The effect of cognitive rehabilitation therapy (CRT) on the executive functions of children with autism spectrum disorder (ASD)

BACKGROUND: Executive functions (EF) impairments are considered as central deficits in autism spectrum disorder (ASD). The purpose of this study was to determine the effectiveness of cognitive rehabilitation therapy (CRT) on EFs of children with high-functioning ASD (HFA).METHODS: This was a quasi-experimental study with a pretest-posttest design and control group. The study population included all children with HFA referred to the comprehensive Arman Shayan Rehabilitation Center in Tehran, Iran. Using the high-functioning Autism Spectrum Screening Questionnaire (ASSQ) and clinical diagnostic interviews by two clinical psychologists, 24 children with HFA were selected purposefully and were randomly assigned to experimental or control groups. Subjects in both groups completed the Behavior Rating Inventory of Executive Function (BRIEF) in pretest and posttest. The experimental group received 1-2 sessions (1 hour) per week of CRT for 6 months. Data analysis was performed using analysis of covariance (ANCOVA) in SPSS.RESULTS: Data analysis showed that the use of CRT resulted in a significant difference between groups in terms of the total EFs score, which was 88.5%, as well as the components of inhibition (57%), orientation (46%), emotional control (42%), initiate (43%), working memory (55%), planning (56%), organizing (36%),and monitoring (36%).CONCLUSION: CRT, as an evidence-based intervention, seems to be effective in improving neuropsychological functions in children with HFA

The Relationship of School Participation with Motor Proficiency and Executive Function in Children with Autism Spectrum Disorder

Abstract Objective participation in meaningful activities are important aspects of development in children with developmental disorder such as autism spectrum disorder. The purpose of this study was to assess the correlation of school participation with motor proficiency and executive function in children with Autism Spectrum Disorder. Materials & Methods In this cross-sectional (descriptive-analytic) study, 52 students aged 6 to 12 years old with ASD were selected through the convenience sampling method. The GARS-2 scale was used to confirm ASD diagnosis. Other psychiatric comorbidities such as ADHA were studied by the CSI-4 tool, and students with comorbidities were excluded. Data were collected using SFA, BOTMP-2, and BRIEF questionnaires. It should be noted that in the BRIEF questionnaire, a higher score indicates a more severe disability Results Our findings showed that motor proficiency and its components had a significant direct correlation with school participation in childrenwith ASD (P ≤0.001). On the other hand, school participation was inversely and significantly correlated with the behavioral regulation and metacognition monitoring indices of the executive function dimension (P <0.05). Conclusion Based on the findings of this research, the development of motor proficiency and improvements in the behavioral regulation andmetacognition monitoring of students with ASD will boost their participation in school activities. Motor proficiency was significantly correlated with school participation in children with ASD. More attention should be paid to perceptual motor interventions and cognitive rehabilitation programs (with a focus on monitoring metacognition and shifting behavioral regulation) to increase the participation of children with ASD in school activities

Does Long-Term Night Shift Work Cause Dry Eye in Hospital Nurses?

Purpose: To determine the long-term effects of night shift work on dry eye in hospital nurses. Methods: Each participant was evaluated four times, including at the beginning of the day shift (8 am), at the end of the day shift (2 pm), at the beginning of the night shift (8 pm), and at the end of the night shift (8 am), using the tear break-up time (TBUT) test and ocular surface disease index (OSDI) questionnaire. Results: The results showed significant differences in the TBUT and OSDI between the end of the day shift (2 pm) (10.26, 16.61) and the end of the night shift (8 am) (6.89, 38.59) relative to each other and relative to the beginning of the day and night shifts. As for the correlation between TBUT and OSDI, a significant correlation was found at all measurement times (correlation coefficient: −0.478, −0.707, −0.556, and −0.365, respectively) (p < 0.05). Conclusion: The results showed that the severity of dry eye increased after the night shift with variation over a 24-hr period. Moreover, a significant correlation was observed between TBUT and OSDI results at the beginning and at the end of the day and night shifts

The Relationship Between Sensory Processing Pattern and Social Participation in 6-12-year-old Children With Autism: A Cross-sectional Study

