The Effect of Soft and Rigid Cervical Collars on Head and Neck Immobilization in Healthy Subjects

STUDY DESIGN: Whiplash injury is a prevalent and often destructive injury of the cervical column, which can lead to serious neck pain. Many approaches have been suggested for the treatment of whiplash injury, including anti-inflammatory drugs, manipulation, supervised exercise, and cervical collars. Cervical collars are generally divided into two groups: soft and rigid collars. PURPOSE: The present study aimed to compare the effect of soft and rigid cervical collars on immobilizing head and neck motion. OVERVIEW OF LITERATURE: Many studies have investigated the effect of collars on neck motion. Rigid collars have been shown to provide more immobilization in the sagittal and transverse planes compared with soft collars. However, according to some studies, soft and rigid collars provide the same range of motion in the frontal plane. METHODS: Twenty-nine healthy subjects aged 18–26 participated in this study. Data were collected using a three-dimensional motion analysis system and six infrared cameras. Eight markers, weighing 4.4 g and thickened 2 cm² were used to record kinematic data. According to the normality of the data, a paired t-test was used for statistical analyses. The level of significance was set at α=0.01. RESULTS: All motion significantly decreased when subjects used soft collars (p<0.01). According to the obtained data, flexion and lateral rotation experienced the maximum (39%) and minimum (11%) immobilization in all six motions using soft collars. Rigid collars caused maximum immobilization in flexion (59%) and minimum immobilization in the lateral rotation (18%) and limited all motion much more than the soft collar. CONCLUSIONS: This study showed that different cervical collars have different effects on neck motion. Rigid and soft cervical collars used in the present study limited the neck motion in both directions. Rigid collars contributed to significantly more immobilization in all directions.

[Production of a protocol on early intervention for speech and language delays in early childhood: a novice experience in Iran]

Objective: Speech and language disorders, when happening during childhood will ultimately lead to important negative outcomes in the life of the child. The farther we move from this critical period, that is, the first 3 years of life, the less will be the positive effects of environmental stimuli on the development of speech and language. Early detection of children at risk for or in the preliminary phases of developmental delays and provision of early intervention services for them is of utmost importance. The objective of this research was to compile and produce protocols for early intervention in childhood speech and language developmental disorders in Iranian children

Materials and Methods: This study was conducted in two main phases: review phase and qualitative phase. In the review phase, all accessible search engines and databases, especially those for systematic reviews and guidelines were searched. In the qualitative study phase, several focus group discussions and rounds of Delphi were carried out with 20 experts in 7 subgroups, who were selected purposively

Results: The result of this study is presented as 7 intervention packages, including the following domains of disorders: prelingual lingual hearing impairment, speech sound disorders, dysphagia, stuttering, and dysarthria

Conclusion: Most studies have confirmed the effectiveness and need for early interventions for children with speech and language impairment. However, most do not explain the details of these interventions. Before the present study, no systematic and evidence-based protocol existed for early intervention in childhood speech and language impairments, in Iran; and due to language differences, as well as possible differences in the speech and language developmental process of children of different communities, making direct use of non-Persian references was not possible and effective. Thus, there was a clear demand for the production of such a protocol

Delayed referral in children with speech and language disorders for rehabilitation services

Speech and language development is one of the main aspects of evolution in humans and is one of the most complex brain functions such that it is referred to as one of the highest cortical functions such as thinking, reading and writing. Speech and language disorders are considered as a major public health problem because they cause many secondary complications in the childhood and adulthood period which affect one's socioeconomic status overall. This study was conducted in two phases. The first phase was to identify all potential factors influencing delay in referral of children with speech and language disorders for receiving rehabilitation services, based on literature as well as the families' and experts' points of view. In the second phase of the study which was designed in a case-control manner, actual factors influencing the time of referral were compared between two groups of participants. Receiving proper counseling by physicians about importance of the issue had significant impact on the on-time referral for treatment of children with speech and language disorders. After definite diagnosis of speech and language disorders in the child, parents' awareness about the consequences of speech and language disorders had a significant influence on early referral for speech and language pathology services and our hypothesis was confirmed. Discussion: This study highlighted the importance of multiple factors and their relationship with the time of referral, the majority of which were somehow related to one of two major factors: parental awareness and concerns, and physicians' counseling. As described earlier, our study showed that before diagnosis of the child's disorder is definitely given, the physicians' counseling regarding the importance and necessity of early diagnosis, as well as of screening and diagnostic tests play a significant role in the time of referral for receiving speech and language pathology services

