Development and Validity of the Persian Handwriting Assessment Tool for Primary School-Aged Children

Background: Handwriting difficulties are one of the most common reasons for referral to school-based occupational therapy. Assessing handwriting performance using standardized tools is necessary for scientific research and clinical assessment. Objectives: The objective of this study was to develop and validate the Persian handwriting assessment tool to evaluate legibility and speed in near-point copying and dictation domains in primary school-aged children. Methods: This methodological study was conducted in Tehran, Iran during 2015-2016. Measurement items were selected by reviewing the past literature and considering the opinions of an expert panel. The scale development, the analysis of content validity, and item analysis were performed in phase one using the data from 131 students in grades two and three. Exploratory factor analysis and discriminant validity were analyzed in phase two using the data from 208 subjects. Sampling was conducted using the random cluster method. Confirmatory factor analysis was conducted on a randomly split sample of half of the data. Results: The content validity ratio of most of the criteria was greater than 0.57. Item analysis confirmed the writing assignments in the copying and dictation domains. Principal component analysis revealed that measurements in the copying and dictation domains loaded into three components separately, which accounted for 71.96% of the variance in the copying domain and 70.46% of the variance in the dictation domain. Confirmatory factor analysis also confirmed the accuracy of the three-dimensional structure designated through exploratory factor analysis. Discriminant validity showed that handwriting speed and legibility increased with maturation. Conclusions: The Persian handwriting assessment tool as a comprehensive and quickly scored tool that can help therapists identify primary school students with handwriting problems so that appropriate interventions for these students can be implemented.