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This article is a review on occupational therapy in Iran. Occupational therapy started in the Rehabilitation faculty of Iran Medical University as a BS degree in 1973. About 2000 students were graduated in occupational therapy and are active in different parts of the country. They assist disabled individuals to achieve maximal independence. In this article a summary of the history and educational structure of occupational therapy and job opportunities of graduates of this speciality in Iran is given.

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Objectives: The visual-motor skill is one of the major factors in the learning process. Visual-spatial and visual analysis skills are components of the visual motor skill. Any deficiency in Visual-Motor skills and their components often causes problem in writing and learning processes in children. The aim of this study was to investigate the effect of occupational therapy (O.T.) intervention on visual-spatial and visual analysis skills in children with L.D.

Methods: Fifty-eight children with learning disorder (L.D.) from “Learning Disorders Centers“ in Tehran were assessed in this study. Out of them, 23children were selected. They were in second, third and forth standard classes. They had normal I.Q and no visual or auditory problem. All of the children took the “Test of Visual Motor Skills-Revised“ (TVMS-R). They were divided into two groups: 11 in experimental group and 12 in control group. O.T interventions were performed for 16 sessions in the experimental group and finally all of the children were assessed with TVMS-R again. TVMS-R includes 8 categories and is designed based on copying some geometric figures. This test was standardized in Exceptional Children Institute, Tehran in 2002.

Results: There was no significant difference of means between the pretest and the post test in the control group (P=0.10), but there was a significant difference of means in the experimental group based on paired t-test (P=0.000)

Disussion: Results showed that the O.T. intervention had a statistically meaningful effect on visual-spatial and visual analysis skills in children with L.D.

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Occupational therapy in Iran is relatively young-established in 1971-with a fluctuated development due to the Iranian revolution in 1979, and eight years war from 1981 to 1989. Today, there are ten Bachelor programs across the country approved by World Federation of Occupational Therapists (WFOT). Furthermore, occupational therapists have opportunities for further postgraduate training in both Master and PhD levels. Fast growing of occupational therapy due to social demands necessitated therapists to develop a professional organization. Therefore, Iranian Occupational Therapy Association (IROTA) was formally established in 1994. This paper aims to present an overview about occupational therapy in Iran. Iranian context including population, health status and culture is also reviewed. This follows with explanation about occupational therapy background, education and development. Finally, conception, development, purposes, and achievements of Iranian Occupational Therapy Association present situation and future perspectives of occupational therapy are discussed.

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Objectives:The aim of this single case study is to describe a child with Landau Kleffner Syndrome who misdiagnosed as a child with autism spectrum disorder. We also explore occupational therapy`s role in correct process for diagnosis and treatment.

Methods:Three times measurement with Autism Treatment Evaluation Checklist was performed to measure severity of symptoms and compare treatment outcomes.

Results: The outcome showed great improvements after pharmacotherapy.

Discussion: Results of this study indicated that correct diagnosis, early detection and early intervention in this disorder are essential to reach a proper treatment. Of course, therapeutic team work is crucial as well. Occupational and speech therapy interventions can also been recommended as a helpful treatment to improve social and sensory-motor and communicative skills. Parent`s consultation should not be ignored to decrease parental stress.

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Objectives: Schizophrenia is responsible for a significant proportion of burden of mental diseases in Iran. Lack of a follow-up system has resulted in the repeated hospitalizations. In this study it is hypothesized that standardized living skills training delivered to participants with schizophrenia in outpatient and inpatient centers can be effective compared to a  control group (with occupational therapy) in reducing psychopathology severity and increasing quality of life.

Methods: This is a multi-centered parallel group randomized controlled trial in Iran and it is single-blinded. Eligible participants are randomly allocated into two groups in a 1:1 ratio. Participants are assigned by stratified balanced block randomization method. The trial is conducted in the cities of Tehran and Mashhad. Its aim is to recruit 160 clients with schizophrenia. The intervention for the experimental group is social living skills training. The intervention for the control group is occupational therapy. The intervention for both groups is conducted in 90 to 120-minute group sessions.

Results: The primary outcome of the study would be a decrease in  psychopathology severity, an improvement in participants' quality of life, and reduction in family burden will be followed for 6 months.

Discussion: This paper presents a protocol for a randomized controlled trial of independent and social living skills training intervention delivered to participants with schizophrenia. If this intervention is effective, it could be scaled up to be developing for policymaking and improving outcomes for schizophrenic participants and their families in Iran.

