Underlying pathway of factors leading to mental health in Iranian young adolescents: A structural equation modeling.

BACKGROUND: The present study aimed to provide a field-tested model of constituting factors affecting mental health in young Iranian adolescents. MATERIALS AND METHODS: In this cross-sectional study, a conceptual model was proposed based on an extensive literature review. A total of 254 young adolescents aged 11-14 years were recruited from north, south, east, and west regions of Tehran megacity by a random cluster sampling procedure, of whom 244 adolescents participated. The adolescents and their mothers altogether completed eight questionnaires pertaining to the proposed conceptual model: (1) Strengths and Difficulties Questionnaire (SDQ), (2) Childhood Experience of Care and Abuse Questionnaire, (3) Child Exposure to Domestic Violence Scale, (4) Drug Abuse Screening Test-10, (5) Baumrind Parenting Style Questionnaire, (6) Conflict Behavior Questionnaire, (7) General Health Questionnaire-28, and (8) Garmaroodi Socioeconomic Status Questionnaire. The statistical analysis was performed using structural equation modeling. RESULTS: This study demonstrated that parent mental health (b = -0.111), experience of father's care (b = -1.112), conflict with mother (b = 0.309), conflict with father (b = 0.135), and exposure to domestic violence (b = 0.217), as well as age (b = 0.93) and gender (b = 0.139), had direct effect on adolescent mental health (all P < 0.05). Further, the results showed that exposure to domestic violence and conflict with mother had the greatest direct impact on adolescent mental health among all other family-related factors, followed by conflict with father and parent mental health. Conflict with mother and conflict with father also affected adolescent mental health indirectly through experience of domestic violence and had a mediating effect for the influence of several other factors on adolescent mental health, thus playing an important role in the pathway leading to young adolescent mental health status in the Iranian population. CONCLUSION: Overall, the final model proved to be fit and the factors constituting the final model were able to predict 88% of the variations in the mental health of Iranian adolescents. This model can guide clinical psychologists, psychiatrists, and other mental health workers in a more realistic and effective prevention or treatment planning for their young clients. Moreover, it may help in arriving at a comprehensive preventive policymaking for mental health policymakers.

Comparative Study of Abdominal Muscle Thickness on Ultrasonography in Healthy Adolescents and Patients With Low Back Pain.

OBJECTIVES: Low back pain (LBP) is a common musculoskeletal disorder among different age groups, including adolescents. The purpose of this study was to compare the abdominal muscle thickness between healthy adolescents and those with LBP. METHODS: One hundred sixty healthy high school adolescents and 80 high school adolescents with LBP participated in the study. All participants were asked to complete a demographic questionnaire and also a visual analog scale and the Oswestry Disability Questionnaire to evaluate the pain intensity and functional disability. Then abdominal muscle thickness was examined with ultrasonography. RESULTS: The healthy high adolescents included 80 boys and 80 girls, and the adolescents with LBP included 40 boys and 40 girls. The results showed a significant difference between healthy adolescents and those with LBP in terms of abdominal muscle thickness (P < .05). Patients with LBP had smaller abdominal muscles compared with healthy adolescents. No significant difference was found between the groups in terms of the subcutaneous fat dimension (P > .05). CONCLUSIONS: The thickness of abdominal muscles was lower in adolescents with LBP. Future studies with a larger sample and a wider age range are recommended to support the results of this study.

Comparing Levels of Mastery Motivation in Children with Cerebral Palsy (CP) and Typically Developing Children.

