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The purpose of this study is to describe the process of developing the Arabic Version of the Preschool Activity Card Sort (A-PACS) derived from the Preschool Activity Card Sort (PACS), an internationally recognized tool, which uses parent interview, and photographs of pre-schoolers engaged in typical activities.Measuring participation among preschool children in daily activities is an essential part of the evaluation process by occupational therapists, utilizing valid and culturally relevant measurement tools. Given the newness of the occupational therapy profession in the Arab world, a major obstacle is the dearth of measurement tools especially for pre-schoolers.Cultural adaptation of the PACS required a four phase process: collection of culturally appropriate activities using focus groups, translation, cognitive pilot testing and validation using two rounds of ranking (Delphi technique). Caregivers interviewed in all phases of the study included 115 participants. All were recruited from different geographical locations and socio-economic levels in Jordan, and were stratified by age and gender.Ninety-five activities were generated in the final version of the A-PACS in which 23 were specific to the Arabic culture. The activities were categorized into self-care (17), community mobility (16), high demand leisure (11), low demand leisure (17), social interaction (15), domestic (8) and education (11). Based on the A-PACS, the most common five activities of Jordanian children were drinking, walking on stairs, eating a sandwich, gathering with family and kicking a ball.A culturally adapted Arabic form of the PACS emerged from this investigation. This is the first step in developing a psychometrically sound assessment tool to evaluate participation of Arabic-speaking preschool children.