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Objectives: The purpose of this study was to develop an Iranian Hand writing Speed Test (I-CHST) for testing of Iranian students aged 8-12. To date, no  norms of handwriting speed have been published for hand-writing speed of the Iranian students.

Methods: A sample of 400 typically developing Iranian students across four age cohorts was recruited. Among those 400 students 50% were girls and 50%  were boys. 73% were studding at government schools and 27% were from the private schools. 79% were right handed and 11% were left handed. The results showed that the handwriting speed assessment test has excellent inter-rater reliability (r=1, P=0.000) and construct validity (r=0.798, P=0.000).

Results: The findings showed that handwriting speed increases with age and the rate of increase was found to be greatest among Iranian children aged 8-12. It is also found that the girls aged 11-12 wrote faster than boys of the same age.

Discussion: Based on this research, I-CHST was a valid and reliable test for testing the hand writing speed in Iranian children and it could be used for testing or intervention purposes by the therapists at clinics.

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Objectives: The blind and visually disabled people form a predominant group in the disabled society and hence, need greater attention. Most of the rehabilitation therapists, especially occupational therapists, do not focus on this group. Thus, the aim of the study is to shed light on the issue of negligent attitude of rehabilitation therapists, especially occupational therapists, toward blind and visually-impaired people. 
Methods:To perform this study, a systematic, evidence-based process (Duffy 2005) was used. Data for the study was gathered from the following sources: Electronic databases: Medline PubMed, CINAHL, OVID Medline, CINAHL Plus with Full Text, Cochrane Databases of Systematic Reviews, ProQuest, UpToDate, Web of Science, OT Search, OTDirect, PEDro, SID, Magiran, IRAN MEDEX, MEDLIB, and IRANDOC. 
Results: From accessible databases, 112 articles related to blind and people with low vision in Iran were found; of these, only 17 articles have been included in this study. 
Discussion: Proper assessment of the visually disabled is required to implement the appropriate intervention technique. Occupational therapists need to pay special attention to the visually disabled people. 

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Objectives: Integration of religion and spirituality in the workplace help people to be more satisfied with their job. The aim of the present study was to explore the role of religious beliefs, faith at work, and spirituality in the prediction of job satisfaction among rehabilitation experts. 
Methods: With the help of simple random sampling, 163 subjects (74 speech and language pathologists, and 89 occupational therapists) were selected from rehabilitation experts employed across educational clinics affiliated to the Tehran University of Medical Sciences. The Islamic religiosity scale, faith at work scale, spirituality and spiritual care rating scale, and Dunnett’s job satisfaction questionnaire were used to collect the data. Multiple regression and Pearson correlation were applied for data analysis. 
Results: The findings showed that religious beliefs and faith at work can significantly influence job satisfaction among rehabilitation experts (P<0.05). However, spirituality did not have the same effect (P>0.05). 
Discussion: These findings showed that religious beliefs are superior to spirituality as far as predictions about job satisfaction were concerned among Iranian rehabilitation experts.

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Objectives: Flexion contracture in fingers of hands is a complication of Dupuytren’s contracture and cannot be stopped by the progressive course. The aim of this study was to review the effect of splinting in the correction of contracture after Dupuytren’s contracture operation.
Methods: To carry out this research, a kind of systematic evidence-based review process (Duffy 2005) was used. For data gathering, we used electronic database and Persian- and English-language specific journals between 1990 and January 2019. The keywords were related to examine the effect of various splinting after Dupuytren’s contracture operation.
Results: After data gathering, 26 articles about Dupuytren’s contracture were found; after checking and deep reviewing of those articles, 17 articles were removed from the study and 9 articles were included in the study for reviewing. The results of a review article based on using splint in Dupuytren’s contracture after operation were classified into 6 categories, including static splint, dynamic splint, day splint, night splint, the time duration of splinting, and prescribed time of splinting.
Discussion: Splint alone has been ineffective in reducing contracture. Static splint and hand therapy (exercise) are together the most effective way for the treatment of Dupuytren’s contracture. Occasional and irregular use of splint also has no effect on pain relief and the reduction of contracture. The pressure and force of splint will be gradually increased, and the splint should be used at least for 3 months, too.

