samaneh karamali esmaili

Women faced enormous burdens during the COVID-19 pandemic. Due to specific conditions in homes during social isolation, women's occupational choices were limited by environmental factors. In a crisis, it is important to understand the human experience of what they do to meet the basic needs of Being, Becoming, and Belonging. This experience can reflect life participation and occupational wholeness during a pandemic. This research aimed to investigate the factors related to women's perceived experiences of Being, Becoming, and Belonging during social isolation/distancing. This cross-sectional study's participants were 1,168 women from Arab countries, France, Germany, Greece, India, Iran, and Spain, recruited using snowball sampling in a larger survey of the COVID-19 pandemic. They completed an internet-based questionnaire with questions extracted from the Occupational Wholeness Questionnaire. This questionnaire also included demographic information, perceived stress, and physical health. Women with postgraduate education had a more positive sense of Being and Belonging. Women over 45 showed a higher negative sense of Being and Becoming. Stress was associated with the sense of Becoming. Older women experience social isolation more negatively. Conversely, women with postgraduate education are more likely to have a positive experience in such a situation. We conclude that an occupational imbalance resulting from a crisis may also positively affect life.

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.

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.

Children with autism spectrum disorder (ASD) face some challenges with performing self-care. Many performance components, including sensory and cognitive functions, are effective in performing self-care.

This study aimed to compare the role of sensory processing and executive functions in performing self-care among preschool children with ASD.

In this cross-sectional study, 70 children with ASD aged 3-6 years were selected and investigated by adopting convenience sampling. The instruments included the Short Sensory Profile-2 (SSP-2), Behavior Rating Inventory of Executive Function (BRIEF), and Pediatric Evaluation of Disability Inventory (PEDI). The data were analyzed using Pearson correlation and linear regression tests.

The results of the correlation revealed that executive functions (P≤0.01) and sensory processing (P ≤ 0.005) had a small yet significant inverse relationship with performing self-care activities. The results of stepwise linear regression showed that executive functions and sensory processing were equally capable of predicting self-care activities.

It was recommended that therapists should pay enough attention to both executive functions and sensory processing in order to solve the self-care problems of preschool children with ASD. Due to the low correlation between variables, it was also suggested that a multifactorial approach to self-care activities should be employed as well as the role of other factors along with sensory processing and executive function should be considered.

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.

 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.

The term “playfulness” is a new word in Persian and one of the intervention areas in pediatric occupational therapy/psychology. The aim of this study was to investigate the face and content validity of the Persian version of the test of playfulness (ToP) and its adaptation to the population of Iranian children aged 3 to 6 years. 

First, the ToP was translated according to the standard forward-backward (IQOLA) methodology. The face validity was qualitatively evaluated by five and content validity was qualitatively-quantitatively examined by ten occupational therapy experts specialized in rehabilitation of children’s play. The content validity ratio (CVR), content validity index (CVI), and modified kappa statistic were calculated. 

The face validity investigation of the Persian version of ToP led to changes in four items and the title of the intensity scale. The CVR for the 21 ToP items ranged from 0.8-1, indicating the necessity of all items. Also, the CVI was in the range of 0.85-1, which indicates the suitability of all items. The Scale-CVI/Ave quality and relevance were 0.93 and 0.95, respectively, and the Scale-CVI/UA quality and relevance were 0.43 and 0.95, respectively.

According to the findings of this study, no items were deleted or added in translation during the cultural adaptation process of the ToP. The experts confirmed that all items measure the construct of playfulness and that the items and instructions in the Persian version of ToP have good face validity and high content validity; therefore, the other dimensions of psychometrics can be examined in future studies.

Aggression and impulsivity are some of the behavioral symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). Neurofeedback (NF) training has been suggested as a promising treatment in these children. This study aimed to investigate the effect of NF training on aggression and impulsivity in schoolchildren with ADHD. 

A total of 40 male elementary school children with ADHD (aged 11.17±0.97 years) were randomized into the NF and sham groups. The NF group received 12 NF training sessions, each taking about 60 minutes for six consecutive weeks (twice a week), based on the Hammond protocol. The subjects’ parents were questioned to evaluate the outcomes, including aggression and impulsivity, using the Buss-Perry Aggression Questionnaire (BPAQ) and Barratt Impulsiveness Scale (BIS).