INTRODUCTION: The present study aimed to compare motivation in school-age children with CP and typically developing children. MATERIAL AND METHODS: 229 parents of children with cerebral palsy and 212 parents of typically developing children participated in the present cross sectional study and completed demographic and DMQ18 forms. The rest of information was measured by an occupational therapist. Average age was equal to 127.12±24.56 months for children with cerebral palsy (CP) and 128.08±15.90 for typically developing children. Independent t-test used to compare two groups; and Pearson correlation coefficient by SPSS software applied to study correlation with other factors. RESULTS: There were differences between DMQ subscales of CP and typically developing groups in terms of all subscales (P<0.05). The lowest motivation scores of subscales obtained in gross motor persistence (2.4870±.81047) and cognitive-oriented persistence (2.8529±.84223) in children with CP. Motivation was correlated with Gross Motor function Classification System (r= -0.831, P<0.001), Manual ability classification system (r=-0.782, P<0.001) and cognitive impairment (r=-0.161, P<0.05). CONCLUSION: Children with CP had lower mastery motivation than typically developing children. Rehabilitation efforts should take to enhance motivation, so that children felt empowered to do tasks or practices.

Cultural adaptation, validation, and standardization of a developmental screening tool (ASQ-3) in Iranian children.

Objectives: This study aimed at culturally adapting, validating, and standardizing the Ages and Stages Questionnaire, third edition (ASQ-3) by implementing a nation-wide cross-sectional methodological study in order to provide a valid and reliable tool for determining the developmental status of Iranian children. Materials & Methods: This cross-sectional and methodological study was conducted on Iranian children between 1-66 months. The ASQ-3 tool was translated; following that, its face and content validity, as well as the cross-cultural adaptation were assessed by 51 specialists and experts in the field of pediatrics and child development. In order to determine the reliability of the ASQ-3 (using Cronbach's alpha), and cut-off points. All statistical analyses were performed using STATA software. Results: This study was enrolled in 2 phases. The face and content validity, as well as the cultural relevance of the Persian version of ASQ-3 was confirmed using panel of specialists views then researchers investigated 11,740 children aged 1-66 months in order to evaluate the reliability of the tool. The Cronbach's alpha coefficients (reliability) determined for the ASQ-3 and the cut-off points for the ASQ-3 of different age groups and domains were determined by calculating one and two SDs below the mean; the latter represents the main cut-off point, and the interval between the two represents the monitoring zone according to the ASQ-3 technical manual. Conclusion: The results of this study showed that the Iranian version of ASQ-3 is valid and reliable; moreover, the cut-off points designated for it can be implemented in the Iranian children community to assess their developmental status.

The effects of thigh corset with side bars suspension in a subject with transtibial amputation: a biomechanical investigation.

This study aims to investigate some biomechanical effects of a thigh corset with side bars (TC-SB) on the gait of a transtibial amputee. During two test conditions of with/without TC-SB, the angles of prosthetic lower limb joints, stride time, stance time and maximum vertical ground reaction force were evaluated. Only the angle of hip joint at initial contact and its maximum flexion at swing phase had significant changes (P < 0.05). This may suggest the amputee has used a compensatory mechanism to overcome the additional weight of the TC-SB suspension. It seems that the participated amputee has no need for this auxiliary suspension.

Genomic characterization of some Iranian children with idiopathic mental retardation using array comparative genomic hybridization.

BACKGROUND: Mental retardation (MR) has a prevalence of 1-3% and genetic causes are present in more than 50% of patients. Chromosomal abnormalities are one of the most common genetic causes of MR and are responsible for 4-28% of mental retardation. However, the smallest loss or gain of material visible by standard cytogenetic is about 4 Mb and for smaller abnormalities, molecular cytogenetic techniques such as array comparative genomic hybridization (array CGH) should be used. It has been shown that 15-25% of idiopathic MR (IMR) has submicroscopic rearrangements detectable by array CGH. In this project, the genomic abnormalities were investigated in 32 MR patients using this technique. MATERIALS AND METHODS: Patients with IMR with dysmorphism were investigated in this study. Karyotype analysis, fragile X and metabolic tests were first carried out on the patients. The copy number variation was then assessed in a total of 32 patients with normal results for the mentioned tests using whole genome oligo array CGH. Multiple ligation probe amplification was carried out as a confirmation test. RESULTS: In total, 19% of the patients showed genomic abnormalities. This is reduced to 12.5% once the two patients with abnormal karyotypes (upon re-evaluation) are removed. CONCLUSION: The array CGH technique increased the detection rate of genomic imbalances in our patients by 12.5%. It is an accurate and reliable method for the determination of genomic imbalances in patients with IMR and dysmorphism.

