Serum Zinc Level in Patients with Simple Febrile Seizure

ObjectiveTo evaluate the serum zinc level of the patients with simple febrile seizure and compare them with febrile children without seizure.Materials & MethodsThis prospective case - control study was performed on 60 patients aged 6 months to 6 years from Apr. 2009 to Jan.2010 in Ghaem, Imam Reza and Dr. Sheikh Hospitals in Mashhad. The serum zinc level was assessed and compared between the cases (30 individuals who suffered from simple febrile seizure) and the controls (30 individuals who had fever without seizure).ResultsMean serum zinc level was 663.7 µg /l and 758.33  µg /l in the case group and the control group, respectively (PConclusionIt was revealed that the serum level of zinc was significantly lower in children with simple febrile seizure in comparison with febrile children without seizure.

Levetiracetam (levebel) Versus Carbamazepine Monotherapy for Focal Epilepsy in Children

Focal epilepsy is one of the most prevalent type of seizures in childhood. In this study we will compare the effect of new approved drug leveitiracetam versus carbamazepine in the treatment of focal epilepsy.Methods and Materials: we studied  newly diagnosed  children with focal epilepsy (in the age range of 1-16). The children were treated randomly with two drug levetiracetam and carbamazepine. Patients have been followed for seizure and drugs side effects at intervals of 1 month and six months. We checked liver function tests and complete blood count for all patients and they asked about any significant side effects such as drowsiness، restlessness and skin reaction. Eventually, they were classified in two groups of 25 consuming levetiracetam and 25 consuming carbamazepine.Results:In our study, two cases were excluded in levetiracetam group because of sever agitation and 3 patients (13%) had relapsing seizures. In the group of carbamazepine,10 patients(40%) had relapse. Seizure was not repeated in 15 (60%) and 20 (87%) cases in  carbamazepin and levetiracetam  groups, respectivelly. chi square examination  showed that the responses to treatment had significant differences (P=0.03). Agitation and drowsiness  were the most prevalent complication in levetiracetam and carbamazepine groups, respectivelly. Fortunately ،liver enzyme dysfunction and blood cell disturbance were observed in none of the groups. Conclusion: According to findings, there were significant differences in controlling  seizures  between two groups that implicate much more influence of levetiracetam (87%) in suppression of focal seizure

Proteus Syndrome: A Case Report

ObjectiveProteus Syndrome is an extremely rare, sporadic and progressive disorder. We describe a four-month-old male baby with central nervous system manifestations in this article.Clinical presentationA four-month-old boy was admitted into our hospital with three tonic - clonic generalized seizure attacks which started from the day before admission. Each seizure attack lasted less than 10 minutes and the baby was well between attacks. No fever was detected. On physical examination, abnormal facial features, macrocrania, a wide nasal bridge, overgrowth of the right lower limb, macrodactyly in the third left toe, epidermal nevus on the left side of the abdomen and skin vascular abnormalities were detected. His developmental status was normal. Brain Magnetic Resonance Imaging (MRI) revealed left sided hemihypertrophy, ventricle enlargement and macrocrania on the same side

A case of recurrent urinary tract infections with neurogenic bladder due to spinal tumors

Neuroblastic tumors are the most common extracranial solid tumors in children. They are manifested by different clinical presentations ranging from cord compression symptoms to asymptomatic cases. A 2.5-year girl with a history of vaginal delivery at 39 gestational weeks and low Apgar score presented by repeated episodes of urinary tract infections and progressive paraplegia started at the age of 8 months.Brain MRI and EEG were normal. Voiding cystourethrography revealed grade II vesicoureteral reflux in the left kidney. Lumbar MRI with and without contrast showed a dumbbell shape mass, the hyper signal in T2 -weighted image and low signal in T1 -weighted image, extramedullary, and intramural with mass effect on the cord.Microscopic examination of tissue obtained by surgery reported ganglioneuroma.Our case was interesting because of her presentation, neurogenic bladder associated with repeated episodes of urinary tract infections, and secondary paraplegia. Neurogenic bladder dysfunction is rarely reported in cases with ganglioneuroma