Background and Objectives: Autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders in children and causes defects in social functions, behaviors, and limited and repetitive interests.One of the symptoms of ASD is a disturbance in sensory function, which can disturb the social participation of affected people. Therefore, the present study was done to determine the relationship between the sensory processing pattern and social participation in children with autism aged 6 to 12 years. Methods: This applied research was carried out in 2022 using a cross-sectional descriptive and analytical method. The research population included 6-12-year-old children with ASD in Tehran. A total of 54 children participated in this study, of whom 49 cases were included in the study after meeting the inclusion criteria. Data collection tools included the Gilliam autism rating scale-3, the children participation assessment scale-parent version (CPAS-P), and sensory profile-2. Finally, the data were analyzed by descriptive and analytical statistics using SPSS software, version 26. Results: The overall score of autism in the studied children was 76.22±33.82. Among the variables of sensory processing, the highest mean score was related to low registration (51.17±18.55) and the lowest was related to sensation seeking (40.16±93.92). No significant relationship was observed between most variables of sensory processing patterns and social participation in CPAS-P. However, there was an inverse and significant statistical relationship between social participation and sensory-seeking pattern. Conclusion: The results showed that sensory seeking is related to social participation in children with autism. There is an inverse and significant statistical relationship between social participation and sensory search pattern and no relation with the others. Therefore, more severe sensory problems in these children are associated with more prominent social problems

Sensory Processing in the Children Aged Under 14 Years

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

Reliability of Persian Handwriting Assessment Tool in Iranian Primary School Students

Objectives: Handwriting problems are among the most frequent reasons for case referrals to school-based occupational therapy centers. Persian Handwriting Assessment Tool (PHAT) is a valid tool available in Iran to evaluate handwriting components in school-aged children. However, its reliability has not been investigated yet. This study aimed to determine the reliability of the PHAT in Iranian primary school-aged children. Methods: The current methodological study was performed in Tehran city, Iran during 2015-2016. In total, 208 primary school-aged students participated in this study that aimed to investigate the internal consistency of the PHAT. Forty-eight students were also recruited to examine the intra- and inter-rater reliabilities of the PHAT. Selection of the schools and sampling were conducted using the random cluster sampling method. Results: Results suggested good to excellent internal consistency (α=0.84 to 0.99) for the measures of PHAT in dictation and copying domains. Intra-rater reliability of the PHAT ranged from 0.87 to 1.00. Furthermore, PHAT inter-rater reliability ranged from 0.7-1.00. Discussion: The PHAT is a reliable tool to evaluate handwriting components in primary school-aged children. It can also be useful for Iranian therapists to identify primary school students with handwriting problems

Comparing Telerehabilitation and In-Person Interventions in School-Based Occupational Therapy for Specific Learning Disorder A Randomized Controlled Trial: Exploring Efficacy, Academic Impact, and Parental Satisfaction in a Novel Approach to Addressing Specific Learning Disorders in Children

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

The Association Between Motor Proficiency and Performing Recreational and Leisure Activities in School for Children with Autism Spectrum Disorder

Background and Objectives: Performing recreational and leisure activities are an important part of children’s school function, including children with autism spectrum disorder (ASD). The purpose of this study was to examine the association between motor proficiency, performing recreational, and leisure activities in school for the children with autism spectrum disorder. Methods: In this cross-sectional study, 52 students with autism spectrum disorder aged 7-12 years old were selected by available sampling method and the students with co morbidity were excluded from the study. Data were collected using a school function assessment (SFA) and the Bruininks-Oseretsky test of motor proficiency- Second Edition (BOTMP-2). Results: The results of Pearson correlation coefficient showed that there was a significant positive linear  relationship with moderate strength between performing recreational and leisure activities and components of motor proficiency, including gross motor skills (P = 0.001, r = 0.41), upper limb coordination (P=0.000, r=0.44), and fine motor skills (P = 0.00, r = 0.58). Also, the results of multiple linear regression model indicated that only the fine motor skills as one of the components of motor proficiency had the ability to predict performing recreational and leisure activities(β = 0.5, P = 0.002). Conclusion: The results of this study revealed that there was a relationship between performing recreational, leisure activities, and motor proficiency and the highest correlation was observed with fine motor skills, upper limb coordination, and gross motor skills, respectively. Also, fine motor skills had a moderate predictive ability. Thus, in order to improve student’s function in their school, perceptual motor interventions would be an important part of their treatment program