The effect of age, sex and obesity on fundamental motor skills among 4 to 6 years-old children.

OBJECTIVE: To examine the effect of age, sex and obesity on Fundamental Motor Skills (FMS) in 4 to 6 years-old children. METHODOLOGY: A total of 400 preschool children (200 boys and 200 girls) between the ages of 4 to 6 years old participated in this research. Subjects were selected through multi-stage cluster random sampling. Fundamental motor skills (FMS) were assessed with using the OSU-SIGMA scale. Body mass index (BMI) was directly measured from height(m)(2)/weight(kg) for each child and based on CDC growth charts, normal weight, overweight and obesity were defined. RESULTS: The results showed that age and sex variables were a significant effect on walking and running skills, but BMI was not significant (P>0.05). Also, these variables had a significant effect on jumping, skipping, hopping and ladder climbing. In both ages, boys in jumping and ladder climbing skills were better than girls, but the girls were better in skipping and hopping skills (P<0.05). Moreover, the results showed that age and BMI variables have a significant effect on stair climbing skill, but sex was not significant (P>0.05). For object control skills, the results showed that age and sex variables were a significant effect on catching and throwing skills, but BMI was not significant (P>0.05). Finally, the age, sex and BMI variables were a significant effect on kicking and sticking skills. CONCLUSION: This research demonstrated that boys performed better than girls, and both overweight and obese children have lower performance than normal children.

A Comparison Study of the Tehran Norms to the Reference Norms on Children Performance of the Bayley III.

Objectives: The Bayley Scales of Infant and Toddler Development (3rd ed.; Bayley III) are widely used to assess cognitive, language, and motor development of children aged 1-42 months. It is unclear whether or not the reference norms of the Bayley III are acceptable for use in other populations or lead to over- or underestimating the developmental status of target children. This study aimed to compare the Tehran norms to the reference norms. Materials & Methods: We used Bayley III norms to assess cognitive, language, and motor development of 1,674 healthy children from health care centers in Tehran. Differences between the scaled scores were calculated based on the Tehran and reference norms. A one-sample multivariate analysis of variance (MANOVA) was used to control the mean difference scores over all subtests. When MANOVA showed significant differences between the scaled scores based on the Tehran and reference norms, we used univariate analysis to see which subtest and age group led to these significant differences. Finally, the proportions of children with low scores (scaled scores <7 or -1 SD and <4 or -2 SD) based on 2 norms were compared using the McNemar test to determine the over- or underestimation of developmental delay. Results: The scaled scores based on the Tehran norms varied across values based on the reference norms in all subtests. The mean differences were significant in all 5 subtests (p < .05) with large effect sizes for receptive and expressive communication, fine and gross motor subtests of .20, .23, .14, and .25, respectively, as well as with a small effect size for the cognition subtest of .02. Large effect sizes for all age groups were found for cognition, expressive communication, and fine motor subtests. More children scored below 1 and 2 SD using the Tehran norms. Using the reference norms resulted in underestimation of developmental delay regarding cognitive, receptive and expressive communication, and fine and gross motor skills. Conclusion: Population-specific norms should be used to identify children with low scores for referral and intervention. The Tehran norms differed from the reference norms for all subtests, and these differences were clinically significant.

Is There Any Association Between Language Acquisition and Cognitive Development in Cochlear-Implanted Children?