Factors affecting job motivation from the viewpoints of staff and managers in semnan welfare organization

Regarding the type of service receivers as well as the technicality of the services provided, these services often bear high complexity and difficulty which can eventually lead to job burnout and shortage of motivation in the staff In this study, the factors affecting job motivation from the viewpoints of staff and managers of Semnan Welfare Organization have been identified and possible differences have been analyzed. In the present study, based on Herzberg's model of job motivation and considering several assessment tools produced according to this model, a draft of a researcher-designed questionnaire was prepared in order to determine the factors affecting job motivation in the staff and managers of the State Welfare Organization in Semnan province. The content and face validity of the questionnaire was determined and approved by 10 experts, 5 managers and 15 staff members of the Semnan Welfare Organization who were selected purposefully, using the Lawsche's method. The reliability of the questionnaire was assessed and approved by test-retest correlation coefficient determination. After informed consent was obtained, all staff and managers conforming to the inclusion criteria were invited to participate in the study and to complete the questionnaire. In contrast to Herzberg's theory which considers intrinsic factors as more important than extrinsic factors in causing motivation, our results demonstrated that staff and managers of Semnan Welfare Organization believed extrinsic factors provoked higher motivation. The major motivation factors for staff and managers of Semnan Welfare province were somehow related to management practices of managers and staff, both of which are categorized as extrinsic factors

Hearing loss related quality of life in adolescents with hearing loss

Quality of life, when referring to an individual's health, is called health-related quality of life. The purpose of this study is to assess self-perceived hearing loss related quality of life of adolescents with hearing loss and its relationship with sex, age sub-groups or school settings with domains of quality of life. A school based survey was conducted in Tehran city. Using stratified sampling, 255 7th to 12th grade students with hearing loss, aged 11-19 years, studying in main streaming and special school sitting, were participated in the study by completing the health-related quality of life adolescent's questionnaire. Physical, Emotional and Social health-related quality of life domain scores as well as Total health-related quality of life scores was calculated in a 0-100 scoring system. As a whole, health-related quality of life of adolescents calculated to be 64.7 +/- 16.5. Students with milder hearing loss reported their quality of life [physical, emotional and social domains, as well as total quality of life] better than those with more severe hearing loss. Girls reported their physical and total health-related quality of life better than boys, and adolescents who were studied in mainstreaming reported better physical, social and total health-related quality of life [P<0.05]. No significant differences were seen between reported health-related quality of life in early, mid or late adolescent age sub-groups. Nevertheless the power of tests was not enough to exclude differences between groups. Findings of this study could be readily used to focus interventions on domains with more weakness in each group of adolescents. Beyond that the results could be helpful as a base line for detecting effectiveness of interventions in future

level of awareness of rehabilitation professionals employed in rehabilitation academic centers regarding Tele-rehabilitation technology

Objective: The aim of this research was to assess the level of awareness of rehabilitation professionals employed in academic rehabilitation centers in Tehran with reference to Tele-rehabilitation technology

Methods: In this study, a descriptive cross-sectional research method was used. The research was implemented by using a researcher-designed questionnaire which was developed by the integration and cultural adaptation of different tools collected in the field of tele-health implementation feasibility. The content and face validity of the questionnaire was determined and approved by Lawsche's method. The reliability of the questionnaire was assessed by test-retest correlation coefficient determinations. After considering the inclusion and exclusion criteria, informed consent was obtained, and the questionnaires were distributed among the study sample, which comprised of 141 rehabilitation professionals

Results: The findings show that a desirable level of awareness does not exist among rehabilitation professionals with regards to this technology. Based upon the results, only 8% of the participants had basic knowledge of this technology required in case of implementation