Depression and Anxiety in Iranian Mothers of Children with Epilepsy

How to Cite this Article: Soltanifar A, Ashrafzadeh F, Mohareri F, Mokhber N. Depression and Anxiety in Iranian Mothers ofChildren with Epilepsy. Iranian Journal of Child Neurology 2012;6(1):29-34. ObjectiveEpilepsy is a common neurological disorder in children. Parents with epileptic children have many psychosocial care needs. So the main goal of this study was to evaluate depression and anxiety in Iranian mothers with epileptic children.Materials & MethodsWe identified 30 mothers of children with epilepsy and 30 mothers of children without epilepsy with children aged between 8 and 12 years who met the study criteria. In all children with epilepsy, the mothers were the main caregivers and all these children lived in two-parent families. Children in the control group were in the same age. Ninety-eight percent of children in the control group lived in two-parent families with the mother as the main caregiver. All mothers fulfilled the Beck Depression Inventory (BDI) and Spielberger State-Trait Anxiety Inventory.ResultsAccording to these data, BDI scores were significantly higher in the mothers of epileptic children (mean of Beck score=16.5) compared to the control group (mean of Beck score=9.8). The total, Spielberger State-Trait Anxiety Inventory scores for mothers of children with epilepsy were 100.3, 51.7 and 48.6. However, these scores in the control group were 86.9, 45.1 and 41.8. These differences were statistically significant.In a second analysis, using the demographic data, we did not find any statistically significant relation between anxiety or depression and the mothers’ job, children’s medication and other demographic variables.ConclusionNeurologists and psychiatrists need to develop better programs for adequate management of psychiatric disorders in mothers with epileptic children. References 1. Cowan LD. The epidemiology of the epilepsies inchildren. Ment Retard Dev Disabil Res Rev 2002;8:171-81.2. Schiariti V, Farrell K, Hoube JS, Lisonkova S. Periodprevalence of epilepsy in children in BC: a population-basedstudy. Can J Neurol Sci 2009 Jan;36(1):36-41.3. Otero S. Psychopathology and psychological adjustmentin children and adolescents with epilepsy. World J Pediatr2009 Feb;5(1):12-7.4. Rodenburg HR, Stams GJJM, Meijer AM, Aldenkamp AP,Dekovic´ M. Psychopathology in children with epilepsy:a metaanalysis. J Pediatr Psychol 2005 Sep;30(6):453-68.Epub 2005 Mar 3.5. Rodenburg R, Meijer AM, Dekovic M, AldenkampAP. Family factors and psychopathology in childrenwith epilepsy: a literature review. Epilepsy Behav 2005Jun;6(4):488-503.6. Lovejoy M, Graczyk PA, O_Hare E, Neuman G. Maternaldepression and parenting behavior: a meta-analytic reviewClin Psychol Rev 2000;20:561-92.7. Shore CP, Buelow JM, Austin JK, Johnson CS.Continuing psychosocial care needs in children with newonsetepilepsy and their parents. J Neurosci Nurs 2009Oct;41(5):244-50.8. Pianta RC, Lothman DJ. Predicting behavior problemsin children with epilepsy: child factors, disease factors,family stress, and child-mother interaction. Child Dev1994 Oct;65(5):1415-28.9. Dunn DW, Austin JK, Huster GA. Symptoms ofdepression in adolescents with epilepsy. J Am Acad ChildAdolesc Psychiatr 1999;38:1133-8.10. Shore CP, Austin JK, Huster GA, Dunn DW. Identifyingrisk factors for maternal depression in families ofadolescents with epilepsy. J Specialists Pediatr Nurs2002;7:71-80.11. Yongli, Cheng-Ye ji, Jiong Qin, Zhi-Xiang Zhang.Parental anxiety and quality of Life of epileptic children.Biomed Environ Sci 2008 Jun;21(3):228-32.12. Williams J, Steel C, Sharp GB, DelosReyes E, PhillipsT, Bates S, et al. Parental anxiety and quality of life inchildren with epilepsy. Epilepsy Behav 2003;4:483-6.13. Lv R, Wu L, Jin L, Lu Q, Wang M, Qu Y, Liu H. Depression,anxiety and quality of life in parents of children withepilepsy. Acta Neurol Scand 2009 Nov;120(5):335-41.14. Baki O, Erdogan A, Kantarci O, Akisik G, KayaalpL, Yalcinkaya C. Anxiety and depression in childrenwith epilepsy and their mothers. Epilepsy Behav 2004Dec;5(6):958-64.15. Yam WK, Ronen GM, Cherk SW, Rosenbaum P, ChanKY, Streiner DL, et al. Health-related quality of lifeof children with epilepsy in Hong Kong: how does itcompare with that of youth with epilepsy in Canada?Epilepsy Behav 2008 Apr;12(3):419-26.16. Ghassemzadeh H, Mojtabai R, Karamghadiri N,Ebrahimkhani N. Psychometric properties of a Persianlanguageversion of the Beck Depression Inventory Second edition: BDI-II-PERSIAN. Depress Anxiety2005;21(4):185-92.17. Hojat M, Shapurian R, Mehryar AH. Psychometricproperties of a Persian version of the short form of theBeck Depression Inventory for Iranian college students.Psychol Rep 1986 Aug;59(1):331-8.18. Kalkhoran MA, Karimollahi M. Religiousness andpreoperative anxiety: a correlational study. Ann GenPsychiatry 2007;6:17.19. Mu PF, Kuo HC, Chang KP. Boundary ambiguity, copingpatterns and depression in mothers caring for children withepilepsy in Taiwan. Int J Nurs Stud 2005 Mar;42(3):273-82.20. Lv R, Wu L, Jin L, Lu Q, Wang M, Qu Y, et al. Depression,anxiety and quality of life in parents of children withepilepsy. Acta Neurol Scand 2009 Nov;120(5):335-41.21. (Wood LJ, Sherman E, Hamiwka LD, Blackman M,Wirrell E. Depression, anxiety, and quality of life insiblings of children with intractable epilepsy. EpilepsyBehav 2008 Jul;13(1):144-8.22. Tosun A, Gokcen S, Ozbaran B, Serdaroglu G, Polat M,Tekgul H, et al. The effect of depression on academicachievement in children with epilepsy. Epilepsy Behav2008 Oct;13(3):494-8.23. Rodenburg R, Meijer AM, Dekovic M, Aldenkamp AP. Family factors and psychopathology in childrenwith epilepsy: a literature review. Epilepsy Behav 2005Jun;6(4):488-503.24. Wirrell EC, Wood L, Hamiwka LD, Sherman EM. Parenting stress in mothers of children with intractableepilepsy. Epilepsy Behav 2008 Jul;13(1):169-73

