Objective: A cross sectional study of the prevalence and etiologic factors of limb paralysis and amputation was performed in Iran.

Materials & Methods: Using systematic cluster sampling (each cluster consists of 15 families) 59678 people have been evaluated. The sample size was 1 per 1000 of total population. The prevalence of different kinds of paralysis and limb defects was 7 per 1000 population.

Results: Hemiplegia and paraplegia were the most prevalent, accounted for 2.8 per 1000 population. The prevalence of disabilities due to cerebral palsy, limb amputation and poliomyelitis per 1000 were 2.0, 1.3 and 0.9 respectively. Prevalence of poliomyelitis was zero in age group 0-4, which supports the recent reports declared that incidence rate of poliomyelitis is very low, and it is the consequence of vaccination done all over the country. 24.5% of all kinds of paralysis and limb defects were congenital other etiologic factors were physical injury, infectious disease, non-infectious disease and aging which accounted for 25.6%, 15.6%, 28.8% and 3.1% respectively. Most of the cases of cerebral palsy were congenital (67.2%). The main cause of hemiplegia and paraplegia was non-infectious disease (54.8%) and the main cause of amputation was physical injury. (73.7%), prevalence of disabilities due to paraplegia, hemiplegia and limb amputation considerably increased with age so it was most prevalent among people of 65 years old and over (29.0 per 1000). The prevalence of the above-mentioned disabilities was 6.3 per 1000 among men and 2.8 per 1000 among women. So male female ratio was 2:1 (p<0.001).

Conclusion: Overall, the prevalence of hemiplegia, paraplegia and limb amputation were 4.9 per 1000 in urban and 4.1 per 1000 in rural areas, but after adjusting for age difference between urban and rural areas was not significant (P=0.059). Logistic Regression analysis declared that variables age, sex and living area have separately significant effect on odds of hemiplegia, paraplegia and limb amputation. Considering these variables concurrently, age and sex again showed significant effect but living area effects through age. (P<0.001)

Objective: Handedness and self-care skills are important in occupational therapy. This research was done in schools of the eleventh zone of Tehran in 2002. This study took place in 61 normal students (32 right-handed, 29 left-handed) and 59 mental retarded student (40 right-handed, 19 left-handed) in preschool, first and second grade.

Materials & Methods: Average age for normal students was less than mental retarded students (P=0.001). Some data were taken from students through questionnaire and applying special tests for students got special data. Handedness and self-care skills were statistically compared between the two groups and relationship between them was calculated.

Results: There was a significant difference between the mean grip strength of right and left hand in right-handed normal students (P=0.001) but not in left-handed students (P= 0.234). There was significant relationship between self-care skills and grip strength in normal and mental retarded students (P=0.001). The difference of correlative comparison between manual skills and self-care skills was more than significant in mental retarded students than normal students (P<0.05).

Conclusion: In this study correlation between handedness and foot preference was more than the correlation between handedness and eye preference. There are significant relationships in comparing right-handed and left-handed in normal students based on birth rank (P=0.00l) but there aren't significant difference based on history of left-handed in family (P=0.963). It is recommended to evaluate and determine the handedness by means of many aspects like strength and handwriting alone is not enough.

Objective: to investigate whether a neoprene sleeve and elastic bandage around the knee joint of subjects with knee osteoarthritis (OA) would , in short term (a) reduce pain (b) improve knee joint position sense and comparison of their effect with each other if they have.

Materials & Methods: In a semi-experimental study, 30 subjects (11 men, 19 women, age between 33-75) with unilateral knee OA. Subjects had to have at least 2cm from 10cm visual analogue scale (VAS) of knee pain for study entry.All patients were randomly assigned to either an elastic bandage or a neoprene sleeve. One week later they were assigned to the opposite selection. Joint position sense was assessed in the sitting position using an electrogoniometer and pain by VAS where 0cm equals no pain and 10 cm equals worst pain. Knee pain and JPS were assessed for each selection one week apart. During each visit assessment were performed at baseline and after 20 min of bandage/neoprene sleeve application.

Results: the mean of scores for knee variables JPS and VAS was taken and paired-t test and Wilcoxon signed rank test was employed to calculate the different between two trails. Neoprene sleeve had significant effect on knee JPS (P=0.037). But elastic bandage had no effect (P=0.631). Both of them had significantly reduced knee pain. (P=0.000)

Conclusion: In subjects with both neoprene sleeve and elastic bandage reduced knee pain with more effect of neoprene sleeve. Only the neoprene sleeve had effect on knee JPS.

