The Auditory Perception of Consonant Contrasts in Cochlear Implant Children.

Background and ObjectivesA major part of speech perception is based on understanding and distinguishing between vocal cues in the speaker's speech. Consonants and vowels are vocal cues that can be affected by hearing impairment and their perception may thus be reduced or distorted. The present study aims to investigate the auditory perception of consonant contrasts in cochlear implant children. Materials and Methods The present cross-sectional, descriptive-analytical study was conducted on 24 cochlear implant children aged 9-13 selected through convenience sampling from schools and cochlear implant centers. A test of non-word pairs based on a study conducted by Khavar-Ghazlani was carried out to measure contrast in consonants, place of and manner of articulation and voicing. Results The results of the test showed that cochlear implant children scored lower in the perception of voicing compared to the other two features. No significant differences were observed between their perceptions of place of articulation and manner of articulation. Conclusion Cochlear implant children appear to have a poorer perception of voicing contrast compared to the other features, which may be due to the greater reliance of this feature on auditory signs.

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.

Development of a speech production test in Azeri Turkish speaking children.

Due to the lack of appropriate tests for the assessment of speech sounds of Azeri Turkish speaking children, the present study aimed to develop and validate a single word test. A total of 150 typically developing children were recruited in the study (30 children for investigating the name agreement and 120 children to establish construct validity). In the first step, a test with 31 items was developed in terms of suggested criteria in the literature including word frequency, word length, syllabic structure, familiarity, and picturability of words. Then, we asked the expert panel's opinion for the test items. The value of the content validity ratio for each target word was 1.00 except for one item. To administer the test, we asked the participants to name images. Name agreement of the items was determined through administrating the test. The percentages for the indices of name agreement were 87.68 and 0.17, respectively. The findings of the item-by-item test-retest and inter-rater reliability showed satisfactory values in terms of consonants in the initial and final positions. Also, the value of the internal consistency was calculated to be kr = 0.78 (p < 0.001). The psychometric properties of this scale with 31 items proved that it is appropriate for quantifying the speech sound production in Azeri Turkish typically developing children.

Comparison of Definitional skills in school-age children with cochlear implants and normal hearing peers.

OBJECTIVE: The auditory experience is important because makes a major contribution to the development of speech, language, cognitive, and social skills. Knowledge of the lexicon has been increased throughout life. Input factors and linguistic and metalinguistic knowledge are effective factors in the acquisition of definitional skills. This study was done to investigate definitional skills in cochlear-implanted (CI) children and their typically developing (TD) peers. MATERIALS & METHODS: A total of 46 third-grade primary school children (16 with cochlear implants and 30 their TD peers) were recruited. The verbal definitional task included 14 common high-frequency nouns and 11 common high-frequency verbs. All definitions were scored for both content (semantic) and grammatical forms. Statistical analysis was conducted to compare the definitional skills between the two groups. RESULTS: There were significant differences between CI children and their TD peers for word definition skills in both categories of content and form (p<0.001). The results showed the mean scores of content andform aspects of word definition in the TD group were approximately twice higher than the CI ones (M±SD=133±28 and M±SD= 78±23, respectively). CONCLUSION: Children with CI may have trouble with definitional skills. It seems that the lower scores of CI children in definitional skills were due to a lack of auditory experience. Considering interventions on definitional skills in CI children is suggested.

Longitudinal Trend of Fasting Blood Glucose and Related Factors in Patients with Type 2 Diabetes.

BACKGROUND: Control of diabetes plays an important role in improving complications and disabilities and quality of life. This study aimed to evaluate the 3-year changes in fasting blood glucose (FBG) values and its related factors in patients with type 2 diabetes. METHODS: In this retrospective cohort study, 500 patients with type 2 diabetes covered by the National Diabetic Prevention and Care Plan during 2013-2016 were selected based on random cluster systematic sampling. A linear mixed model was used to study changes in FBG levels and their related factors. The data were analyzed using the R3.2.0 software. RESULTS: The patients' mean age was 47.7 years. Among these patients, 58.6% were female, 19.8% had a history of smoking. High FBG was associated with high disease duration, high body mass index (BMI), low age, normal BMI at baseline, insulin therapy, smoking, and family history of diabetes. Trend of FBG in follow-up was decreasing. CONCLUSIONS: Given that patients who received insulin therapy had higher mean FBG, it is recommended to examine their insulin dose and modifications should be made in terms of the patients' needs during their continuous follow-up. Weight loss during follow-up and cessation of smoking indicate a favorable prognosis of disease. More attention should be paid to younger patients in care. Patients are encouraged to start treatment and care at the same time diagnose.