Discussion: Since rehabilitation professionals' awareness and knowledge can be a major key to a better implementation and application of this technology, it seems that there is a need for some developmental and training programs, such as informative educational workshops and seminars, to help them improve their level of knowledge and awareness

Validity and reliability determination of parents evaluation of developmental status [PEDS] in 4-60 months old children in Tehran

Objective: There are various developmental screening tools that are different in terms of psychometric characteristics and choosing the best one is challenging for the pediatrician. This research was designed to identify the validity and reliability of Parents Evaluation of Developmental Status, a developmental screening questionnaire, in 4-60 months-old children in the city of Tehran

Methods: In order to validate the Parents Evaluation of Developmental Status, a precise translation of the questionnaire was performed by the research team. A Persian version was back-translated by three English language experts who were unfamiliar with the Parents Evaluation of Developmental Status. The back-translated version was compared with the original version. The content validity of the finalized Persian version was verified by three pediatricians. The questionnaire was performed on 648 children ranging from 4 to 60 months old in healthcare clinics. A test-retest method with 2-3 weeks interval and Cronbach's alpha were used in order to determine the reliability of the questionnaire

Results: All of the questions in Parents Evaluation of Developmental Status had desirable content validity and there was no need to change them. The total Cronbach's alpha coefficient was 0.63, which, when considering the low number of items in Parents Evaluation of Developmental Status, is acceptable. The test-retest correlation coefficient was determined to be 0.87, which is desirable. The estimated Kappa measure agreement between Parents Evaluation of Developmental Status and Ages and Stages Questionnaires was 0.30. Due to the rather large sample size and similarity of the screening results by both questionnaires in 71.5% of cases, it is possible to conclude that this measure is an acceptable one

Discussion: This research showed that Parents Evaluation of Developmental Status has a good content validity and reliability and can be used for developmental screening of children in Tehran city. Because the test is brief, using it can lead to saving time and resources

[Personal-social developmental screening of 0- 60 months old children by using DDST-II and ASQ]

Objective: This research was made to personal- social developmental screening of 4-60 months old children in Tehran city by DDST-II and ASQ and determining the agreement coefficient of two tests

Materials and Methods: In this study, the personal-social developmental status of 197 children 4-60 months old were screened by using ASQ and PDQ [93 girls and 104 boys]. Convenient sampling was used. Data was analyzed by SPSS software

Results: By using DDST-II and ASQ personal- social developmental delay detected in 11% and 1.5% of children respectively. The estimated consistency coefficient between DDST-II and ASQ for Personal- social domain was 0.06

Conclusion: In this study personal- social developmental screening of children showed different results and kappa measure agreement of two tests was weak. For selecting a suitable tool we must consider the psychometric characteristics [sensitivity, specificity, positive and negative predicting power] of the tool. This study showed that the results of developmental screening of 4-60 months old children in Tehran by using ASQ and PDQ lead to different results. This finding emphasizes the need to comparing the results of screening tests with a diagnostic gold standard test

Validity and reliability of General Evaluation Tool for Clinical Training in Rehabilitation disciplines

Objectives: One of the problems in the process of assessment and evaluation, especially the evaluation of clinical training in rehabilitation disciplines, is the lack of an appropriate instrument for this purpose. Considering the effects of appropriate evaluation on quality assurance of clinical training, the aim of the present study was to design a valid and reliable tool for general evaluation of clinical training in rehabilitation disciplines.

Methods: This study was carried out initially by literature review and then by holding a focus group discussion with the trainers and mentors of rehabilitation clinics whom were recruited by convenient purposive sampling. The main indicators for evaluation of training in these fields were determined. After classification of the indicators, evaluation tool was developed. The face validity and content validity of the tool were determined with the Lawasche's method. The reliability was determined with the test- retest method and Cronbakh's alpha coefficient.

Results: Content analysis of the focus group discussion [FGD] resulted in determining 57 indices which were classified in 5 categories [including: the educator or trainer, the Trainees [students in these disciplines], administration of clinical training, fields of training and evaluation of clinical training]. The final tool was adjusted in two separate questionnaires. The correlation coefficient for the questionnaire of the clinical trainers was 0.9, its Cronbakh's alpha coefficient was 0.88 and its content validity coefficient was 0.84. The correlation coefficient for the questionnaire of the students was 0.7, its Cronbakh's alpha was 0.92 and its content validity coefficient was 0.81.