Objective: In some clients, for lower extremity, long leg brace, is prescribed. Then it will be fabricated bye orthotist and worn by patient. According to clinical principles, the brace should be as fit as possible with limb form. Also, an individual, walks and sits with his or her brace. Brace functions around joint motion axis. Quality and exact place of movement is define by biomechanical principles. Therefore, brace should be adapted with biochemical principles of the limb.

Materials & Methods: A brace is made up several components which are assembled through acceptable technical orthopaedic methods and this procedure should be done without omission or neglect. If orthotist has enough scientific knowledge and observes all details, he or she will fabricate a perfect brace. We considered fabricated long leg brace according to this principle to meet study objectives while answering some question of study, we will disguss on the finding of our assessment. Also, we examine some possible deviations with accured by unsuitable fabrication, more over we suggest that some failur in designing procedure which leads to such deviation material and methods: In this descriptive analytic cross sectional study, long leg braces of 193 clients who were selected by random stratified sampling method, were evaluated by a previously designed questionare .

Results: A. By assessment of 7 variables, it was revealed that 28.86% of manufactured braces, was not adapted with defined fundamentals, biomechanically. B. By evaluation of 9 variables, it was made known that 30 % of produced braces was not adapted with established fabricating fundamentals of lower limb braces clinically. C. By examination of 23 variables it was find out that 25.4% of fabricated braces, it was observed, which has some failures by attention to defined fabricating technical orthopaedic fundamentals.

Conclusion: All the details, fabrication and design procedures should be carefully observed and associated theories should be considered.

Objective: this research was conducted to determine the attitude of dormitory students in the university of IRAN medical medical sciences a bout existing deviant behavior in dormitories.

Materials & Methods: The present study is a descriptive and cross sectional one, which was completed in the year 1383. The ultimate goal of the research is determining of the attitude of dormitory students regarding the existence of Deviant behavior among the students. In order to achieve the main objective, 325 students were selected through random sampling out of 2014 students (183 boys and 187 girls).

Results: The results are as follows: More than 50% of the students believe that, living in dormitory is one of the best period of their whole life. 41.7% found dormitory as a place to take rest after the class. 53.4% believe that marriage can fulfill firstly the affection needs and secondly the sexual needs as well. 86.3% thing that roommate from different provinces leads to maladjustment.

Conclusion: There are some other factors to raise deviant behavior such as:

- Limitation in social relation among the students in the university in 55.7%.

- Existing social problems in the social structure which prevent marriage in 40.9%.

- Family Conflicts and quarrels in 65.6%.

- Deprivation of having relation with opposite gender in 79.3%.

Lithium preparations have been used in bipolar mood disorders since 19th Century. Lethal toxic effect of lithium due to it's narrow (therapeutic) index had been known from several years ago and is the most problem when is prescribed. Serum level of lithium is accepted for monitoring of toxicity, but frequency of blood testing especially in stabilizing period is stressful for patients, also it is difficult in such psychiatric patients especially in children. Many researchers worked to find a less aggressive method. One of these methods is monitoring based on salivary lithium concentration, which is controversy according to this review articles. All papers from 1949 till now are reviewed in this article and revealed this controversy. According to this review article, three ways are being suggested to solve this problem 1- Stimulation of salivary – serum ratio of lithium based on tree separated paired tests 2- Improving methods and techniques of testing. 3- Modifying of this ratio based on natural markers.

Objective: The aim of the present study was to determine the effects of home based cardiac rehabilitation programs (CRP) on quality of life in post Myocardial Infarction (MI) patients.

Materials & Methods: We conducted a quasi experimental design study with a non randomized sampling, pretest - posttest control group. After matching, 38 subjects were allocated randomized either a home based CRP (n=18) and a control group (n=20). At the base line knowledge about disease management and quality of life (QOL) were measured .Then experimental group were instructed by multidisciplinary team about home based CRP. The patients received an instructional booklet containing the above mentioned information and also received support and guidance through phone call and home visits, on the other hand, disease management and health behavior were been measured in ever home visiting. At the end of three months follow up, patient's knowledge and QOL were measured again.