A Rare presentation of neurobrucellosis in a child with Recurrent transient ischemic attacks and pseudotumor cerebri (A case report and review of literature)

How to Cite This Article: Akhondian J, Ashrafzadeh F, Beiraghi Toosi M, Hashemi N. A Rare Presentation of Neurobrucellosis in A Child with Recurrent Transient Ischemic Attacks and Pseudotumor Cerebri (A Case Report and Review of Literature). Iran J Child Neurol. 2014 Spring; 8(2):65-69. Brucellosis is a multi-system infectious disease that presents with various manifestations and complications. Neurobrucellosis is an uncommon but serious presentation of brucellosis that can be seen in all stages of the disease. Highindex of suspicion, especially in endemic areas is essential to prevent morbidity from this disease.The case was an 11- year -old female patient who was admitted with a severe headache that was worsening over a period of 2 months. The day after each attack, she experienced transient right hemiparesia that was lasting less than one hour (TIA) as well as blurred vision and bilateral papilledema. Laboratory findings revealed serum agglutination Wright test positive at 1/320 and 2ME test positive at 1/160. A lumbar puncture showed a clear CSF with increased opening pressure (32 cmH2O), CSF examination was within normal range (pseudotumor cerebri).To our knowledge, there has been no report for recurrent TIA in pediatric neurobrucellosis in the base of pseudotumor cerebri.In endemic areas like Iran, unexplained neurological signs or symptoms should be evaluated for brucellosis. References1. Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med 2005; 352 2325-2336.2. Young EJ, Mandel GL, Bennett JE, et al. Principles and practice of infectious diseases. Philadelphia: Churchill Livingstone; 2002; Pp:23 86-93.3. Gul HC, Erdem H, Bek S. Overview of neurobrucellosis: a pooled analysis of 187 cases. Int J Infect Dis. 2009;13(6):339-343.4. McLean DR, Russell N, Khan MY. Neurobrucellosis: Clinical and therapeutic features. Clin Infect Dis. 1992; 15:582-90.5. Young EJ, Douglas M. Brucella species. Bennett’s principles and practice of infectious diseases. 6th ed. Churchill Livingstone Co. 2005; 6: 2669-73.6. Fatima ZO, Samer Z, Ropert A. Neurobrucellosis in children. Developmental Medicine & Child Neurol.1997;39:762-765.7. Habib YKR, AL – Najdi AKN, Sadek SAH. Paediatric Neurobrucellosis: Case Report and Literature Review. J Infection 1998; 37:59-62.8. Bucher A, Gaustad P, Pape E. Chronic neurobrucellosis due to Brucella melitensis. Scand J Infect Dis 1990; 22:223-6.9. Al Deeb SM, Yaqub BA, Sharif HS, et al. Neurobrucellosis: clinical characteristics, diagnosis, and outcome. Neurology 1989; 39:498-501.10. Shakir RA, Al-Din ASN, Araj GF, et al. Clinical categories of neurobrucellosis; a report on 19 cases. Brain. 1987;110: 213-223.11.Haji-Abdolbagi M, Rasooli-Nejad M, Jafari S, et al. Clinical and laboratory findings in neurobrucellosis: Review of 31 Cases. Arch Iranian Med 2008; 11 (1): 21-25.12. Ranjbar M, Rezaiee AA, Hashemi SH, et al. Neurobrucellosis: report of a rare disease in 20 Iranian patients referred to a tertiary hospital. Eastern Mediterranean Health Journal. 