Discussion: The designed tool for the evaluation of clinical training in rehabilitation disciplines indicated acceptable validity and reliability and is appropriate for the assessment of trainings.

Review of Structural Social Determinants of Health in Early Childhood Development

Development is a dynamic and continuous phenomenon that is under the influence of various factors forming a complicated multidimensional system together. Any impairment in these factors can lead to impaired development in children, which is one of the most common problems in children. Therefore, this study provides a brief overview of these factors and the way they affect early childhood development. A brief review was performed in databases including Google scholar, PUBMED, Proquest, SID, Magiran, Iranmedex, Irandoc with following keywords: child development, income, occupation, education, employment, boy, girl, gender, sex, social class, Race and Ethnicity. All of article was reviewed then categorized based on WHO model. Among the papers reviewed, most of the studies were about employment, education, and income and most of them investigated these risk factors in terms of socioeconomic status. Structural factors of social determinants of health had a close relationship with each other, and they had affected development through each other. Given that, only few studies on structural factors, except for socioeconomic factors, have been conducted and little attention has been paid to the way these factors affect child development, further studies in this area are required to propose a model in order to better understand the interaction between these factors.

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

[Comparing quality of life among rural and urban elderly outpatients]

Objective [s]: The purpose of this study was to compare quality of life among rural and urban elderly outpatients attending the Imam Sajjad Hospital of Shahryar during 2010-2011

Methods: This was a cross-sectional study of a sample of 203 rural and urban elderly outpatients. HRQoL was measured using the Short Form Health Survey [SF-36]. Data were analyzed using student t-test, ANOVA, and regression analysis in order to indicate the major quality of life determinants

Results: In a step-wise regression analysis gender, age and employment had significant effect on physical functioning. For role physical, education; for bodily pain, education, gender and living area; for general health, gender and employment; for vitality, employment; for social functioning, employment; for role emotional, living area; and for mental health, gender had a significant effect on quality of life

Conclusion: Overall the findings suggest that the urban and rural environment do not have significant effect on health-related quality of life

Cross-cultural adaptation, validation and standardization of ages and stages questionnaire [ASQ] in Iranian children

To provide the validated and standardized form of the Persian version of the Ages and Stages Questionnaires as an appropriate developmental screening tool for evaluation of Iranian children's development. This was a cross- sectional study. Translation and back-translation, content validity determination, cultural and lingual modifications, pilot study on 100 parents and inter-rater reliability determinations were performed, respectively. The national and final stage was carried out 11000, 4-60 month- old children in selected cities throughout the country in order to determine the validity, standard deviation, reliability, sensitivity, specificity, and mean scores points of the test. The reliability, determined by cronbach's alpha ranged from 0.76 to 0.86 and the inter-rater reliability was 0.93. The validity determined by factor analysis was satisfactory. The mean scores of Iranian children were identified and compared with those of the normative sample as well as with three other populations of children. The developmental status of Iranian children was higher in the communication, problem-solving and personal-social domains, especially under the age of 24 months, after which their developmental status seems to deteriorate, especially in the motor domains. The Persian version of the ASQ has appropriate validity and reliability for screening developmental disorders in Iran

[Standardization and validation of the ASQ developmental disorders screening tool in children of Tehran city]