Results: The research findings indicated the improvement QOL for the Experimental group following the application of home-based CRP, this improvement included all dimensions such as physical, mental, and psychological ones (P = 0.000). No significant improvement was observed in social dimension of QOL following the experimental group (P=0.308). For control group, the reduction of averages in different dimensions of QOLwas noticeable. However, this reduction was noticeable and just meaningful in social dimension (P=0.009). Comparing groups, before the intervention, indicated that there weren’t significant differences in different dimensions of QOL but, after the intervention, there was significant difference just in psychological dimension (P=0.032).

Conclusion: Significant positive changes in physical, psychological dimensions and whole of QOL indicated positive effect on homebased CRP on QOL in experimental group. Although there was just significant difference between groups in psychological demands of QOL after the treatment, but research hypothesis, "positive effect of homebased CRP on QOL" wasn’t supported. It may be due to the fact that QOL is a subjective, dynamic and multidimensional concept and defensible outcomes need using larger sample with longer period of time especially based on team approach.

Objective: This Study was aimed to determine the educational situation of rehabilitation branches in welfare and Rehabilitation University.

Materials & Methods: This descriptive evaluation was performed using the viewpoints of undergraduate students studying in 3rd and 4th year together with the postgraduates in their 2 nd year that practiced the census of 160 students. The data was gathered using the questionnaire with the collaboration of studernts' representatives and analysed utilizing the likurt Index through the correlation coefficient.

Results: Final findings of this research showed that the situation of evaluation for each educational heading is as follows: The situation of location for theoretical classess " rather desirable" and for practical classes "rather desirable". The Situation of practical classes "undesirable" , The status of classes affairs office "rather desirable" the status of educational experts "rather desirable" , the situation of lessons planning "undesirable" , the situation of presenting the theoretical lessons "rather desirable " the situation of education in clinical centers " undesirable" and the situation of clinical centers "undesirable".

Conclusion: From all the student's viewpoints it concludes that situation of classes location, status of classes affairs office and, quality of theoretical classes are rather desirable but situation of practical classes and quality of clinical education are undesirable. Among educational groups speechtherapy department had better than others.

Objective: Anxiety in the recent modern world, especially in elderly who have low power of adaptation, it can produce serious health problems for elder people. So this study was conducted in order to investigate and determine the effects of Slow Stroke Back Massage (SSBM) on anxiety in elderly clients.

Materials & Methods: This study is a quasi-experimental research that was carried out in Kahrizak charity foundation for elderly, in 2007. For this study 102 elderly clients were allocated to two groups of experimental and control with randomize permuted block. Data were gathered by client demographic characteristics and Spielberger State anxiety inventory. The patients in experimental group have received five minutes of SSBM for five consecutive days during 3-7 the afternoon. State anxiety was measured in both groups before and after intervention. Data were analyzed by use of Chi-esquare, independent T test, Kolmogorov-Smirnov test, Mann Whitney test and pair T test.

Results: Results did not show significant difference between groups in average of state anxiety levels before execution of SSBM (P>0.05), but were observed significant difference between two groups after intervenion (P<0.05).

Conclusion: According to the result, SSBM was effective to decrease state anxiety levels of elderly clients, therefore it can be used in current and complementary treatment of anxiety.

Objective: The aim of this investigation is to measure the satisfaction rate between rehabilitation centers of the red crescent organization in Tehran city. This investigation attemps to gain access to his strength and weakness points in the organization, and helps to progress the quality and efficiency of the rehabilitation services.

Materials & Methods: This study has been done as descriptive and survey methods. Data collection was done by using the produced- investigator questionnaire. Its reliability was measured 0.82. Sample sizes were 190 persons from the rehabilitation centers clients in Tehran’s Red Crescent that were selected by cluster sampling. Data were analyzed by use of Chi-square, independent T test and variance analysis. 

Results: The findings showed that there is significant relationship between participation rate in the treatment process and clients satisfaction (P=0.021), Also, there is significant relationship between the efficiency of rehabilitation equipments and their satisfaction (P=0.002), between rehabilitation service quality and satisfaction (P<0.001) and between behavior and contact of personnel with clients satisfaction (P<0.001).

Conclusion: The results showed that rehabilitation services by influence of different factors led to reduce client’s satisfaction. The satisfaction could be introduced as fanction of the client participation rate in treatment process, service efficiency and quality rate and behavior type and personnel contacts (such as physician, technicians and etc). Then, by doing short-time educational terms for personnels, to equip centers by proper rehabilitation possibilities, to inform and to provide clients participation from treatment process, can to meet clients and their family’s expectations and to increase their satisfaction.