2009; 15(1): 143-148.13. Sturniolo G, Mondello P, Bruno S, et al. Neurobrucellosis associated with syndrome of inappropriate antidiuretic hormone with resultant diabetes insipidus and hypothyroidism. Journal of clinical microbiology. 2010; 48(10): 3806-3809.14. Trifiletti RR, Restivo DA, Pavone P, et al. Diabetes insipidus in neurobrucellosis. Clin Neurol Neurosurg. 2000; 102: 163- 165.15. Zaidan R, Al Tahan AR. Cerebral venous thrombosis: a new manifestation of neurobrucellosis. Clin Infect Dis.1999; 28: 399 - 400.16. Namiduru M, Karaoglan I, Yilmaz M. Guillain-Barre syndrome associated with acute neurobrucellosis. Int J Clin Pract. 2003; 57: 919 - 920.17. Tuncer-Ertem G, Tülek N, Yetkin MA. Case report: subdural hemorrhage in neurobrucellosis. Mikrobiyol Bul. 2004; 38: 253 - 256.18. Tena D, Gonzáles-Praetorius A, López- Alonso A, Peña JL, Pérez-Pomata MT, Bisquert J. Acute meningitis due to Brucella spp. Eur J Pediatr 2006; 165:726-727.19. Salih M A, Abdel G M. Abdel G, et al. Infectious and in ammatory disorders of the circulatory system as risk factors for stroke in Saudi children. Saudi Med J. 2006;27: 41-52.20. Sayyahfar Sh, Karimi A, Fahimzad A , et al. Rare presentation of neurobrucellosis. Pak J Med Sci. 2008; 24(3): 464-467.21. Hernandez MA, Anciones B, Frank A, et al. Neurobrucellosis and cerebral vasculitis. Neurologia 1988; 3:241-243.22. Adaletli I, Albayram S, Gurses B, et al. Vasculopathic changes in the cerebral arterial system with neurobrucellosis. Am J Neuroradiol 2006; 27:384-386.23. Bingöl A, Togay-Isıkay C. Neurobrucellosis as an exceptional cause of transient ischemic attacks. Eur J Neurol 2006; 13:544-548.24.Elrazak MA. Brucella optic neuritis. Arch Intern Med 1991;151:776-8.25. Karakurum G B, Yerdelen D, Karatas M, et al. Abducens nerve palsy and optic neuritis as initial manifestation in brucellosis. Scand J Infect Dis 2006; 38:721-5.26. Karapinar B, Yilmaz D, Vardar F, et al. Unusual presentation of brucellosis in a child: Acute blindness. Acta Paediatrica. 2005;94:378-80.27. Marques R, Martins C, Machado I, et al. Unilateral optic neuritis as a presentation of neurobrucellosis. Pediatric Reports. 2011; 3(11): 36-38.28. Tali ET, Keskin T, Oznur II, et al. MRI of brucella polyneuritis in a child. Neuroradiology. 1996; 38(1): 190-2.29. Yilmaz M, Ozaras R, Mert A, et al. Abducent nerve palsy during treatment of brucellosis. Clin Neurol Neurosurg 2003; 105:218-20.30. Balcer LJ. Optic neuritis. N Engl J Med 2006; 354:1273-1280.31. Dirge KB. Idiopathic intracranial hypertension. BMJ 2010; 341:109-110.32. Emadoleslamia M, Mahmoudianb T. A case of pseudotumor cerebri and brucellosis. Pediatr Infec Dis J .2007;2: 251-253.33. Yasar anlar F, yalcin S, Secmeer G. Persistant hypoglycorrhachia in neurobrucellosis. pediatr infec j. 1994;13(8):747-8.34. Erdem H, Ulu-Kilic A, Kilic S, et al. Efficacy and tolerability of antibiotic combinations in neurobrucellosis: results of the Istanbul study. Antimicrob Agents Chemother. 2012; 56(3):1523-8. 

