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Bagpuss

Sensory Questionnaire

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Hi,

 

We've just received this thru the post from dd's physio. Very interesting. Filled it out yesterday and looking forward to hearing the results. During one of our Early Bird Plus sessions we discussed sensory issues. Hadn't even considered them before and it was a real eye opener and answered alot of questions. That same week we had a meeting with the physio and brought this issue up, hence her sending us the questionnaire. Our dd has a very restricted diet but loves strong flavours like pickled onions and salt and vinegar crisps and marmite, has to have lights on in all rooms, gets distressed by certain smells like mens loos, noises like hand dryers etc send her into hysterics, she strokes certain materials, and these are just the tip of the iceberg. The questionnaire has brought issues to our attention which we didn't even think were "sensory" like the fact she like rides which spin round and likes falling.....

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We have just filled out a sensory profile too,i was surprised also at what is considered to be sensory.

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Lindy-lou or Bagpuss could i be so bold as to ask you to pm me with the questionaire, (not your answers but just the questions). I would be very interested to see what kinda of questions they ask... Like you say its strange what they consider to be sensory..

 

Thanks

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ok, have a spare hour tonight at 8 so will try to post as much as i can, and then if don't get it finished will add rest tomorrow. :D

 

 

i cant remember the name of the scale its worked out by but im sure if you look on it bagpuss you will see it on there,im sure they are all done by the same method,maybe if you see what it is then there will be a sample one online maybe?it will take a long time to type all that out!!

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Hi Lindy Lou

 

Its called Sensory Profile, by Winnie Dunn, a Caregivers Questionnaire. Not sure about scales???? Where would I find that, might be staring straight at it ? Would be great if another way, other than me typing it out, could be suggested. Could it found online???

Edited by Bagpuss

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On the 1 i had it had boxes for the OT to mark,like a scale and it was called the something scale,its going to bug the hell out of me now,i would have thought the same thing would have been used nationally but maybe not. :blink:

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Ours has a score key,

 

1 for Always

2 for Frequently

3 for Occassionally

4 for Seldom

5 for Never

 

For each question you tick one of the above. At the end of each section it says "section raw score total"

 

Will begin typing it up now, and see how we get on...........

 

AUDITORY PROCESSING

 

1. Responds negatively to unexpected or loud noises ie hoover, barking, hair dryer

2. Holds hands over ears to protect ears from sound

3. Has trouble completing tasks when radio is on

4. Is distracted or has trouble functioning if there is a lot of noise around

5. Can't work with background noise ie. fan / fridge

6. Appears to not hear what you say

7. Doesn't respond when name is called but you know hearing is ok

8. Enjoys strange noises/seeks to make coise for noise's sake

 

VISUAL PROCESSING

 

9. Prefers to be in the dark

10. Expresses discomfort with or avoids bright lights, ie sunshine in car

11. Happy to be in the dark

12. Becomes frustrated when trying to find objects in competing backgrounds ie cluttered drawer

13. Has difficulty putting puzzles together as compared to same age children

14. Is bothered by bright lights after others have adapted to the light

15. Covers eyes or squints to protect eyes from light

16. Looks carefully or intensely at objects/people ie stares

17. Has a hard time finding objects in competing backgrounds ie. shoes in a messy room

 

VESTIBULAR PROCESSING

 

18. Becomes anxious or distressed when feet leave the ground

19. Dislikes activities where head is upside down ie somersaults

20. Avoids playground equipment or moving toys ie merry go round

21. Dislikes riding in a car

22. Holds head upright, even when bending over or leaning ie maintains a rigid position during activity

23. Becomes disoriented after bending over sink or table ie gets dizzy or falls

24. Seeks all kinds of movement and this interferes wit daily routines ie can't sit still, fidgets

25. Seeks out all kinds of movement activities ie. whirled by adult, merry go round, moving toys

26. Twirls/spins self frequently throughout day ie likes dizzy feeling

27. Rocks unconsciously ie when watching TV

28. Rocks in desk/chair/on floor

 

TOUCH PROCESSING

 

29. Avoids getting messy ie paste, sand, finger paint, glue, tape

30. Expresses distress during grooming ie cries or fights during face washing, fingernail cutting

31. Prefers long sleeved clothing when it is warm or short sleeved when it its cold

32. Expresses discomfort at dental work, or toothbrushing

33. Is sensitive to certain fabrics

34. Becomes irritated by shoes or socks

35. Avoids going barefoot, especially in grass or sand

36. Reacts emotionally or aggressively to touch

37. Withdraws from splashing water

38. Has difficulty standing in line or close to other people

39. Rubs or scratches out a spot that has been touched

40. Touches people and objects to the point of irritating others

41. Displays unusual need for touching certain toys, surfaces, or textures

42. Decreases awareness of pain and temperature

43. Doesn't seem to notice when someone touches arm or back

44. Avoids wearing shoes, loves to be barefoot

45. Touches people and objects

46. Doesn't seem to notice when face or hands are messy

 