Objective: Study of prevalence of stuttering in Iranian bilingual societies is essential for determine the effects of linguistic factors in stuttering and therapy demands in these bilingual societies. The aim of this study is to determine the prevalence of stuttering among Javanrud’s bilingual students.

Materials & Methods: In this cross- sectional, descriptive and analytical study, all of bilingual students of Javanrud’s schools were examined and in order to this purpose, teacher referral method was used for the primary screening of speech disorders at all. Essential information about speech disorders specifically stuttering had been given to teachers before this primary step. Then researcher diagnosed stuttering students based on personal interview, reading, spontaneous speech and description of serial images that tell a story in Kurdish and Persian. Data were analysed by statistical tests such as Chi-square and Logistic Regression.

Results: Among 11425 bilingual students of Javanrud’s schools, 129 students were identified as stutterers. These findings indicated that overall prevalence of stuttering in this population is 1/13 percent. Among primary, guidance and high school students the prevalence of stuttering was 2/06, 0/87 and 0/5 percent respectively. Prevalence of stuttering among boys was 1/35 and among girls was 0/88 percent. An overall male/female ratio was 1/5. Prevalence of stuttering in primary, guidance and high school was differ from each other significantly (P<0/001). Prevalence of stuttering in male was higher than female significantly (P=0/034).

Conclusion: Prevalence of stuttering among Javanrood’s bilingual students was higher than accepted prevalence in monolinguals (1%). Risk of being stuttering in male was higher than female.

Objective: 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.

Materials & Methods: 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 (F1 & F2) of the Persian simple vowels /i, e, æ, a, o, u/ were evaluated by the version of 1.2 of SFSwin software. Data were analyzed by Independent T test.

Results: The findings indicated that there were significant differences between two groups in the mean of F2/i/ (P=0.046), F1/e/ (P=0.011), F2/e/ (P=0.005), F2/æ/ (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 then in the mean of F1/i/, F1/æ/, F2/a/, F1/o/, F1/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).

Conclusion: 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.

Objective: Gestures of the hands and arms have long been observed to accompany speech in spontaneous conversation. However, the way in which these two modes of expression are related in production is not yet fully understood. So, the present study aims to investigate the spontaneous gestures that accompany speech in adults who stutter in comparison to fluent controls. 

Materials & Methods: In this cross-sectional and comparative research, ten adults who stutter were selected randomly from speech and language pathology clinics and compared with ten healthy persons as control group who were matched with stutterers according to sex, age and education. The cartoon story-retelling task used to elicit spontaneous gestures that accompany speech. Participants were asked to watch the animation carefully and then retell the storyline in as much detail as possible to a listener sitting across from him or her and his or her narration was video recorded simultaneously. Then recorded utterances and gestures were analyzed. The statistical methods such as Kolmogorov- Smirnov and Independent t-test were used for data analyzing.

Results: The results indicated that stutterers in comparison to controls in average use fewer iconic gestures in their narration (P=0.005). Also, stutterers in comparison to controls in average use fewer iconic gestures per each utterance and word (P=0.019). Furthermore, the execution of gesture production during moments of dysfluency revealed that more than 70% of the gestures produced with stuttering were frozen or abandoned at the moment of dysfluency.

Conclusion: It seems gesture and speech have such an intricate and deep association that show similar frequency and timing patterns and move completely parallel to each other in such a way that deficit in speech results in deficiency in hand gesture.

Objective: Among the traditional and modern drugs, appearance and spreading of ecstasy drugs is a new phenomenon that has affected different nations, among them Iranian youth. While, it seems that unawareness in society of these industrial drugs, has a great influence in spreading its use. This research was conducted to evaluate students' knowledge about the effects of ecstasy drugs. 

Materials & Methods: This study is a descriptive and cross-sectional research. 154 high school students, by simple random sampling, in district 9 of Tehran were selected and their awareness about research object were evaluated by researcher made questionnaire. The face validity of questionnaire was confirmed by specialists consideiation and its rehabilitee was confirmed by Cronbach’s alpha coefficient (r = 0.85). Data were analyzed by Correlation coefficient and Mann-Whitney U. 