Epstein-Barr Virus Encephalitis: A Case Report

How to Cite This Article: Hashemian S, Ashrafzadeh F, Akhondian J, Beiraghi Toosi M. Epstein-Barr Virus Encephalitis: A Case Report. Iran J Child Neurol. 2015 Winter;9(1):107-110.  Abstract Many neurologic manifestations of Epstein-Barr virus (EBV) infection have been documented, including encephalitis, aseptic meningitis, transverse myelitis, and Guillain-Barre syndrome. These manifestations can occur alone or coincidentally with the clinical picture of infectious mononucleosis. EBV encephalitis is rare and is indicated as a wide range of clinical manifestations. We report a 10-year-old girl presented with fever, gait disturbance, and bizarre behavior for one week. The results of the physical examination were unremarkable. The diagnosis of EBV encephalitis was made by changes in titers of EBV specific antibodies and MRI findings. A cranial MRI demonstrated abnormal high signal intensities in the basal ganglia and the striatal body, especially in the putamen and caudate nucleus. EBV infection should be considered when lesions are localized to the basal ganglia.ReferencesFujimoto H, Asaoka K, Imiazumi T, Ayabe M, Shoji H, Kaji M. Epstein-Barr virus Infections of the Central Nervous System. Intern Med 2003; 42:33-40.Mathew AG, Parvez Y. Fulminant Epstein Barr virus encephalitis. Indian Pediatrics 2013; 50:418-419Kalita J, Maurya PK, Kumar B, Misra UK. Epstein Barr virus encephalitis: Clinical diversity and radiological similarity. Neurol India 2011; 59:605-7Baskin HJ, Hedlund G. Neuroimaging of Herpes Virus Infections in Children. Pediatr Radiol 2007; 37:949-63.Weinberg A, Li SH, Palmer M, Tyler K .Quantitative CSF PCR in Epstein-Barr Virus Infections of the Central Nervous System. Ann Neurol 2002; 52:543-8.Ono J, Shimizu K, Harada k, Mano T, Okada S. Characteristic MR Features of Encephalitis Caused by Epstein-Barr virus. Pediatr Radiol 1998; 28:569-70.Hausler M, Raamaekers T, Doenges M, Shweizer K ,Ritter K. Neurological Complications of Acute and Persistent Epstein-Barr Virus Infection in Pediatric Patients. Journal of Medical Virology 2002; 68:253-63.Young JY, Hyang LK. Transient Asymptomatic White Matter Lesions Following Epstein-Barr virus Encephalitis. Korean pediatric society 2011; 54:389- 93.Doja A, Bitnun A, Jones EL, Richardson S, Tellier R, Petric M, et al. Pediatric Epstein-Barr Virus-Associated Encephalitis:10-Year Review. Child Neurol 2006; 21:385-91.Kou K, Itoh M, Kawano Y. A Case Report of EB Virus- Induced Meningoencephalitis Associated with Brain MRI Abnormalities (basal ganglia). J Japan Peditr Sos 1994; 98:2052-9.Kunlong H, Hung-Tsai L, Minlan T. Epstein-Barr Virus Encephalitis in Children. Acta Pediatrica Taiwanica 2000; 3:140-6