Are the Norms of Bayley Screening Test Appropriate for Persian Language Children?

OBJECTIVE: We aimed to assess the distribution of the Bayley screening test by age, and compare developmental risk category distributions between Persian language children and reference norms. MATERIALS & METHODS: A representative sample of 417 children, 1 to 42-months-old, by consecutive sampling from health -care centers were enrolled, during 2014 to 2015 in Tehran, Iran. The cognitive, language and motor development of children were evaluated using Bayley screening test. For determining cut-off point for the subtest scores, two cut-offs were determined for each age group, that classified children to the at risk, emerging, and competent categories. We estimated the agreement of the risk categories between the two samples using weighted kappa statistics. RESULTS: About 70%-80% of all tests operated to the participating children were classified as normal by both norms. Weighted kappa coefficients for the five subtests ranged from 0.56 to 0.89 suggesting moderate agreement between two classification norms. Expressive and receptive communication had the lowest kappa scores (0.56 and 0.59, respectively), and classification of gross motor revealed the highest level of agreement (0.89). CONCLUSION: Developmental disabilities are common disorders that impose important functional limitations on the affected children. Identifying infants at risk for developmental disorders by screening is a main step to minimize complications. Dependence on reference-based norms for the Bayley screening test in Persian language children results in misclassification of risk category.

The association between parental mental health and behavioral disorders in pre-school children.

BACKGROUND AND AIM: Behavioral disorders among children reflect psychological problems of parents, as mental illness of either parent would increase the likelihood of mental disorder in the child. In view of the negative relationship between parents' and children's illness, the current study intended to determine the correlation between mental health of parents and behavioral disorders of pre-school children. METHODS: The present descriptive-correlational research studied 80 children registered at pre-school centers in Pardis Township, Tehran, Iran during 2014-2015 using convenience sampling. The research tools included General Health Questionnaire (GHQ) and Preschool Behavior Questionnaire (PBQ). The resulted data were analyzed using Pearson Product-moment Correlation Coefficient and regression analysis in SPSS 21. RESULTS: The research results showed that there was a significant positive correlation between all dimensions of mental health of parents with general behavioral disorders (p<0.001). The results of the regression analysis showed that parents' depression was the first and the only predictive variable of behavioral disorders in children with 26.8% predictive strength. CONCLUSION: Given the strong relationship between children's behavioral disorders and parents' general health, and the significant role of parents' depression in children's behavioral disorders, it seems necessary to take measures to decrease the impact of parents' disorders on children.

Psychological Disorders among Iranian Infertile Couples Undergoing Assisted Reproductive Technology (ART).

BACKGROUND: Worldwide, infertility affects 10%-15% of couples and most of them seek medical help including Assisted Reproductive Technology (ART) treatments. Undergoing ART treatments create many physical and emotional burdens. This study examined the psychological consequences of infertility in Iranian infertile males and females as well as their spouses, unlike previous studies that examined mainly females with infertility. METHODS: Subjects in this descriptive analytical design were recruited from the IVF Department of Mirza Koochak Khan Hospital and the Rouyesh Infertility Treatment Center of Tehran, Iran between Aug 2014 and Sep 2015. Overall, 256 couples (64% response rate), consisting of 78 infertile male and their spouses and 50 infertile female and their spouses, were included in this research. The psychological disorders were measured by the Persian version of Symptoms Checklist-90-Revised and Cattle Inventory. RESULTS: Psychological disorders of infertile couples are significantly associated with increasing age, higher education, longer duration of infertility and unemployment (P<0.05). Prevalence of anxiety, depression, hypochondriasis and paranoia in infertile females and spouses of infertile males were significantly higher than husbands of infertile females (P<0.05). Obsession was more sever in infertile females was significantly greater than infertile males (P=0.01). Depression was significantly lower in infertile males than their spouses (P=0.016). CONCLUSION: Iranian infertile females and spouses of infertile males experienced more psychological disorders than infertile males and spouses of infertile females. These results may be due to the impact of cultural beliefs and gender roles in Iranian society. Anxiety, depression, obsession, paranoia and hypochondriasis should be addressed before any ART treatments.

A Psychometric Study of the Bayley Scales of Infant and Toddler Development in Persian Language Children.

