Reliability of Persian Handwriting Assessment Tool in Iranian Primary School Students

Objectives: Handwriting problems are among the most frequent reasons for case referrals to school-based occupational therapy centers. Persian Handwriting Assessment Tool (PHAT) is a valid tool available in Iran to evaluate handwriting components in school-aged children. However, its reliability has not been investigated yet. This study aimed to determine the reliability of the PHAT in Iranian primary school-aged children. Methods: The current methodological study was performed in Tehran city, Iran during 2015-2016. In total, 208 primary school-aged students participated in this study that aimed to investigate the internal consistency of the PHAT. Forty-eight students were also recruited to examine the intra- and inter-rater reliabilities of the PHAT. Selection of the schools and sampling were conducted using the random cluster sampling method. Results: Results suggested good to excellent internal consistency (α=0.84 to 0.99) for the measures of PHAT in dictation and copying domains. Intra-rater reliability of the PHAT ranged from 0.87 to 1.00. Furthermore, PHAT inter-rater reliability ranged from 0.7-1.00. Discussion: The PHAT is a reliable tool to evaluate handwriting components in primary school-aged children. It can also be useful for Iranian therapists to identify primary school students with handwriting problems.