A Study on the Risk Factors for Obstetrical Brachial Plexus Palsy

ObjectiveConsiderable medical and legal debates have surrounded the prognosis and outcome of obstetrical brachial plexus injuries and obstetricians are oftenconsidered responsible for the injury. In this study, we assessed the factors related to the outcome of brachial plexus palsy.Material & MethodsDuring 24 months, 21 neonates with obstetrical brachial plexus injuries were enrolled.Electrophysiology studies were done at the age of three weeks. They received physiotherapy and occupational therapy. They were examined every 3 monthsfor one year and limbs function was assessed according to Mallet scores; also, maternal and neonatal factors were collected by a questionnaire.Results There were 10 boys and 11 girls.Of all, 76.2% had Erb's palsy, 19% had total brachial palsy and 4.8% hadklumpke paralysis.Risk factors including primiparity, high birth weight, shoulder dystocia, andprolonged second stage of labor were assessed.Electrophysiology studies showed neuropraxia in 52.4% and axonal injuries in42.9% of the patients.At the end of the first year, 81% of the patients had functioned recovery aroundgrade III or IV of Mallet scores.There were only significant relationships between functional improvement andneurophysiologic findings.ConclusionOutcome of obstetrical brachial injuries has a close relationship toneurophysiologic study results than other risk factors

Homocystinuria: A Rare Disorder Presenting as Cerebral Sinovenous Thrombosis

How to Cite This Article: Eslamiyeh H, Ashrafzadeh F, Akhondian J, Beiraghi Toosi M. Homocystinuria: A Rare Disorder Presenting as Cerebral Sinovenous Thrombosis. Iran J Child Neurol. Spring 2015;9(2):53-57.AbstractObjectiveHomocystinuria is an inborn error of amino acid metabolism caused by cystathionine beta-synthase deficiency that affects methionine metabolism. The clinical features are heterogeneous ranging from mental retardation, ectopia lentis, and osteoporosis to vascular events such as deep vein thrombosis,   sagital sinus thrombosis, and myocardial infarction. Cerebral sinovenous thrombosis (CVST) is an unusual disorder in children and requires prompt and accurate management. Some causal factors for thedevelopment of CVST differ between children and adults. The majority of cases with CSVT are found to have an underlying cause for thrombosis like dehydration, infections, prothrombotic and hematologic disorders, malignancy and trauma.Although homocystinuria is usually associated with ischemic strokes, CVST as initial clinical presentation of homocystinuria is rare in children.In this article, we presented a 10-year old boy with seizure, hemiparesis, and ataxia due to CSVT caused by homocystinuria

The Effects of Imitative Vs. Cognitive Methods on The Speech Development of Children With Autism

