assessment of effects of different assisted reproductive techniques ( art ) like in vitro fertilization ( ivf ) and intra cytoplasmic sperm injection ( icsi ) on speech and language development needs comprehensive studies . some studies showed that they are more susceptible to cerebral palsy which causes speech and language defects . development of speech and language consists of four periods : prelinguistic , linguistic , school and adolescence period . defects in prelinguistic behavior , i.e. physical defect like cleft palate , neurological defect like cerebral palsy or developmental defect like down syndrome produce speech defects . in two studies in belgium and finland in infants of art there was no difference between development of these children with infants of normal conception[5 , 6 ] . in another study no differences in mental , motor , social and expressive language development were found , and while receptive language development was in the normal range , ivf infants scored lower than control infants . one study did not report any excess of neurodevelopmental disorders in ivf / icsi children . the majority of studies followed the children during infancy , thereby precluding pertinent conclusion on the risk of neurodevelopmental disorders which express at older ages such as fine manipulation disability or dyslexia . one study shows that a large proportions of preterm deliveries in ivf children have increased risk of cerebral palsy . regarding the importance of this subject and the lack of a comprehensive study on the prelinguistic behavior of infants of art in iran , this study was designed . the aim of this study is to evaluate prelinguistic behavior of 9 month old art infants of royan institute . in this descriptive , cross sectional study , 151 term infants of art from royan institute have been evaluated in children 's health and development research center of tehran from august 2007 until august 2009 . the research ethics committee of the academic center of education , culture and research ( acecr ) and royan institute approved the study . the sampling method was non random sequential with the inclusion criteria of infants conceived through one of the art methods ( ivf / icsi ) , born in term and being resident in tehran . preterm born infants were excluded . after signing of research consents by parents , prelinguistic behavior of 151 infants who were born full term ( > 37 weeks ) are assessed . this scale is used for assessment of development of speech and language in children from birth to 3 years old . it has sensitivity of 90 - 95% for primary detection of speech , language and cognition defects . the method of art , sex of infants , age of mother at pregnancy , time and speech and language defect of parents at present and past time also were mentioned in questionnaire . the prelinguistic behavior of infants include : crying at birth , different cries , smiling , cooing , babbling , reduplicated babbling and echolalia , which are assessed in this study . one - hundred one term infants of art were evaluated . in this study , 76 ( 50.5% ) were male and 75 ( 49.5% ) female . there was 129 ( 85.4% ) of infants conceived by icsi and 22 ( 14.5% ) by ivf . prelinguistic behavior delay which had been assessed according to elm-2 is shown in table 1 . number of infants with delay in reduplicated babbling in icsi method was more than un ivf . prevalence of prelinguistic behavior delay in assisted reproductive techniques methods ivf : invitro fertilization ; icsi : intra cytoplasmic sperm injection the prelinguistic behavior delays in different sex and mothers age is shown in table 2 . there was a significant difference only in echolalia delay in the two sexes . prevalence of prelinguistic behavior delay in different sexes and mothers age mothers of 118 infants were younger than 35 years and 33 ones were older . two studies showed that art infants had normal cognition development [ 11 , 12 ] . zhu jl in showed that infertility treatment , especially icsi , may be associated with a slightly delayed cognitive language development . another study showed that there was no difference between cognitive development of infants of art and normal infants . in this study infants showed delay in reduplicated babbling and echolalia . in a study by sutcliffe children were assessed with the griffiths mental  development scales . icsi children were around the midpoint for the griffiths scales and did not differ significantly for griffiths quotients and suhquotients . one study reported significantly lower mental scores in 1 year old infants born after icsi than in age matched infants born after ivf and naturally conceived infants . stratification for gender revealed that lower mental development index scores were only found in boys , not in girls . in our study delay of reduplicated babbling and echolalia were more in boys . there is no study about effect of mother 's age on speech and language development in infants . bonduelle and his collegues in their study , by selection of infants of mothers with the same age exclude affect of this variable . in our study delay of reduplicated there was no relation between speech and language defect of parents and prelinguistic behavior of infants . limited sample size , difficult access to this group of infants and unwillingness of parents to complete the questionnaires render less reliable results . this study was a new study in our country which shows differences between art infants in some prelinguistic behavior such as reduplicated babbling and echolalia . this study showed that prelinguistic behavior of art infants are affected by art method , infants sex and mother 's age at the time of pregnancy . detection and correction of any defect or delay in this period prevent major speech and language problems . more studies with larger sample size to compare art infants with infants of normal conception would be desirable .
objectivethe aim of this study is assessment of effects of different assisted reproductive techniques ( art ) like in vitro fertilization ( ivf ) and intra cytoplasmic sperm injection ( icsi ) on prelinguistic behavior of infants conceived by these techniques.methodsin this descriptive , cross sectional study , prelinguistic behavior of 151 full term art infants of royan institute have been assessed in children 's health and development research center of tehran from august 2007 until august 2009 . 
 questionnaires were completed by parents at 9 months old . 
 the questionnaire was standard according to early language milestone scale-2 ( elm-2 ) . 
 data were analyzed by spss version 16 and using chi - square test.findingstwenty-two ( 14.5% ) of infants were conceived by ivf and 129 ( 85.4% ) by icsi . 
 number of infants with delay in reduplicated babbling in icsi method was more than in ivf . 
 there was only a significant difference in echolalia delay in the two sexes . 
 echolalia was delayed more in boys . 
 delay of reduplicated babbling was more in infants of younger mothers . 
 there was no relation between speech and language defect of parents and infants.conclusionthis study showed that prelingustic behavior of art infants are affected by kind of art method , infant sex , and mother 's age at the time of pregnancy .