Results: 14.7 percent of responses were incorrect, and 38 percent were don’t know. Students' awareness of accidents and bad effects of ecstasy drugs is in a low level. There was no significant difference between boys and girls' knowledge about the effects of ecstacy (P= 0.573). Also, there was no significant relation between student sexuality and their awareness about Ecstasy side effects (P=0.572).

Conclusion: Students' knowledge about the Effects of ecstasy drugs is in a low level (47.3 percent).

Objective: Phonological processes are the changes which children make in pronunciation while uttering words. The present study aimed at investigating phonological processes of 2-4 year old Farsi-speaking children.
Materials & Methods: The subjects of this cross-sectional and descriptive-analytical study included 128 24-48 months old Farsi-speaking boys and girls without any auditory, visual, physical, mental, speech, language, emotional, structural and functional articulation disorders. They were selected by simple random selection method from nurseries of different areas of Tehran. The research tool was an experimental and researcher made test of phonological processes which were designed for this study, and composed of 43 one-to-four syllable words including all Farsi phonemes by which the categories of syllable structure, consonant substitution, vowel substitution, complete assimilation, replacement and other processes were gathered and assessed. The data were analyzed by Independent T-test, Man-Whitney, One-way ANOVA and Kruskal-Wallis.
Results: Findings showed no significant difference at phonological processes between boys and girls (P>0.05). Phonological processes showed a decrease trend by increasing age. Different age groups revealed significant difference in syllable structure (P<0.001), consonant substitution (P<0.001), vowel substitution (P=0.003) and complete assimilation (P=0.003).
Conclusion: The findings of the present research reveal that gender has no effect on phonological processes. But by increasing age, these processes decrease which may reflect greater mastery of older children on phonological perception and pronunciation.

Objective: One of the most widespread cardiovascular disorders is Heart failure and is expressed as a chronic, progressive and disabling disorder .Many research have shown that quality of life in heart failure patients is low. one of the promoting ways of quality of life is self care education. The purpose of this study is to evaluate the effect of self care education on quality of life among heart failure patients .

Materials & Methods: This study is a quasi-experimental research which is done on 126 heart failure patients whom were selected from persons referring to Tehran Rajaei Heart Center and were assigned equivalently in intervention and control group by the way of randomly permuted blocks. Data collection was tooled by demographic specification form, questionnaire of quality of life of heart failure patients and “European heart Failure Self-Care Behaviour Scale”. Intervention group patients lied in 6 groups, each group contents of 10 persons for education and participants were educated in 4-6 sessions. The educational package was given to these patients, finally. Time for each session was 30-45 minutes. For data analyzing, Paired T-test and Independent T-test, Chi-square, Kolmogorov-Smirnov test, Levens test and analyze of covariance were used.

Results: There was no significant difference between two groups in total quality of life (P=0.214) and self care (P=0.795) before intervention, but after intervention these differences were significant (P<0.001). Also, there were significant differences between two groups after intervention in average of physical-activity, socio-economical, mental and general health dimensions of quality of life (P<0.001). Quality of life and self care of intervention group were more significantly than before intervention (P<0.001), but there was no significant difference between before and after score of quality of life (P=0.154) and self care (P=0.431) in control group.

Conclusion: Results of study show that the education of self care was effective on quality of life among heart failure patients and researchers recommend this intervention as a one of the suitable and benefit styles for promoting the quality of life in these patients.

Objective: The present research attempted to compare the effect of postoperative immobilization orthosis (POIO) and plaster support on Metatarsophalangeal joint alingment in Hallux valgus patients.
Materials & Methods: In this quasi experimental and interventional study, 24 Hallux valgus patients were selected simply and conveniently based on inclusion criteria(age:19-50years, Hallux valgus angle<25˚, inter metatarsal angle=11˚-13˚, no degenerative change in first metatarsophalangeal joint and no general systemic disease) from orthopedic clinic of Milad hospital and were assigned by randomized permuted blocks into two equal groups. In splint group, a positive plaster model was constructed from their feet before surgery and immediately after surgery the orthoses were applied for six weeks. In plaster support group, all the forefoot plasters were applied at the end of operation. The Hallux valgus angle of patients' feet of two groups was measured by radiography immediately and six week after surgery. Chi-square, Independent T test, Pair T test, One way ANOVA and ANCOVA were used to analyze data.
Results: Means difference between Hallux valgus angle means of immediately after surgery and six weeks after surgery of two groups had no significant difference (P=1.00) and also there was no significant difference in Hallux valgus angle mean between immediately and six weeks after surgery in each group (P=1.00).
Conclusion: The effect of plaster support doesn’t differ with splinting in the maintenance of Hallux valgus angle after surgery, so both methods can be used according to patients situation.

