SENSORY PROCESSING MEASURE - PREESCHOOL HOME

SENSORY PROCESSING MEASURE – PREESCHOOL

QUESTIONNAIRE FOR PARENTS AND CAREGIVERS (PRESCHOOL 2-5 years)

Child's name:
Date:
Your relationship with the minor:
Comments about the minor's behavior:

Instructions
Please answer the questions on this questionnaire based on your child's typical behavior over the
past month, using the following scale:

NEVER (N): the behavior almost never happens or is observed

OCCASIONALLY (O): the behavior is observed sometimes
FREQUENTLY (F): the behavior is observed most of the time
ALWAYS (S): the behavior is always or almost always observed

SOCIAL PARTICIPATION

N–O–F–S 1. Plays cooperatively with peers/friends.

N–O–F–S 2. Share things when asked.
N–O–F–S 3. Integrates into other games without interrupting the ongoing activity.
N–O–F–S 4. Participates and interacts appropriately during meals.
N–O–F–S 5. Participates appropriately during family outings (such as visiting museums, going to the park,
going out to eat, etc.)
N–O–F–S 6. Appropriately participates in family gatherings (weddings, birthdays, etc.)
N–O–F–S 7. Appropriately participates in activities with friends, such as birthday parties, in the park, etc.
N–O–F–S 8. Cooperates with family chores and procedures (going to the supermarket, picking up siblings
from school, etc.)

VISION

N–O–F–S 9. He seems to be bothered by light, especially bright lights (blinks, squints, complains, etc.)
N–O–F–S 10. Has difficulty finding an object when it is part of a group of things.
N–O–F–S 11. Has difficulty recognizing when objects are the same or different based on their color, shape,
etc.
N–O–F–S 12. He enjoys looking at objects that rotate or move more than most children his age.
N–O–F–S 13. Collides with objects or other people as if they were not there.
N–O–F–S 14. Enjoy turning light switches on and off repeatedly.
N–O–F–S 15. He enjoys looking at objects that move from the periphery of his eyes.
N–O–F–S 16. Has difficulty paying attention if there are many things to look at around him.
N–O–F–S 17. Gets upset in environments with a lot of visual stimuli (such as a store with a lot of things or a
crowded room).
N–O–F–S 18. He is easily distracted by looking at things around him when walking.
N–O–F–S 19. Has difficulty completing simple tasks when there are many things to look at.
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HEARING

N–O–F–S 20. Is bothered by common household sounds such as the vacuum cleaner, hair dryer, and toilet
flush.
N–O–F–S 21. Responds negatively to loud noises, starting, crying, or covering their ears with their hands.
N–O–F–S 22. He doesn't seem to hear certain sounds.
N–O–F–S 23. Becomes disturbed or concentratedly interested in sounds that others tend not to notice.
N–O–F–S 24. Is easily distracted by background (environmental) noises, such as the lawn mower, air
conditioner, refrigerator, etc.
N–O–F–S 25. Likes to cause certain noises to occur repeatedly (flushes the toilet over and over again).
N–O–F–S 26. Expresses discomfort with sharp or strident sounds such as whistles, bugles, flutes, etc.
N–O–F–S 27. Gets upset and/or desperate in noisy environments (parties, room full of people).
N–O–F–S 28. He is easily startled when he hears a loud or unexpected sound.

TOUCH

N–O–F–S 29. He walks away after being lightly touched.

N–O–F–S 30. He prefers to touch rather than be touched.
N–O–F–S 31. Gets irritated or bothered when his nails are cut.
N–O–F–S 32. They get upset when someone touches their face.
N–O–F–S 33. Avoid touching or playing with finger paint, glue, sand, clay, mud or other messy materials.
N–O–F–S 34. He has an exceptionally high pain tolerance.
N–O–F–S 35. He dislikes brushing his teeth (more than other children his age).
N–O–F–S 36. He seems to enjoy sensations that should be painful, such as falling abruptly to the ground or
suddenly colliding with objects.
N–O–F–S 37. It bothers him to have his hair combed or brushed.
N–O–F–S 38. He resents having his hair cut.
N–O–F–S 39. Avoid eating foods with certain textures.
N–O–F–S 40. Gags in response to foods of certain textures.
N–O–F–S 41. It bothers you to have your face cleaned or washed.
N–O–F–S 42. He tends to salivate more than other children his age.

TASTE AND SMELL

N–O–F–S 43. He likes to try non-edible items, such as paint or glue.

N–O–F–S 44. He seems to ignore or not notice strong odors to which other children do react.
N–O–F–S 45. He is selective about certain flavors of food to the point of refusing to eat other foods offered
to him.
N–O–F–S 46. Refuses to use toothpaste on toothbrush

BODY AWARENESS

N–O–F–S 47. When picking up objects (such as a pencil or spoon), they squeeze them so much that it
becomes difficult to use the object.
N–O–F–S 48. Shows a marked tendency to pursue activities such as pushing, pulling, dragging, lifting and
jumping.
N–O–F–S 49. You seem unsure of how much to raise or lower your body when performing a movement
such as sitting down or stepping over an obstacle.
N–O–F–S 50. Holds an object (such as a pencil or spoon) so loosely that it is difficult to use the object.
N–O–F–S 51. Use too much force for the task, such as walking heavily, slamming doors, or pressing down
too hard on pencils or crayons.
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N–O–F–S 52. Jump a lot.

N–O–F–S 53. He tends to use a lot of force when petting animals.
N–O–F–S 54. Hits or pushes other children.
N–O–F–S 55. Chews on objects, clothing, or other objects more than other children.

BALANCE AND MOVEMENT

N–O–F–S 56. He seems to have an excessive fear of movement, such as going up and down stairs, climbing
on swings, slides, or other games in the park.
N–O–F–S 57. Avoid balance activities such as walking on the side of the road, etc.
N–O–F–S 58. He falls out of his chair when he moves his body.
N–O–F–S 59. He fails to react in time when he is about to fall and falls.
N–O–F–S 60. He doesn't seem to get dizzy when the other kids do.
N–O–F–S 61. He turns and rotates his body more than other children.
N–O–F–S 62. Expresses annoyance and/or despair when his head is tilted (or is not upright).
N–O–F–S 63. He shows poor coordination and appears to be clumsy.
N–O–F–S 64. Relies on other people or furniture when sitting and tries to stand.
N–O–F–S 65. He sways his body when sitting.
N–O–F–S 66. He is afraid of going down stairs or hills.

PLANNING AND IDEAS

N–O–F–S 67. Has difficulty figuring out how to carry multiple objects at the same time.
N–O–F–S 68. He doesn't know how how to store objects and materials in their corresponding places.
N–O–F–S 69. Gets confused about the correct sequence of actions when performing familiar daily routines,
such as getting dressed or going to bed.
N–O–F–S 70. Fails to complete multi-step tasks.
N–O–F–S 71. Has difficulty imitating demonstrations of actions, such as games or songs with gestures and
movements.
N–O–F–S 72. Has difficulty building by copying a model from an adult or child (Legos, cubes, etc.)
N–O–F–S 73. Has difficulty generating new ideas during play.
N–O–F–S 74. You tend to play the same games over and over, instead of trying new activities when given
the opportunity.
N–O–F–S 75. Has difficulty getting in and out of a chair or car seat.