (KMO) index was (0.890), and five factors indicating 55.02% of the total variance were obtained. The confirmatory factor analysis confirmed the results. The discriminant validity between the age groups was statistically significant (P The results indicated the excellent validity of the SICPSBS to assess the performance skills of 5 to7 year-old Iranian children in terms of school competency. The test evaluates all sensory-perceptual, motor-praxis, visual-perception, cognitive, social interaction, and process domains for each child.