OBJECTIVE: Different studies on normal children and children with a sensory or intellectual disability indicate a strong correlation between the child's vocabulary domain and his cognitive abilities. Based on this, the main focus of the present study was to investigate the cognitive performance of cochlear-implanted children after a cognition-based language intervention program. METHODS: In this experimental study, 60 cochlear-implanted children were selected and randomly allocated into case and control groups. The control group received auditory verbal therapy (AVT), while the intervention group was trained by using both AVT and a language intervention protocol that was recently developed by the authors. Finally, the participants' communication abilities were assessed through the adapted version of the language subtest of Bayley Scales of Infant and Toddler Development - Third Edition (BSID 3). Five months later, the cognitive subtest was carried out. The data gathered were then analyzed using SPSS software. RESULTS: The study was performed on 2 groups of 20- to 24-month-old cochlear implant users, and our results confirmed a high correlation between language acquisition and cognitive development (r = 0.76). In addition, the cognitive and language performance of the participants who were trained by the new and specifically designed language intervention protocol as well as AVT was significantly higher than that of the control group (P ≤ .001). CONCLUSION: The new and specifically designed language intervention protocol that was mainly established based on cognitive factors such as attention and semantic memory enhancement in cochlear-implanted children improved not only their language acquisition but also their cognitive development.

Prevalence of fundamental movement skill proficiency among Iranian children aged 2.5-14 years.

OBJECTIVES: To determine the prevalence of fundamental movement skill (FMS) proficiency among a sample of Iranian children. DESIGN: Cross sectional, representative sample of 2200 children aged 2.5-14 years (50% girls), living in Tehran in 2018. METHODS: Trained field staff assessed 7 locomotor and 4 object control skills in educational settings using the Ohio State University Scale of Intra-Gross Motor Assessment (OSU-SIGMA). Scores for levels 1-3 represent immature performance and level 4 represents proficiency. Data were analyzed by age and sex. RESULTS: Overall, proficiency prevalences were higher in boys than girls. Proficiency in walking and running emerged in children from age 2.5 years, and proficiency in more complex locomotor skills (i.e., jumping, skipping, hopping, ladder-climbing) and object control skills emerged at age 6 years. The prevalence of proficiency in hopping, jumping, skipping and all object control skills were low in children aged <9 years. All children aged ≥9 years were proficient in all locomotor skills. At age 9 years, the prevalence of object control proficiency were high for throwing (boys 100%, girls 89%), catching (boys 89%, girls 65%), striking (boys 69%, girls 53%) and low for kicking (boys 45%, girls 41%). All children ≥11 years were proficient in all FMS except kicking (boys 61%, girls 55%). CONCLUSIONS: FMS proficiency were age and sex related with proficiency in most skills emerging around age 6 years. All children aged ≥11 years were proficient in all FMS, except kicking. The findings may be useful to guide the development of intervention programs in Iranian children aged 2.5-10 years.

The development of postural control among children: Repeatability and normative data for computerized dynamic posturography system.

BACKGROUND: The purpose of this study was to investigate the normal development of postural control in children aged 2-18 years in Tehran, and to provide normative data of computerized dynamic posturography (CDP) device variables. METHODS: The study population included 400 boys and 400 girls aged 2-18 years (eight age groups with 2-year interval) and 100 adults aged 22-25 years. In each age group, 100 people were selected based on the inclusion and exclusion criteria. To evaluate the postural control of the subjects, the sensory organization test (SOT) was performed by using a CDP. RESULTS: The results of this study led to the determination and presentation of normative data for the development of postural control in boys, girls and children aged 2-18 years. The results related to the repeatability of data produced by the CDP, thereby showing that this system is highly reliable. The results of an independent t-test also showed that girls across all age groups performed better than boys (p ≤ 0.05). CONCLUSION: The results of this study demonstrated a nonlinear trend of natural development of postural control. Overall, according to the results of the present study, it seems that like adults, 14-16 year-old teens are capable of processing, integrating and organizing sensory systems information for postural control.

The Psychometric Properties of the Persian Version of Childhood Experience of Care and Abuse Questionnaire (CECA).

BACKGROUND: The present study aimed to determine the psychometric properties of the Persian version of the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), a tool based on a retrospective interview with the child. MATERIALS AND METHODS: To this aim, 251 adolescents from four regions of Tehran megacity completed the questionnaire. The reliability of the questionnaire was examined, along with the face and content validity. In addition, the construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS: EFA and CFA supported a 4-factor solution including mother's role scale items, father's role scale items, maternal behavior scale items, and paternal behavior scale items. The total variance extracted in EFA ranged from 33.9 to 60.7. The internal consistency for mother's role, father's role, maternal behavior, and paternal behavior was 0.61, 0.65, 0.86, and 0.9 respectively. Thus, the questionnaire had a suitable fit, as well as reasonable reliability and validity. CONCLUSION: The Persian version of the CECA.Q had adequate reliability and validity as a self-report measurement for childhood experience of care and abuse.