After the intervention, in the NF group, the BPAQ score changed from 87.60±9.33 to 81±7.23 and the BIS score from 94.7±7.25 to 88.05±5.4, which were significant (P=0.001). The results indicated the large effect size of NF on aggression and impulsivity in ADHD.

Our findings suggest NF training as a clinically applicable method for decreasing aggression and impulsivity, also support concurrent use of medication and NF training in children with ADHD.

Self-determination is the ability of recognizing, setting and achieving goals based on knowledge and self-assessment. This ability is essential for the healthy development of adolescents. Self-determination is influenced by knowledge, skills, beliefs, and contextual factors that exist in one's living environment. Since it is an essential element for having a successful life, its assessment and related skills are also important; however, there is no assessment tool for its measurement in Iranian population. The aim of this study was to translate the Self-Determination Student Scale (SSDS) into Persian and determine its psychometric properties including face, content, and construct validity as well as internal consistency and test-retest reliability in adolescents aged 14-18 years.

In this methodological study, the SSDS was translated into Persian to be used on Iranian population and validated according to the International Quality of Life Assessment (IQOLA) protocol. Samples were 498 high school students (mean age = 15.15±0.9; 227 females and 221 males) who were selected using convenience sampling technique with maximum diversity in Tehran. They were divided into two groups of with and without emotional/behavioral symptoms using the Youth Self-Report tool. The face validity of the translated SSDS was determined based on the opinions of samples and experts. The Content Validity Index (CVI) and Content Validity Ratio (CVR) were also calculated for each items of the translated version. The construct validity was tested by comparing known groups (gender groups and groups at risk of emotional/behavioral disorders). Moreover, its internal consistency was estimated by Kuder-Richardson formula, and test-retest reliability was tested using Intraclass Correlation Coefficient (ICC) on 16 students with a time interval of 14 days.

In the Persian version of SDSS, 4 items were removed from the original version. After confirmation of its face validity after modification, it was found that its items had appropriate content validity based on CVI and CVR scores. The mean of self-determination score under all subscales and most of items was significant between the gender group and the group at risk of emotional/behavioral disorders (P< 0.001). The Kuder-Richardson coefficient was obtained 0.89 and for five subscales, it was in a range of 0.51 to 0.72. The ICC (0.98; 95% CI:0.95 to 0.98) approved the good reliability of the instrument.

The Persian version of SDSS had good validity (face, content, and construct) and reliability after testing it on the high school students. Therefore, it can be used in clinical and research studies to assess the self-determination of students. Considering the importance of self-definition in adolescence, there is a need for further studies using the SDSS to highlight the potential problems of high school students in self-determination and designing related training programs.

  The progressive prevalence of Autism Spectrum Disorder and the high cost of its treatment suggest that health services should be purposefully provided to people with this disorder. Occupational therapists play a key role in the rehabilitation of autism. This study sought to monitor occupational therapy services provided to individuals with autism.

A survey about occupational therapy services for people with autism spectrum disorder was distributed to therapists. They completed a researcher-made questionnaire asking them about working conditions, knowledge sources, assessments, and interventions that have been used in autism. 225 questionnaires were distributed among occupational therapists who had the inclusion criteria.

The number of the full-filled questionnaires was 124. The therapists worked more individual therapy (95%) than group sessions (23%). Household economic problems were reported as the most common cause of occupational therapy discontinuation. They focused more on sensory approaches and cognitive models. The education level of the therapist was significantly correlated with autism-specific experience (r=0.376, P=0.00). Of the respondents, 50.8% reported their competency to treat autism as higher than average. Perceived competency was significantly correlated with providing consultation by the therapists (r=0.256, P=0.004).

Occupational therapists apply sensory and cognitive approaches in autism. Therapists should try to resolve the problems that exist for group therapy sessions. The use of sensory-based therapies and their impact on the participation in everyday life is controversial. Finding a solution to compensate for the high cost of occupational therapy for autism can make people more likely to receive occupational therapy services.

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.

Nature, definitions and theories of play in humanistic sciences is known with psychologocal origin. Among medicine and rehabilitation sciences, occupational therapy is the only profession that deals with a particular focus on play.
In this paper, the role of play in pediatric occupational therapy is discussed and the exsicting model is explained. Overall, the viewpoint of this model is congruent with exsicting definitions about play in psychology. It proposes that the special criterias are necessary to name an activity as a play; we can not name every structural training exercise as the play.