The aim of this study was to provide a valid Persian version of the Ages and Stages Questionnaires, in order to compensate the lack of developmental screening tools in Iran. Forward and backward translation, face and content validity determination, and cultural and linguistic adaptation of the questionnaires were performed, consecutively. Next, a pilot study was carried out on 100 Iranian parents of 4- to 60-month-old children, recruited by consecutive sampling in Tehran, Iran during the year 2006 to determine the degree of clarity for each item and explore cultural adaptations. In order to determine inter-rater reliability, we had parents of 38 children complete the questionnaires. For determining the psychometric properties of the tests, we later recruited a representative sample of 555, 4- to 6-year-old children by consecutive sampling from health care centers in five main geographical areas in Tehran. Performing cultural and lingual adaptations, our expert team made some inevitable changes to the questionnaires. Almost in all age groups older than 10 months, cultural or linguistic changes were made in items in the "communication" domain. Overall, the questionnaires' Cronbach alpha was 0.79. The constructive validity of the tests was also satisfactory. Another important finding was determination of the children's developmental mean scores. The culturally adapted Persian copies of the Ages and Stages Questionnai-res have proper validity and reliability for being used as developmental screening tools for children in Tehran

[Has denver developmental screening test-II appropriate validity and reliability for screening of developmental disorders in 0-6 years old children in Tehran city?]

To identify the validity and reliability of Denver Developmental Screening Test II [DDST II] in Iranian children, in order to provide an appropriate developmental screening tool for evaluation of Iranian children development. A precise translation of the original test to Persian was done and it was revised by three developmental pediatricians. Then, DDST II was performed on 221 children aged 0 to 6 years, in four child health care centers of Tehran city. Available sampling was used. In order to determine agreement coefficient, these children were also evaluated by ASQ test in 4-60 months old children, and by developmental pediatricians in children who were out of this range. Obtained data was analyzed by SPSS software. There were developmental disorders in 34% and 12% of children who were examined by DDST II, and ASQ test respectively. The estimated consistency coefficient between DDST II and ASQ was weak [0.21], and between DDST II and physician's examination was 0.44. All of the questions in DDST II had content validity, and there was no need to change them. Test-retest and interrater methods were used in order to determine reliability of test, and Cronbach's alpha and Kauder-Richardson coefficients. Kauder- Richardson coefficient for different developmental domains was 61- 74%. Kappa measure of agreement for test-retest and interrater were 87% and 76% respectively. DDST II has a good validity and reliability, and can be used as a screening tool for developmental screening of Iranian children, but it is necessary to prepare and standardize of diagnostic developmental tests in Iran due to the low and medium consistency coefficient between DDST II and ASQ and physician's examination respectively

Evaluating the validity and reliability of PDQ-II and comparison with DDST-II for two step developmental screening

This research was designed to identify the validity and reliability of the Prescreening Developmental Questionnaire 2 [PDQ-II] in Tehran in comparison with the Denver Developmental Screening Test-II [DDST-II]. After translation and back translation, the final Persian version of test was verified by three pediatricians and also by reviewing relevant literature for content validity. The test was performed on 237 children ranging from 0 to 6 years old, recruited by convenient sampling, from four health care clinics in Tehran city. They were also evaluated by DDST II simultaneously. Interrater methods and Cronbach's alpha were used to determine reliability of the test. The Kappa agreement coefficient between PDQ and DDST II was determined. The data was analyzed by SPSS software. All of the questions in PDQ had satisfactory content validity. The total Cronbach's alpha coefficient of 0-9 months, 9-24 months, 2-4 years and 4-6 years questionnaires were 0.951, 0.926, 0.950 and 0.876, respectively. The Kappa measure of agreement for interrater tests was 0.89. The estimated agreement coefficient between PDQ and DDST II was 0.383. Based on two different categorizing possibilities for questionable scores, that is, "Delayed" or "Normal", sensitivity and specificity of PDQ was determined to be 35.7-63% and 75.8-92.2%, respectively. PDQ has a good content validity and reliability and moderate sensitivity and specificity in comparison with the DDST-II, but by considering their relatively weak agreement coefficient, using it along with DDST-II for a two-stage developmental screening process, remains doubtful

Survey of the tardive dyskinesia induced by antipsychotic drugs in patients with schizophrenia