Study of Face and Content Validity of the Persian Version of Behavior Rating Inventory of Executive Function, Preschool Version

Objective Executive functions are referred to higher and self-tuning cognitive processes that help managing behaviors and thought controls. Executive functions in children are assessed in different ways. The most prestigious and valuable way is using daily functions reports on a child's natural environment. This study aimed to prepare the Persian version of behavior rating inventory of executive function-preschool (BRIFF-P) and study of its face and content validity among Iranian children. The questionnaire completed by parents of 2-5 years old children. Materials & Methods This study has methodological and psychometric design. We studied the Persian version of tests using standard protocols IQOLA and determined its validity. This protocol includes translation, evaluation of translation quality, backward translation, and comparing the English version with its Persian one. Face validity was determined by 20 samples (parent) and the impact score was measured. Content validity index (CVI) and ratio of the content validity (CVR) was determined by asking the opinions of 15 experts. Moreover, the simplicity, relevance, and transparency of each item was evaluated. Results Based on the simplicity and clarity of questionnaire items, over 80% agreement of the sample group indicated the simplicity and clarity of the items. also the difficult and complex items were discussed among experts in several sessions and as a result the simpler and clearer concepts took the place of difficult and ambiguous items. Then, the score of proportion index effect and relation of items for each of 63 items of questionnaire was calculated. the results showed that all items of questionnaire were simple and clear, also all items except 7 achieved impact score of higher than 1.5. To evaluate the content validity of the questionnaire, we used ratio of content validity and index calculation. Content validity showed that almost all items of the questionnaire achieved CVI score of higher than 0.79 (The lowest score was 0.8 and highest one was 1); however, as regards the index of relatedness, 3 items got scores lower than 0.79 The scores of the content validity ratio were more than 0.49, except the fifth item. Conclusion The Persian version of this questionnaire possesses a good match in terms of cultural and face validity. The results of content validity confirms that the Persian version is clear, simple, and understandable for the target society. However, 7 items of the questionnaire got scores lower than 1.5. of course, as in this study, the parents of normal children were investigated, the importance of these items in evaluation of abnormal children must be considered, because in many abnormal growth development of children (like attention deficit/hyperactivity, autism) such behaviors are clearly considered problematic. Therefore, the importance of these items are seen in final questionnaire and in spite of low score of 1.5 of some items, in the sample group (normal children), these items were kept and inserted in the final questionnaire. The results of content validity were also indicative of different cultural assumptions from some items of this questionnaire. We suggest that in future studies, the content validity of the Persian version was estimted with regard to opinions of parents of abnormal children with growth development problems and then the results were compared. We also suggest examining the other kinds of reliability and validity of this test

The Development and Validation of a Scale for the Activities of Daily Living in Iranian Children

Introduction: Activities of Daily Living (ADL), as an ultimate goal of rehabilitation, rely on cultural and environmental factors. This study aimed to develop a questionnaire based on the occupational therapy practice frame to accurately evaluate Iranian children’s occupational performance. Methods: This scale was developed in two phases of planning and construction. The planning phase involved a literature review and a collection of the available evaluation tools in the area. The advice of two expert panels was used to develop a preliminary 87-item questionnaire. In the construction phase, 40 parents were surveyed to assess the popularity of the activities in Iran. After a face to content validation, the final version of the questionnaire was prepared with 93 items. Results: The final 93-item questionnaire was used to assess the ADL of 3-6-year-old children. The 93 items, selected according to criteria found in the literature and the panel of experts, were categorized into six ranges of occupational therapy practice framework (bathing/washing/personal hygiene, toileting, dressing, eating/feeding, functional mobility, and others). Conclusion: The ADL in Iranian children is a practical and culturally relevant tool for measuring the occupational performance of Iranian children. It can be used in clinical and population-based research