Risk factors associated with cerebral palsy in children born in eastern and northern districts of Tehran

Cerebral palsy is a group of non-progressive motor impairment syndromes caused by lesions of the brain arising early in development. In this study, we evaluated perinatal risk factors of children born in eastern and northern districts of Tehran city, when perinatal records were widely available. This was a case-control study performed on one to six year-old children living in Tehran, at healthcare centers of Shahid Beheshti University of Medical Sciences and Asma Rehabilitation Center, over 12 months. During the study period, 112 subjects in the case and 3465 in the control groups were studied. The main factors associated with cerebral palsy were [odds ratios, confidence interval]: neonatal convulsion [81.35, 35.09-188.6], low Apgar score [<5] at 5 min or beyond [21.83, 13.13-36.26], low birth weight [5.83, 3.47-9.77], mother's complication during pregnancy [7.83, 4.23-14.50] and maternal age over 35 years [3.88, 2.03-7.42]. Neonatal encephalopathy, low birth weight, and high risk pregnancy were the most powerful independent predictors of cerebral palsy in this population. The majority of infants with cerebral palsy were born at term; therefore, cerebral palsy is quantitatively mainly an issue of term infants

Comparison of persian simple vowels production in cochlear implanted children based on implantation age

Age at implantation is one of the most important factors in improving speech and language skills in children with cochlear implants. Moreover, good vowel articulation is very important in the speech. So, the purpose of this research was to determine whether age at cochlear implantation influences the production of Persian simple vowels when cochlear implantation is undertaken below the age of 2 years as compared with cochlear implantation later in life. This research was a comparative and cross-sectional study. Based on inclusive and exclusive criteria [i.e., have physical and mental health, monolingual or bilingual, have 9 +/- 1 months post-surgery rehabilitation, no hearing handicapped parents and no medical problems history], 140 children who cochlear implanted in Amir-Alam and Hazrate Rasool hospital of Tehran city were selected by convenient sampling and assigned to two groups, children implanted under the age of 2 years and those implanted above the age of 2 years Also 238 normally hearing children were selected for control group by randomized sampling. The first and second formant frequency [Fl and F2] of the Persian simple vowels /i, e, ae, a, o, u/ were evaluated by the version of 1.2 of SFSwin software. Data were analyzed by Independent T test. The findings indicated that there were significant differences between two groups in the mean of F2/i/ [P=0.046], Fl/e/ [P=0.011], F2/e/ [P=0.005], F2/a3/ [P-0.039], F2/a/ [P-0.012], F2/o/ [P=0.012] and F2/u/ [P=0.006], but there was no significant difference between them in the mean of Fl/i/, Fl/ae/, Fl/a/, Fl/o/, Fl/u/ [P>0.05]. According to these results, no significant difference was seen between normal group and children who received their cochlear implants under the age of 2 years in the mean of variables [P>0.05]. Observing significant differences in the quality of the production of Persian simple vowels between children implanted under the age of 2 years and children who received their implants after the age of 2 years, and no significant differences between children who implanted before 2 years of age and normally hearing children is in the favor of the positive effect of early cochlear implantation on speech sound development. Also, the results indicate that when performed under the ages of 2 years, cochlear implantation can prevent from vowels distortions in the speech flow of the receivers

[Hearing screening in children from 40 years ago to now]

Hearing is a key sense in human communication development and communication is the basic need for learning. Speech is the best way of communication and speech development is impeded by hearing loss. Hearing loss compromises optimal development and personal achievement because language and communication serve as the foundations for learning and also normal child development delay in the acquisition of these skills affect literacy and academic achievement as well as personal and social development. The studies show that auditory deprivation specially in critical period of the brain development [first Year of life] results in considerable changes in cochlear nuclei of the brain stem Therefore, early detection of hearing loss in children has been a long standing clinical priority in audiology. In this article we have reviewed 60 years of effort for early detection of hearing loss and finally emphasize that the basic assumption of new born hearing screening is early intervention. Early detection followed by early intervention will result in near normal speech achievement in these children which means personal and social independence in life. In other words, early intervention maximizes the benefits the child, the family and the society will receive

[ age of diagnosis and rehabilitation in the sensorineural hearing impaired children in deaf welfare clinic, Tehran, Iran, 1996]

Hearing Loss is the most common sensory disorder in children. In an authorized newborn screening project in the United States, they concluded that in each 100/000 births, 3 had PKU, 2 Galactosemia, 2 adrenal hyperplasia, 28 hypothyroidism, 47 sickle cell anemia and 314 cases had hearing disorders. Screening is being done in newborns for two main purposes: The first is early detection and timely rehabilitation in a period of time in which a child's CNS has the highest potential and ability of neuroplasticity. Considering this potential aural rehabilitation will yield the best result. The second is prevention of disability occuring secondarily.The only way of timely diagnosis of children's hearing loss is new-born hearing screening. The best age of hearing disorder detection is before three months and the best time for aural rehabilitation is by six months of age. In our study, hearing loss spectrum is not comparable to other studies in developed countries. We believe that most parents and some physicians don't care for mild and moderate hearing loss in children and these hearing disorders are missed. In reference to Deaf Welfare Clinic related to Behzisty Organization the lowest age of diagnosing of hearing disorder is 3 years, so, at best, we are faced with 2.5 years delay in diagnosis which is uncompensatable. In order to fight the dilemma of delay in the diagnosis of hearing loss, we should focus: 1] New born hearing screening and its follow up up to six years. 2] Offering more data on children's hearing disorder to general practitioners and pediatricians about prevalence of hearing loss and importance of early detection