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Objectives: People with Heart Failure (HF) encounter many limitations while performing their daily activities. These limitations can have adverse effects on their quality of life and self-satisfaction. Hence, to assess problems in the Activities of Daily Living (ADL) and plan effective interventions, we should properly identify people’s challenges in performing daily activities. This study aimed to recognize the ADL challenges in people with HF and their effects on ADL.
Methods: Twelve people with HF (aged 38 to 65 years) recruited from Rajai Hospital participated in this study using a purposeful sampling method. They were interviewed up to data saturation. Each semi-structured interview session lasted for 20-45 minutes (average 32.5 minutes). The obtained data were analyzed using a qualitative content analysis approach. 
Results: The challenges of the participants with performing ADL were summarized under two themes: “obstacles preventing normal functioning” and “disturbances in doing daily living activities as a burden”. The first theme consisted of “interference of previous experience in performance” and “challenges during the performance”. The second theme consisted of “personal laborious activities” and “interruption of activities performance related to family roles and outdoor tasks”.
Discussion: Patients with HF have serious challenges with performing ADLs which are crucial for their living. Therefore, identifying their barriers and needs will play a major role in designing compensatory, educational, and coping programs based on the limited activities and the interrupted parameters in ADL performance.

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Objectives: Mental practice, as a neuropsychological factor effective in motor recovery, is a cognitive rehearsal of a physical skill without muscular activity. Considering the high level of fatigue in patients with Multiple Sclerosis (MS), we hypothesized that using mental practice as a low-level energy-consuming method added to physical practice could be a useful therapeutic strategy. Therefore, the current study aimed to investigate the effects of combined mental and physical practices on walking and daily living activities in patients with MS.
Methods: A randomized double-blind controlled trial was applied in the present research. In total, 22 subjects with MS were randomly allocated into the occupational therapy and mental practice groups; all study subjects received equal occupational therapy interventions 3 days a week for 6 weeks. However, in addition to occupational therapy services, the study group received mental exercises. Such practices included the visual and kinesthetic imagery of walking activity in the presence of external cues. Walking ability and daily living activities were assessed at pre-treatment, post-treatment, and 2 weeks after the treatment (follow-up). Gait parameters (distance and speed) were measured by the functional scales of the 6-Minute Walk Test and the Timed 25-Foot Walk Test. The Barthel Index was used to test individuals’ performance in daily living activities.
Results: The presented combined mental and physical practice significantly improved walking distance and walking speed in post-treatment (P=0.047, P<0.001) and follow-up (P=0.044, P=0.001) assessments, respectively. The Barthel Index scores significantly changed per group; however, no significant differences were found between the control and test groups in this regard (P=0.386).
Discussion: The present study data revealed that performing mental practice along with occupational therapy interventions are more effective than regular interventions alone in the gait rehabilitation of patients with MS. These significant differences in walking performance in the intervention group remained obvious till the follow-up stage.

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Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common disorder among neurodevelopmental disorders. Children with ADHD have serious difficulties in their playing patterns. This review aims at seeing occupational therapy interventions using to improve play among children with ADHD.
Methods: Four databases (PubMed, Web of Science, Scopus, and Elsevier) were searched. Rayyan QCRI online application was used for managing and screening the obtained data. The included articles were reviewed for their quality based on the Centre of Evidence-Based Medicine, research pyramid, CONSORT (CONsolidated Standards Of Reporting Trials), and STARD (Standards for Reporting Diagnostic Accuracy) statement.
Results: A total of 104 articles were found after the search. After the screening and review process, six articles were included for the main review. Data extraction was done for these six articles (two randomized trial control and four non-randomized trial control studies).
Discussion: Play-based interventions could be effective for improving social play in ADHD when delivered by a therapist. For parent-delivered interventions, more studies with larger sample sizes are required.

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Objectives: In order to rehabilitate cognitive disorders, it is necessary to carefully evaluate cognitive function. Given the variety of assessments, including computerized and functional tests, the aim of this study was to determine whether computerized test scores really reflect a person’s functional ability. In this study, we measured the correlation between computerized and functional evaluation results
Methods: In this cross-section study, 45 people (9 males and 36 females) with multiple sclerosis with an Expanded Disability Score (EDSS) of 1 to 5 were recruited. To assess their cognitive function, the CANTAB tests (SOC, DMS, and SSP tests) and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery were used. The data were then processed with SPSS software v. 22.
Results: The results showed that the CANTAB test is well correlated with the LOTCA battery. A high correlation was observed between LOTCA’s “visual perception” with delayed matching to sample (r=0.909), LOTCA’s “spatial perception” with spatial span test (r=0.907), LOTCA’s “visual organization” with stocking of Cambridge (r=0.961), and “mental operations” in LOTCA with “stocking of Cambridge” (r=0.835). 
Discussion: Due to the very good convergence of these two tests, in many cases, computerized tests can be used instead of functional tests.

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