Social Determinants of Health, Maternal Involvement, and Child Development: Direct and Mediated Pathways.

OBJECTIVES: In the process of child development, a variety of factors are at play. In this regard, social determinants of health play a determining role in the development and growth of the child. This study aimed to design and test the model for social determinants of health for the development of 36-6o-month-old children in Tehran with the mediation of maternal involvement. MATERIALS & METHODS: This cross-sectional study was conducted among 1067 mothers and their 36-60-month-old children in childcare centers in Tehran, using multistage sampling. Data gathering tools consisted of a demographic questionnaire for mothers and children, a questionnaire on unhealthy behaviors, Ages and Stages Questionnaire, Economic and Social Status Questionnaire, Perceived Social Support Questionnaire, Perceived Stress Questionnaire, Spielberger Anxiety Inventory, Beck Depression Inventory, ENRICH: Marital Satisfaction Scale, and Participation Scale for Parents and Mothers. RESULTS: Model fit measures were suitable and goodness of fit (RMSEA = 0.031, GFI = 1) was satisfactory. In addition, the results of path analysis indicated that the participation of mothers in the development of children had a direct positive (ß = 0.089) and increasing effect. CONCLUSION: Findings indicated that depression, anxiety, stress, and marital satisfaction have both direct and indirect effects on the participation of mothers and child development. Moreover, the model fit measures indicated the utility and high proportionality of the model, as well as the logic of the adjusted relationships of variables based on the conceptual model.

The Psychometric Properties of the Drug Abuse Screening Test.

BACKGROUND: Substance abuse is a critical problem in most countries, especially in developing ones. Early detection is the pre-requisite of early control, for which reliable and valid tools are required. In the present study, we aimed at measuring the psychometric properties of the 10-item Drug Abuse Screening Test (DAST-10) in Iranian individuals. METHODS: After translation and back-translation of the questionnaire, 244 adults were recruited from Tehran Megacity, Iran, and completed the questionnaires. Participants were recruited by a multistage randomized cluster sampling method. Reliability was determined by Cronbach's alpha. Also, construct validity was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). FINDINGS: The internal consistency using Cronbach's alpha coefficients for the total score of the Persian version of DAST-10 was 0.93. EFA evoked only one factor for DAST-10. The CFA for 1-factor models for DAST-10 indicated an acceptable fit for the proposed models. CONCLUSION: The results prove desirable reliability and validity of the Persian version of the DAST which can be utilized as a screening instrument for drug abuse among Iranian adults.

Perinatal and neonatal risk factors for neurodevelopmental outcome in infants in Karaj.

BACKGROUND: Although it is well-known that the incidence of developmental delay in high-risk infants is higher than in low-risk ones, little is known about the risk factors among Iranian infants. The objective of this study was to determine the various pre-, peri-, and neonatal factors in developmental delay in participants and to compare the incidence of each factor with that of the normal population. METHODS: The Infant Neurological International Battery developmental assessment was employed as the diagnostic tool by a team of experts. Neurological examinations were performed and a questionnaire was completed as well. The subjects consisted of 6,150 infants divided into two groups respectively, with normal and abnormal scores for the evaluation over a period of 12 months in city of Karaj (Tehran Province). RESULTS: The mean age of the participants was 39 weeks. Factors associated with a significant increased risk of developmental delay in the studied population included postneonatal seizures (OR=5.54, 95%CI: 3.1 - 9.6), neonatal seizures (OR=4.37, 95%CI: 1.7 - 10.8), preterm delivery (OR=2.52, 95%CI: 1.3 - 4.7), and type II pneumonia (OR=2.39, 95%CI: 1.4 - 3.8). CONCLUSION: To increase the survival rate of neonates and effectiveness of early intervention, the above-mentioned risk factors could be considered as valuable clues. Routine neurodevelopmental screening for neonates and infants for early detection of neurodevelopmental delays is highly recommended. If economic limitations prevent mass-screening of neonates, at least high-risk infants should be routinely re-evaluated.