How to Cite This Article: Jalili M, Jahangiri N, Yazdi Aa, Ashrafzadeh F. The Effects of Imitative Vs. Cognitive Methods on The Speech Development of Children With Autism. Iran J Child Neurol. 2014 Winter; 8(1):37-46.ObjectiveThe present study was performed to examine the effects of two speech therapy methods on six verbal behaviors of autistic children, including oral speech, listening, organizing, speaking, semantics, and syntax.Materials & MethodsIn this study, thirty 6-8 years old children with autism were assigned to one of two groups: imitative and cognitive groups. Before starting the main procedures of the study, the children of both groups were homogenized concerning their autism level. In the first phase of the study, the speech development level of the two groups was measured in a pre-test, in which both groups showed similar results. Then, both groups of children received 6 months of speech therapy instruction, during which one group was taught using an imitative method, while the other group was being worked with cognitive method.ResultsAfter 6-month treatment period, a post-test was done, and the t-tests based on the data of the two groups revealed a significant difference between the results.ConclusionThe statistics showed that after the teaching period, autistic that worked with cognitive method gained a better development in their speech abilities, comparing to those worked with the imitative method.Reference:Samadi SA, Mahmoodizadeh A, McConkey R. A national study of the prevalence of Autism among five year old children in Iran. Autism 2012;16(1):5-14.Fombonne E, Simmons H, Ford T, Meltzer H, Goodman R. Prevalence of pervasive developmental disorders in the British nationwide survey of child mental health. J Am Acad Child Adolesc Psychiatry 2001;40(7):820-7.Fombonne, E. The changing epidemiology of Autism. J Appl Res Intellect Disabil 2005,18(4):281-94.Filipek PA, Accardo PJ, Ashwal S, Baranek GT, Cook EH Jr, Dawson G, et al. Practice parameter: screening and diagnosis of autism: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology 2000;55(4):468-79.Samadi, SA. Comparative policy brief: status of intellectual disabilities in the Islamic republic of Iran. J Policy Pract Intellect Disabil 2008;5:129-32.Rogers SJ, An examination of the imitation deficit in autism. In: Nadel J, Butterworth G, editors. Imitation in infancy. Cambridge: Cambridge University Press; 1999. p.254-83.Ozonoff S, Pennington BF, Rogers SJ. Executive function deficits in high-functioning autistic individuals: Relationship to theory of mind. J Child Psychol Psychiatry 1991;32(7):1081-105.Williams JH, Whiten A, Suddendorf T, Perrett DI. Imitation, mirror neurons and autism. Neurosci Biobehav Rev 2001;25(4):287-95.Rogers SJ, Hepburn SL, Stackhouse T, Wehner E. Imitation performance in toddlers with autism and those with other developmental disorders. J Child Psychol Psychiatry 2003;44(5):763-81.Gena A, Krantz PJ, McClannahan LE, Poulson CL. Training and generalization of affective behavior displayed by youth with autism. J Appl Behav Anal 1996;29(3):291-304.Ingenmey R, Van Houten R. Using time delay to promote spontaneous speech in an autistic child. J Appl Behav Anal 1991;24(3):591-6.Ayzenson J. Language and speech disorders in children. Tehran: Roshd publications; 2010.De Giacomo A, Fombonne E. Parental recognition of developmental abnormalities in autism. Eur Child Adolesc Psychiatry 1998;7(3):131-6.Hodgdon LA. Solving behavior problems in autism: improving communication with visual strategies. Quirkroberts publishing; 2001. P.32.Bertrand J, Mars A, Boyle C, Bove F, Yeargin-Allsopp M, Decoufle P. Prevalence of autism in a United States population: the Brick Township, New Jersey, investigation. Pediatrics 2001;108(5):1155-61.Siegel B. Helping children with autism learn: a guide to treatment approaches for parents and professionals. Oxford: Oxford Press Inc; 2002. P.3.Plimley L, Bowen M. Social skills and autism spectrum disorders, London: Paul Chapman publishing; 2007.Mohammadi M, Mesgarpour B, Sahimi Izadian E, Mohammadi M. Psychiatric tests for children and young adults: CARS test. Tehran: Teimourzadeh publications; 2006.Schopler E, Mesibov GB. Diagnosis and Assessment in Autism. New York, NY: Springer publications; 1988. P.3-4.Newcomer P, Hammill D. TOLD: test of language development. (Adaption and standardization to Persian language by Hassanzadeh S and Minaei A.). Tehran: Publications of Ministry of Education; 1977.Dequinzio JA. Generalized Imitation of Facial Models by Children with Autism. J Appl Behav Anal 2007;40(4):755-9.Hatch E. Farhady H. Research design and statistics for applied linguistics. Rahnama publications; 2007. P.28.Brown JS, Rodgers T. Doing second language research. Oxford: Oxford University Press; 2004. P.47.Brown J. Understanding research in second language learning. A teacher’s guide to statistics and research design. Cambridge: Cambridge university press; 1995. P.31