Objective: Attention Deficit Hyperactivity Disorder (ADHD) is the most common psychiatric disorders of childhood and adolescence. Psychosocial interventions such as group parent management training are needed, for children's behaviors and parent – child interaction. The aim of this study is to investigate the effect of group parent management training on behavioral disorders among children with Attention Deficit Hyperactivity Disorder.
Materials & Methods: In this interventional and quasi experimental study, fifty four children with ADHD were selected from seven mental occupational therapy clinics of Tehran city.They were assigned into two Equal groups and all of them received routine occupational therapy and medication. Parent management training program by using positive parenting program (triple p) manual (Sanders 2005) was added to the Intervention Group program. These sessions lasted 2 hours a week for 8 weeks. Data collection tools were 2 questionnaires: Demographic questionnaire and Conners Parent Rating Scale (CPRS 48). Statistical snalysis of data was done by chi square ,Independent T test, Paired T test and analysis of covariance.
Results: Although both groups showed significant improvement in all subscales of behavioral questionnaire (CPRS) pretest, improvement of intervention group score was more significantly than control group in conduct subscale (P<0.001), anxiety (P<0.001), hyperactivity index (P=0.016) and total score (P<0.001). But in psychosomatic subscale (P=0.526 ), learning subscale (P=0.052) and impulsion and hyperactivity subscale (P=0.267) there was no significant difference between two groups.
Conclusion: Group parent management training is significantly effective in decreasing behavioral disorders and anxiety status of children with attention deficit hyperactivity disorder and this psychosocial intervention could be used as an effective complementary method beside medication and occupational therapy programs.

Objective: Since presence of cerebral palsied child affects the life quality of family and specially family caregivers, the aim of this study was to determine the effect of education to caregivers about caring of children with cerebral palsy on quality of life of them.
Materials & Methods: In this interventional and quasi-experimental study, twenty five family caregivers of spastic cerebral palsy children were selected based on inclusion criteria from welfare centers of Babolsar. Instruction courses performed 6-8 sessions and each session takes 30 minutes. The quality of life was assessed using SF36 (short form health survey with 36 question) at the beginning and 3 months after the instruction courses . Paired T test and Wilcoxon nonparametric test were used for data analysis.
Results: The scores of quality of life followed by instruction courses showed that there was meaningful improvement in whole of eight realms , both total realms of physical health and mental health ,as well as total quality of life (P<0.001) .The minimum increase in mean difference found in mental health(11.36±13.59) and the maximum increase found in emotional role (50.66±87.24). The amount of change between pre test and post test in the score of total quality of life was (13.18±13.54).
Conclusion: Findings of this study showed that life quality of family caregivers promoted after instruction about how to do correct care on cerebral palsied children. therefore, the importance of family instruction can be concluded for better life of cerebral palsied child caregivers. It should be noted that the effectiveness of rehabilitation program for cerebral palsied children might have positive effects on life quality of their caregivers.

Objective: Pragmatics is the study of speech acts and social aspects of communicative interactions in context. Hearing-impaired children suffer from language impairments due to lack of hearing sense which has important role in developing language skills. The purpose of this study is comparison of some of pragmatic skills including topic maintenance, turn-taking and repairs between 4 to 6 year-old Farsi speaking hard of hearing children with normal hearing peers.

Materials & Methods: In this cross-sectional and case-control research, twenty one normal hearing children were chosen by simple random sampling method from ordinary kindergartens and twenty one hard of hearing children (71-95 db) were selected from deaf rehabilitation centers and speech therapy clinics of Tehran and Karaj by simple sampling method. The children of both groups were assessed by nonverbal intelligence subtests. If they did not show any difficulties, the pragmatic skills of them (topic maintenance, turn-taking and repair) were evaluated by researcher made tasks which their content validity was confirmed by a linguistic and two speech and language pathologists and reliability of them was determined by test-retest (0.70)

Results: There were significant differences between two groups in duration of topic maintenance (P<0.001), scores of turn-talking (P<0.001), repairs in form of reply to request for clarification (P=0.003) and request for clarification (P=0.002).

Conclusion: The pragmatic abilities of hearing-impaired children were Significantly lower than those of normal hearing.