The Effect of the Timing of Umbilical Cord Clamping on Hemoglobin Levels, Neonatal Outcomes and Developmental Status in Infants at 4 Months Old.

OBJECTIVES: Delayed umbilical cord clamping (DCC) increases blood transfer to newborns. Hence we investigated the effect of the timing of DCC on hemoglobin levels, neonatal outcomes and developmental status in infants at four months old. MATERIALS & METHODS: This clinical trial examined infants born to 400 pregnant women immediately upon birth and at the age of four months in Isfahan, central Iran in 2016. A table of random numbers was used to randomly allocate the newborns to intervention group with a 90-120-sec delay in umbilical cord clamping and the control group with a clamping delay of below 60 sec, and blood samples were taken from their umbilical cords. The Ages and Stages Questionnaire was used to evaluate the infants' developmental status. RESULTS: Umbilical cord hemoglobin was significantly higher in the intervention group compared to in the controls (P=0.024). No significant differences were observed between the two groups in terms of neonatal complications except neonatal jaundice was significantly more common in the intervention group (P=0.025), although the need for phototherapy was not different between the groups. Overall, no significant differences were observed between the two groups in terms of developmental status at four months old; however, the infants had better problem-solving skills in the DCC group (P=0.015). CONCLUSION: Despite elevating hemoglobin, DCC has no effects on infant development except in terms of problem-solving skills. Further studies are recommended on the effects of DCC on infant development.

The effectiveness of a specifically-designed language intervention protocol on the cochlear implanted children's communication development.

OBJECTIVE: Although various studies have depicted the importance of language intervention programs in facilitating language acquisition in cochlear implanted children, to this date rarely has a specific language intervention approach been recommended as better than the other and no best practice has been introduced in terms of language acquisition outcomes. Thus, the therapists remain uncertain as to which approach to follow and how to apply evidence to practice. Hence, the main goal of this study was to take a step in this regard by comparing the communication development of pediatric cochlear implant users who enrolled in two different language intervention approaches: the routine auditory-verbal approach, and the routine auditory-verbal approach plus a new intervention protocol specifically designed to enhance receptive vocabulary development in cochlear implanted children. METHOD AND MATERIALS: This prospective experimental study compared the receptive and expressive communication developmental scores of 26 cochlear implanted 20-24 months old children who received both a routine auditory-verbal intervention and a new cognitive based intervention protocol specifically designed to enhance receptive vocabulary development, with that of a group of 25 participants whose intervention program was only auditory-verbal. The children were recruited from Fars cochlear implant center situated in the city of Shiraz in Iran, and were assigned randomly to the two groups. The communication development of both groups was evaluated by the Bayley scales of Infant and Toddler Development- Third Edition, and statistical analysis was performed using the Statistical Package for Social Sciences-version 21(SPSS-21). RESULTS: The two groups were not significantly different in terms of age, sex and parents' educational level. Both the receptive and expressive communication outcomes of the children who received auditory-verbal as well as the new specifically-designed cognitive-based intervention protocol focusing on receptive vocabulary enhancement, were significantly higher than the control group (p < 0.001). CONCLUSION: The new specifically-designed cognitive-based language intervention protocol focusing on receptive vocabulary enhancement was significantly more effective in promoting and enhancing the communication development of cochlear implanted children than the routine auditory-verbal intervention.

The Development of an Interventional Package on "Receptive Vocabulary" For Cochlear Implanted Children.