Tardive Dyskinesia [TD], is one of the important problems of the patients with schizophrenia. The emergence of these side effects depends on so many factors such as the patients' age and the duration of antipsychotic treatment. By discovering new drugs [Atypical], there has been an outstanding decrease in the emergence of these side effects. The present study investigates the symptoms of TD in the Patients with schizophrenia who were under treatments for more than 6 months. The sample of this study was 200 Patients with schizophrenia of four wards in Razi hospital [two acute and two chronic wards] who were hospitalized in the winter of 2006 and were qualified for this study. The subjects were 101 males and 99 females who were younger than 60 and had received antipsychotic drugs for at least 6 months. After psychiatric interview and filling the demographic questionnaire by the patients, the required information about the drugs and the intensity of the symptoms was acquired. Then clinical and physical examinations of tardive dyskinesia were done. Next, the tardive dyskinesia disorders' check list [AIMS] was used. Findings of this cross-sectional, descriptive study were analyzed by SPSS. There was a high ratio of 95% between TD and the age factor [P=0.05]. There was no relationship between symptoms frequency and duration of treatment [P=0.68]. Facial muscles and oral zones were mostly involved in T.D disorder [72%]. No significant difference was observed between nine fold symptoms of T.D in patients who were using traditional drugs and those who were using the new ones [typical and atypical]. Findings showed that in the intensity of the symptoms, gender does not play a major role

Validity and reliability determination of Denver developmental screening test-II in 0-6 year-olds in Tehran

This research was designed to identify the validity and reliability of the Persian version of Denver Developmental Screening Test II [DDST-II] in Iranian children, in order to provide an appropriate developmental screening tool for Iranian child health workers. At first a precise translation of test was done by three specialists in English literature and then it was revised by three pediatricians familiar with developmental domains. Then, DDST-II was performed on 221 children ranging from 0 to 6 years, in four Child Health Clinics, in north, south, east and west regions of Tehran city. In order to determine the agreement coefficient, these children were also evaluated by Ages and Stages Questionnaires [ASQ] test. Because ASQ is designed to use for 4-60 month- old children, children who were out of this rang were evaluated by developmental pediatricians. Available sampling was used. Obtained data was analyzed by SPSS software. Developmental disorders were observed in 34% of children who were examined by DDST-II, and in 12% of children who were examined by ASQ test. The estimated consistency coefficient between DDST-II and ASQ was 0.21, which is weak, and between DDST-II and the physicians' examination was 0.44. The content validity of DDST-II was verified by reviewing books and journals, and by specialists' opinions. All of the questions in DDST-II had appropriate content validity, and there was no need to change them. Test-retest and Inter-rater methods were used in order to determine reliability of the test, by Cronbach's alpha and Kauder-Richardson coefficients. Kauder-Richardson coefficient for different developmental domains was between 61% and 74%, which is good. Cronbach's alpha coefficient and Kappa measure of agreement for test-retest were 92% and 87% and for Inter-rater 90% and 76%, respectively. Persian version of DDST-II has a good validity and reliability, and can be used as a screening tool for developmental screening of children in Tehran city

Risk factor profiles of adverse neuromotor outcome in infants

Assessment of risk predictors for adverse neurodevelopmental outcome at 1 year of age in term and near-term infants. This case-control study was a representative sample of infants from different health-care centers of north and east of Tehran. The association between risk factors and delayed motor development [developmental quotient below 70 indicating a significant delay] was analyzed using correlating risk factors; including the perinatal and neonatal data to the developmental status. The case group consisted of 143 infants whose DQ score was less than 70 and the control group consisted of 140 infants who had a DQ score of more than 70. Neonatal seizures, Apgar score less than 3 after 5 minutes of birth [OR = 2.87 [95% CI; 1.68, 4.92]], low birth weight [OR= 5.86[95% CI; 3.07, 11.18]], preterm delivery [OR =6.17 [95% CI; 3.04, 12.52]], Premature rupture of membranes [PROM]>24 hours [OR = 6.18[95% CI; 2.07, 18.51]] and hyperbilirubinemia leading to phototherapy or exchange transfusion [OR=3.75 [95%CI; 2.12, 6.65]] were associated with an increased risk for neuromotor delay on developmental examination at 1 year. This study identified distinct risk factors for an adverse outcome in infants. In this environment, perinatal risk predictors are most important

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

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. 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]. 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]. To increase the survival rate of neonates and effectiveness of early intervention, the above-mentioned risk factors could be considered as valuable clues. Routine neuro developmental 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