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Objective 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. Materials & Methods The study adopted a Randomized Controlled Trial (RCT) design involving 31 children diagnosed with SLD, implementing TR and inperson 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). Results Both TR and in-person interventions exhibited significant enhancements in academic self-efficacy (F=23.96, p<0.001, Partial η²=0.461), occupational competence (F=70.59, p<0.001, Partial η ²=0.716), and parent satisfaction (F=17.03, p<0.001, Partial η²=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. Conclusion In conclusion, the study demonstrated the efficacy of TR and inperson 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. [ABSTRACT FROM AUTHOR]

Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Background: 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. Objectives: 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. Methods: 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. Result: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Objectives: 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. Methods: 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. Results: 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." Discussion: 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. [ABSTRACT FROM AUTHOR]

Objectives: 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. Methods: 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. Results: 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. Discussion: 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). [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: 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. Methods: 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. Results: 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). Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background: Activities of daily living as an ultimate goal of rehabilitation relies on cultural and environmental factor. The purpose of this study was to develop a questionnaire based on Occupational therapy practice frame to accurately evaluate the occupational performance of Iranian children. Methods: This scale was developed in two phases of planning and constructing. 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. Results: The final 93-item questionnaire was used to assess the daily activities of 3-6 year old children. The 93 items, selected according to criteria found in the literature and the panel of experts, were categorized in 6 areas of occupational therapy practice framework (bathing/washing/personal hygiene, toileting, dressing, eating/feeding, functional mobility and others). Conclusion: The activities of daily living in Iranian children is a useful and culturally relevant tool for measuring the occupational performance of Iranian children. It can be utilized in clinical and populationbased researches. [ABSTRACT FROM AUTHOR]

Objective: 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. Method: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background: 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. Objectives: Accordingly, this study aimed to examine the relationship between set-shifting and school function in children with autism spectrum disorder. Methods: 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. Results: 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). Conclusions: 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. [ABSTRACT FROM AUTHOR]

Introduction: Semantic system plays a key role in all areas of language including understanding and expression of language. Based on a traditional view, the left hemisphere is dominant for processing of various linguistic information, including semantic information. It is believed that lesions in the left hemisphere impair the semantic component of language. In this study, we aim to study different types of semantic impairment in patients with aphasia; so that with early diagnosis of these sematic impairment we can identify patients who need treatment. Materials and Methods: This is a cross-sectional, descriptive-analytic study. A total of 39 subjects, comprising 13 patients with left cerebral ischemic stroke in the temporoparietal region and 26 healthy subjects, were evaluated using pyramids and palm trees test, concrete and abstract word synonym test, and Bilingual Aphasia Test (BAT). Results: In concrete and abstract word synonym test, patients with left hemisphere damage had lower performance than the normal group. Only in the verbal version of the pyramids and palm trees test, patients with left hemisphere damage obtained significantly lower scores than the normal participants. In the BAT test, patients with left hemisphere had a heterogeneous performance. Conclusion: Based on these findings, although a large part of semantic processing is performed by the dominant hemisphere of the brain, the right hemisphere has a complementary role in semantic processing. [ABSTRACT FROM AUTHOR]

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

Background: Despite their high effectiveness, rehabilitation therapies can reduce the number of families with children with autism spectrum disorder (ASD) visiting clinicsdueto thenumberof treatment sessionsandthe 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. Objectives: The present study was carried out to examine the effectiveness of tDCS in behavioral and cognitive aspects of executive functions in children with ASD. Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Background: 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. Methods: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Background and Objectives: The onset of rehabilitation interventions in children with autism spectrum disorder below 5 years old has been associated with the reduction of autism symptoms in all developmental domains. The present study aimed to illustrate the importance of early family-oriented interventions in the reduction of the problems and symptoms of children with autism spectrum disorder., Methodology: This study was a pretest-posttest clinical trial without a control group. Fifty patients were selected using a convenience sampling method, of which forty patients were male and 10 females with a mean age of 3.2 ± 1.4. The efficacy assessment was evaluated using the Autism Behavior Checklist (ABC) and the Autism Treatment Evaluation Checklist (ATEC) as pretest and posttest. Data were analyzed by independent T-test using SPSS software., Results: The difference between pretest and posttest was significant in all aspects of the ATEC test (communication, health, sensory and cognitive awareness, socialization) at the level of P < 0.001. Moreover, the difference between pretest and posttest was significant at P < 0.001 for the aspects of speech, social and communication, and general performance, and at P < 0.002 for the sensory processing., Conclusion: Timely interventions under 6 years old with an emphasis on family-oriented and growth aspects over one year can help autistic children in the aspects of speech, social and communication, sensory processing, and sensory and cognitive awareness., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)