OBJECTIVES: Considering the shortage of language intervention protocols which specifically concentrate on cochlear implanted children and considering the importance of timely language intervention in this group of children, the aim of the present study was to develop an interventional package on "receptive vocabulary" for cochlear implanted children. MATERIALS & METHODS: By reviewing the literature related to language acquisition theories in normal and language disordered children, as well as literature on production of intervention protocols, especially those for language impaired children, and also considering the normal process of language and speech development in normal children, the first draft of the intervention protocol was prepared. Then, the face and content validity of the intervention protocol was assessed by a Delphi team through three rounds and finally approved. RESULTS: A language intervention protocol was developed to enhance receptive vocabulary in 12-48 months-old cochlear implanted children, based on cognitive, behavioral and developmental theories. This protocol includes 5 interventional stages: 1-Drilling and Imitation; 2-Modeling; 3-Motor training; 4-Deliberate error correction; 5- Reinstatement and Generalization. Each stage consists of the description of the aims of that stage, a list of techniques, the tools required, the detailed step by step explanation of the intervention, how re-enforcement must take place, and finally the indicators of success which permit to move forward to the next stage. CONCLUSION: The interventional package produced is believed to facilitate language acquisition in cochlear implanted children, according to expert qualitative assessment and approval. Experimental research is required for verification of this assumption.

Marital Satisfaction and Depression in Mothers of 3-4 Year Old Children with Developmental Delay in Comparison with Mothers of Normal Children.

OBJECTIVES: The present study evaluated the depression and marital satisfaction in mothers of 36-48 months old children with developmental delay in comparison with mothers of normal children. MATERIALS & METHODS: This cross-sectional study was performed on 616 mothers and their children, aged 36 - 48 months, from Apr 2015 to Feb 2016, in some kindergartens in Tehran, Iran. Participants were selected through multi-stage random sampling. The children were divided according to the developmental status into two groups of normal development and developmental delay. The following instruments were used: A demographic and children specification questionnaire, marital satisfaction scale, the Beck Depression Inventory, and the Ages and Stages Questionnaire. The data were analyzed using SPSS16 software. Independent t-test and Pearson correlation were employed at significance level of 0.05. RESULTS: The mean age of children with developmental delay and normal development was 41.94±4.48 and 42.17±5.02 months, respectively. The prevalence of developmental delay in children aged 36-48 months was 17.4% and in normal development children was 82.6%. Developmental delay in boys was 23%. The highest incidence of developmental delays was in fine motor skills. Independent t-test revealed a significant difference between mothers' depression and marital satisfaction with and without developmental delays in their children (P=0.0001). In addition, the correlation was observed between the mother's depression and marital satisfaction (P=0.0001). CONCLUSION: Mothers of children with developmental delay suffer more from depression and have less marital satisfaction compared to mothers of healthy children. Interventional studies to reduce depression and increase marital satisfaction and its impact on development status should be conducted.

Normal values of abdominal muscles thickness in healthy children using ultrasonography.

Abdominal muscles are one of the important elements to support the lumbar spine. Evaluation of muscle thickness using ultrasonography (US) is considered to be a source of information from muscles characteristics. The purpose of this study was to demonstrate normal reference data of abdominal muscles thickness and subcutaneous fat in adolescents using US. A random sample of 160 healthy adolescents (80 boys and 80 girls) at the age range of 15-18 years was recruited. Three abdominal muscles including Transversus Abdominis (TA), Internal Oblique (IO), External Oblique (EO) and subcutaneous fat (SF) were bilaterally measured using US. The range of normal values for TA muscle thickness was between 2.31 and 2.57 mm, for IO muscle thickness was between 4.02 and 5.15 mm and for EO muscle thickness was between 2.81 and 3.17 mm. The normal patterns of abdominal muscles were found as IO > EO > TA at both sides. Boys were taller, heavier with greater body mass index (BMI) and had larger abdominal muscles thickness than girls. A weak negative correlation was found between age and muscles size [r = (-0.06) - (-0.23), p < .05], but a significant positive correlation was found between BMI and muscle size (r = 0.21-0.68, p < .05). It seems that abdominal muscles thickness in adolescents followed the same pattern of muscle size in adults. BMI appeared to be the best predictor of muscle thickness. However, further studies are recommended to support the findings of the present study.