OBJECTIVE: Bayley Scales of infant & toddler development is a well-known diagnostic developmental assessment tool for children aged 1-42 months. Our aim was investigating the validity & reliability of this scale in Persian speaking children. MATERIALS & METHODS: The method was descriptive-analytic. Translation- back translation and cultural adaptation was done. Content & face validity of translated scale was determined by experts' opinions. Overall, 403 children aged 1 to 42 months were recruited from health centers of Tehran, during years of 2013-2014 for developmental assessment in cognitive, communicative (receptive & expressive) and motor (fine & gross) domains. Reliability of scale was calculated through three methods; internal consistency using Cronbach's alpha coefficient, test-retest and interrater methods. Construct validity was calculated using factor analysis and comparison of the mean scores methods. RESULTS: Cultural and linguistic changes were made in items of all domains especially on communication subscale. Content and face validity of the test were approved by experts' opinions. Cronbach's alpha coefficient was above 0.74 in all domains. Pearson correlation coefficient in various domains, were ≥ 0.982 in test retest method, and ≥0.993 in inter-rater method. Construct validity of the test was approved by factor analysis. Moreover, the mean scores for the different age groups were compared and statistically significant differences were observed between mean scores of different age groups, that confirms validity of the test. CONCLUSION: The Bayley Scales of Infant and Toddler Development is a valid and reliable tool for child developmental assessment in Persian language children.

Vowels Development in Babbling of typically developing 6-to-12-month old Persian-learning Infants.

OBJECTIVES: Pre-linguistic vocalizations including early consonants, vowels, and their combinations into syllables are considered as important predictors of the speech and language development. The purpose of this study was to examine vowel development in babblings of normally developing Persian-learning infants. METHODS: Eight typically developing 6-8-month-old Persian-learning infants (3 boys and 5 girls) participated in this 4-month longitudinal descriptive-analytic study. A weekly 30-60-minute audio- and video-recording was obtained at home from the comfort state vocalizations of infants and the mother-child interactions. A total of 74:02:03 hours of vocalizations were phonetically transcribed. Seven vowels comprising /i/,/e/,/a/,/u/,/o/,/ɑ/, and /ә/ were identified in the babblings. The inter-rater reliability was obtained for 20% of vocalizations. The data were analyzed by repeated measures ANOVA and Pearson's correlation coefficient using SPSS software version 20. RESULTS: The results showed that two vowels /a/ (46.04) and /e/ (23.60) were produced with the highest mean frequency of occurrence, respectively. Regarding front/back dimension, the front vowels were the most prominent ones (71.87); in terms of height, low (46.78) and mid (32.45) vowels occurred maximally. A good inter-rater reliability was obtained (0.99, P < .01). CONCLUSION: The increased frequency of occurrence of the low and mid front vowels in the current study was consistent with previous studies on the emergence of vowels in pre-linguistic vocalization in other languages.

Relationship among temporary separation, attachment styles, and adjustment in first-grade Iranian children.

If mothers work outside the home, some degree of mother-child separation will be experienced and mother-child attachment will be affected. In this study, regarding the attachment styles, sociobehavioral problems in first-grade children with experience of preschool and in those taught by their mothers at-home are compared. A casual-comparative method was used to compare children in the two groups. A total of 320 first-grade children participated in the study. The study measures included a separation anxiety test, an adaptive behavior scale, and a children's symptom inventory. Data were analyzed using multivariate statistics. Secure attachment in the group with experience of preschool was significantly higher than that in the at-home group. None of the variables, including parents' education and father's income, significantly affected attachment style. Neither father's education, father's income, or attachment significantly influenced adjustment. Father's education significantly influenced children's symptoms. Attachment style and hours of preschool attendance had no effect on Child Symptom Inventory scores. Associations among age at joining preschool, attachment style, and behavioral and adaptive problems in first-grade children were nonlinear and multivariate. By taking into account parents' awareness, sensitivity, and responsiveness, relative welfare, appropriate quality of child-care centers, and having fewer hours of preschool attendance, the risk factors for early parent-child separation and institutional care can be reduced.

Effectiveness of social work intervention with a systematic approach to improve general health in opioid addicts in addiction treatment centers.

