Adaptation and Contextual Development of Occupational Therapy Recommendations on Activities of Daily Living in Autism Spectrum Disorder for the Iranian Context
| Author | Khadije Khazaeli | en |
| Author | Seyed Ali Hosseini | en |
| Author | Hooshang Mirzaie | en |
| Author | Armin Shirvani | en |
| Author | Zahra Nobakht | en |
| Orcid | Khadije Khazaeli [0000-0002-3362-6160] | en |
| Orcid | Seyed Ali Hosseini [0000-0001-5500-8593] | en |
| Orcid | Hooshang Mirzaie [0000-0001-7616-4288] | en |
| Orcid | Armin Shirvani [0000-0001-9048-8289] | en |
| Orcid | Zahra Nobakht [0000-0001-6514-1777] | en |
| Issued Date | 2026-10-31 | en |
| Abstract | Background: Children with autism spectrum disorder (ASD) often experience difficulties with activities of daily living (ADL), which can limit their independence and participation. Occupational therapy can address these challenges; however, culturally adapted clinical guidelines for ADL-related occupational therapy interventions are limited in Iran. Therefore, international guidelines must be adapted to support evidence-informed, context-sensitive practice. Objectives: This study aimed to adapt and contextualize international occupational therapy recommendations on ADL for children with ASD in Iran. Methods: This mixed-methods methodological study followed the National Model for Adaptation of Clinical Practice Guidelines in the Islamic Republic of Iran. The adaptation process comprised seven phases: team formation; scope definition and clinical question development; systematic search for source guidelines; selection of relevant guidelines and recommendations; development of clinical scenarios; expert rating using the RAND/UCLA Appropriateness Method (RAM); and final decision-making. National and international guideline repositories and scientific databases were searched, including NICE, SIGN, G-I-N, AHRQ, EBSCO DynaMed, NHMRC, ICSI, BMJ Best Practice, PubMed, AOTA, CAOT, GALE, and Epistemonikos. In accordance with the national adaptation model, the process focused on identifying relevant recommendations and reviewing the supporting evidence from underlying studies, supplemented by population, intervention, comparison, and outcome (PICO)-based searches, to assess contextual applicability in Iran. Results: Of 116 initially identified records, four source guidelines were selected, yielding 12 core recommendations relevant to occupational therapy and ADL in children with ASD. These recommendations were supplemented by 58 articles identified through citation tracking and PICO-based supplementary searches, which were reviewed to support contextual adaptation. This process resulted in the development of 40 clinical scenarios tailored to the Iranian healthcare context. A 13-member expert panel evaluated these scenarios across four contextual dimensions: accessibility, cost, acceptability, and feasibility. Following a two-stage RAM-based consensus process, eight final clinical recommendations were approved. Conclusions: This study developed eight expert-approved clinical recommendations tailored to the Iranian healthcare context through a structured adaptation process that integrated guideline-based evidence, supplementary literature, and multidisciplinary consensus. These recommendations may inform context-sensitive occupational therapy practice for children with ASD in Iran. Further research is needed to evaluate their implementation, external validity, and impact in routine practice. | en |
| DOI | https://doi.org/10.5812/mejrh-173050 | en |
| URI | https://brieflands.com/journals/mejrh/articles/173050 | en |
| Keyword | Cross-cultural Adaptation | en |
| Keyword | Occupational Therapy | en |
| Keyword | Recommendations | en |
| Keyword | Activities of Daily Living | en |
| Keyword | Autism Spectrum Disorder | en |
| Publisher | Brieflands | en |
| Title | Adaptation and Contextual Development of Occupational Therapy Recommendations on Activities of Daily Living in Autism Spectrum Disorder for the Iranian Context | en |
| Type | Research Article | en |
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