MULTISENSORY PROCESSING

 

47. Gets lost easily, even in familiar places

48. Has difficult paying attention

49. Looks away from tasks to notice all actions in the room

50. Seems oblivious within an active environment

51. Hangs on people, furniture, or objects even in familiar situation

52. Walks on toes

53. Leaves clothing twisted on body.

 

ORAL SENSORY PROCESSING

 

54. Gags easily with food textures or food utensils in mouth

55. Avoids certain tastes or food smells that are typically part of childrens diet

56. Will only eat certain tastes ~ please list

57. Limits self to particular food textures/temperatures ~ please list

58. Picky eater, especially regarding food textures

59. Routinely smells nonfood objects

60. Shows strong preferences for certain smells ~ please list

61. Shows strong preference for certain tastes ~ please list

62. Craves certain foods ~ please list

63. Seeks out certain tastes or smells ~ please list

64. Chews or licks on nonfood objects

65. Mouths objects ie pencil or hands

 

SENSORY PROCESSING RELATED TO ENDURANCE/TONE

 

66. Moves stiffly

67. Tires easily,especially when standing or holding particular body position

68. Locks joints for stability ie knees or elbows

69. Seems to have weak muscles

70. Has a weak grasp

71. Can't lift heavy objects ie weak by comparision to same age children

72. Props to support self even during activity

73. Poor endurance/tires easily

74. Appears lethargic ie sluggish or no energy

 

MODULATION REALTED TO BODY POSITION AND MOVEMENT

 

75. Seems accident prone

76. Hesitates going up or down curbs or steps

77. Fears falling or heights

78. Avoids climbing/jumping or avoids bumpy/uneven ground

79. Holds onto walls or banister ie clings

80. Takes excessive risks during play ie climbs high into a tree or jumps off tall furniture

81. Takes movement or climbing risks during play which compromise personal safety

82. Turns whole body to look at you

83. Seeks opportunities to fall without regard to personal safety

84. Appears to enjoy falling

 

MODULATION OF MOVEMENT AFFECTING ACTIVITY LEVEL

 

85. Spends most of the day in sedentary play ie does quiet things

86. Prefers quiet, sedentary play ie watching TV or reading book

87. Seeks sedentary play options

88. Prefers sedentary activities

89. Becomes overly excitable during movement activity

90. On the go

91. Avoids quiet play activities

 

MODULATION OF SENSORY INPUT AFFECTING EMOTIONAL RESPONSES

 

92. Needs more protection from life than other children ie defenseless physcially or emotionally

93. Rigid rituals in personal hygiene

94. Is overly affectionate with others

95. Doesn't perceive body language or facial expressions

 

MODULATION OF VISUAL INPUT AFFECTING EMOTIONAL RESPONSES AND ACTIVITY LEVEL

 

96. Avoids eye contact

97. Stares intensively at objects or people

98. Watches everyone when they move around the room

99. Doesn't notice when people come into the room

 

EMOTIONAL/SOCIAL RESPONSES

 

100. Seems to have difficulty liking self ie low self esteem

101. Has trouble growing up ie reacts immaturely to situations

102. Is sensitive to criticism

103. Has definite fears ie. fears that are predictable

104. Seems anxious

105. Displays excessive emotional outbursts when unsuccessful at a task

106. Expresses feeling like a failure

107. Is stubborn or uncooperative

108. Has temper tantrums

109. Poor frustration tolerance

110. Cries easily

111. Overly serious

112. Has difficulty making friends ie does not interact

113. Has nightmares

114. Has fears that interfere with daily routine

115. Doesn't have a sense of humour

116. Doesn't express emotions

 

BEHAVIOURAL OUTCOMES OF SENSORY PROCESSING

 

117. Talks self through tasks

118. Writing is illegible

119. Has trouble staying between the lines when colouring or writing

120. Uses ineffiecient ways of doing things ie wastes time, moves slowly, does things the harder way

121. Has difficulty tolerating changes in plans and expectations

122. Has difficulty tolerating changes in routines

 

ITEMS INDICATING THRESHOLDS FOR RESPONSE

 

123. Jumps from one actitivity to another so that it interferes with play

124. Deliberately smells objects

125. Does not seem to smell strong odours

 

 

PHEW.............Alongside these questions were also either a blank space (indicating neither low nor high threshold) or and L indicating low threshold or H indicating high threshold

 

Hope this helps :D

89.

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Bagpuss you are an angel, thanks so much, i am sorry i never realised it was that long, you will have to bill me for repetitive strain injury :lol:

 

thanks

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