PURPOSE: This study takes a systematic approach to investigate the effect of social work intervention aimed at increasing general health among opioid addicts in addiction treatment centers. PATIENTS AND METHODS: This is an experimental plan (pretest to posttest with a control group); the study sample included 60 patients with drug dependencies undergoing treatment in addiction treatment centers. These patients were randomly assigned as case (30) and control (30) groups. The case group was subjected to intervention over ten sessions, whereas the control group received no intervention. Both groups then passed through a posttest, while a follow-up was conducted after 4 months. Data were obtained via a General Health Questionnaire. RESULTS: A covariance analysis test and independent and dependent t-test results indicated that a social work intervention adopting systematic approach was effective in increasing the general health of drug-addicted patients under treatment. CONCLUSION: Thus, the nature of the presence of social workers in addiction treatment centers has been effective and can have a significant influence by reducing anxiety and insomnia and somatic symptoms, improving patients' self-understanding and self-recognition, and enhancing social functioning.

Bitter experiences of elderly parents of children with intellectual disabilities: A phenomenological study.

BACKGROUND: It is predicted that over the next 30 years, there will be a significant increase in the number of elderly parents who care for their children with intellectual disability. This paper is part of a larger qualitative study which investigated the unpleasant experiences of these parents. MATERIALS AND METHODS: A phenomenological approach was adopted and data were collected through unstructured in-depth interviews with elderly parents of children with intellectual disability. The data were analyzed using Colaizzi's seven-step method. RESULTS: "Bitterness" is one of the four emergent themes extracted in this study which has five theme clusters: inappropriate behavior toward the child in the society, the society's failure to support the child with intellectual disability, sorrows experienced by parents, the child's problems, and barriers in the care of the child with intellectual disability. One significant barrier in the last theme cluster is limitations due to aging. CONCLUSIONS: The findings of this study suggest that the elderly parents of children with intellectual disability experience many sorrows and unpleasant feelings, but they mostly consider the social factors as the cause of problems and not the presence of the child. The results also indicate that older parents cannot look after the child as before in their old age; so, future well-designed studies are required for identification of the process of supporting them.

Is the Bayley Scales of Infant and Toddler Developmental Screening Test, Valid and Reliable for Persian Speaking Children?

BACKGROUND: Advances in perinatal and neonatal care have substantially improved the survival of at-risk infants over the past two decades. OBJECTIVES: The purpose of this study was to assess the reliability and validity of the Bayley Scales of infant and toddler developmental Screening test in Persian-speaking children. METHODS: This was a cross-sectional prospective study of 403 children aged 1 - 42-months. The Bayley scales screening instrument, which consists of five domains (cognitive, receptive, and expressive communication and fine and gross motor items), was used to measure infants' and toddlers' development. The psychometric properties examined included the face and content validity of the scale, in addition to cultural and linguistic modifications to the scale and its test-retest and inter-rater reliability. RESULTS: An expert team changed some of the test items relating to cultural and linguistic issues. In almost all the age groups, cultural or linguistic changes were made to items in the communication domains. According to Cronbach's alpha for internal consistency, the reliability of the cognitive scale was r = 0.79, and the reliability of the receptive scale was r = 0.76. The reliability for expressive communication, fine motor, and gross motor scales was r = 0.81, r = 0.80, and r = 0.81, respectively. The construct validity of the tests was confirmed using a factor analysis and comparison of the mean scores of the age groups. The intra- and inter-rater reliabilities of the Bayley Scales were good-to-excellent. CONCLUSIONS: The results indicated that the Bayley Scales had a high level of reliability in the present study. Thus, the scale can be used in a Persian population.

Predicting developmental disorder in infants using an artificial neural network.

Early recognition of developmental disorders is an important goal, and equally important is avoiding misdiagnosing a disorder in a healthy child without pathology. The aim of the present study was to develop an artificial neural network using perinatal information to predict developmental disorder at infancy. A total of 1,232 mother-child dyads were recruited from 6,150 in the original data of Karaj, Alborz Province, Iran. Thousands of variables are examined in this data including basic characteristics, medical history, and variables related to infants.  The validated Infant Neurological International Battery test was employed to assess the infant's development. The concordance indexes showed that true prediction of developmental disorder in the artificial neural network model, compared to the logistic regression model, was 83.1% vs. 79.5% and the area under ROC curves, calculated from testing data, were 0.79 and 0.68, respectively. In addition, specificity and sensitivity of the ANN model vs. LR model was calculated 93.2% vs. 92.7% and 39.1% vs. 21.7%. An artificial neural network performed significantly better than a logistic regression model.