School Companion Sensory Profile 2

Teacher Questionnaire Admin LSP:

Enter score under this
column as given on the
My Student… score questionnaire Score Summary
1 misses verbal directions in class more than same-aged students
2 tunes me out or seems to ignore me Quadrant Factor Grids
3 struggles to complete taskes in a noisy setting
AUDITORY

4 tells others to be quiet Seeking/Seeker Avoiding/Avoider Sensitivity/Sensor Registration/Bystander

5 becomes distressed during assemblies, lunch, or other large gatherings Item Raw score Item Raw score Item Raw score Item Raw score
6 reacts strongly to unexpected or loud noises (e.g. fire alarm, books dropping to floor, doors slamming, announcements, bells) 11 0 5 0 4 0 1 0
7 has difficulty participating in group activities where there is a lot of talking 14 0 22 0 6 0 2 0
AUDITORY Raw Score 0 15 0 30 0 7 0 3 0
8 misses written or demostrated directions more than same-aged students 17 0 31 0 12 0 8 0
9 struggles to keep materials and supplies organised for use during the day 18 0 32 0 19 0 9 0
10 leaves items blank on a busy worksheet, despite knowing the answers 24 0 36 0 20 0 10 0
VISUAL

11 watches people as they move around in the room 28 0 37 0 21 0 13 0

12 looks away from tasks to notice all actions in the room 29 0 38 0 25 0 16 0
13 misses eye contact with me during everyday interactions 0 40 0 35 0 23 0
14 is attracted to TV or computer screens with fast-paced, brightly coloured graphics 41 0 39 0 26 0
VISUAL Raw Score 0 42 0 44 0 27 0
15 gets too close to others when talking face-to-face 43 0 0 33 0
16 doesn't seem to notice when face and hands remain dirty 0 34 0
17 touches people or objects to the point of annoying others 0
18 displays need to touch objects, surfaces, or textures (e.g. wants to get the feeling of everything)
TOUCH

19 wants to wipe hands quickly during messy tasks School Factor Grid
20 is easily upset by minor injuries (e.g. bumps into something, scrapes or cuts self)
21 uses only fingertips to work on projects requiring manipulation School Factor 1 School Factor 2 School Factor 3 School Factor 4
22 flinches or recoils when body is touched or when others get too close Item Raw score Item Raw score Item Raw score Item Raw score
TOUCH Raw Score 0 1 0 4 0 3 0 13 0
23 fails to steady objects when working (e.g. does not hold paper down when writing) 2 0 11 0 5 0 23 0
24 plays or fiddles with objects (e.g. pencils, notebooks, folders) 8 0 12 0 6 0 30 0
25 is fidgety or disruptive when standing in line or close to other people (e.g. getting on the bus, entering school, sitting in assembly) 9 0 14 0 7 0 31 0
26 slouches, slumps, or sprawls in chair 10 0 18 0 21 0 32 0
MOVEMENT

27 bumps into things, failing to notice objects or people in the way 15 0 19 0 22 0 34 0

28 is "on the go" 16 0 20 0 33 0 36 0
29 seems to find endless reasons to approach a teach 17 0 29 0 38 0 37 0
30 is slower to participate in physically active tasks or activities than same-aged students 24 0 35 0 39 0 43 0
MOVEMENT Raw Score 0 25 0 44 0 40 0 0
31 stands or sits at the side of the playground during recess 26 0 0 41 0
32 refuses to participate in team games (e.g. soccer, basketball) 27 0 42 0
33 does things in a harder way than is needed (e.g. wastes time, moves slowly) 28 0 0
34 appears tired (e.g. has no energy, is sluggish) 0
35 could be described as overreactive or dramatic compared to same-aged students
36 lacks a sense of humour
37 could be described as inflexible compared to same-aged students
BEHAVIOURAL

38 is distressed by changes in plans, routines, or expectations

39 can be stubborn or uncoorperative Key
40 perseverates to a point that interferes with participation (e.g. can't "shift gears") 5 - Almost always
41 withdraws when there are changes in the environment or routine 4 - Frequently
42 gets frustrated easily 3 - Half the time
43 interacts or participates in groups less than same-aged students 2 - Occassionally
BEHAVIOURAL Raw Score 0 1 - Almost always
44 is bothered by rules being broken 0 0 - Does not apply
 Child Sensory Profile 2
Admin LSP:
Caregiver Questionnaire Enter score under this
column as given on the
questionnaire
My child… score
1 reacts strongly to unexpected or loud noises (e.g. sirens, dog barking, hair dryer) 0 Score Summary
2 holds hands over ears to protect them from sound 0 Quadrant Grid
3 struggles to complete tasks when music or TV is on 0
AUDITORY

4 is distracted when there is a lot of noise around 0 Seeking/Seeker Avoiding/Avoider Sensitivity/Sensor Registration/Bystander
5 becomes unproductive with background noise (e.g. fan, refrigerator) 0 Item Raw score Item Raw score Item Raw score Item Raw score
6 tunes me out or seems to ignore me 0 14 0 1 0 3 0 8 1
7 seems not to hear when I call his or her name (even though hearing is OK) 0 21 0 2 0 4 0 12 0
8 enjoys strange noises or makes noise(s) for fun 1 22 0 5 0 6 0 23 0
AUDITORY Raw Score 1 25 0 15 0 7 0 24 0
9 prefers to play or work in low lighting 0 27 0 18 0 9 0 26 0
10 prefers bright colours or patterns for clothing 0 28 0 58 0 13 0 33 0
11 enjoys looking at visual details in objects 0 30 0 59 0 16 0 34 0
VISUAL

12 needs help to find objects that are obvious to others 0 31 0 61 0 19 0 35 0

13 is more bothered by bright lights than other same-aged children 0 32 0 63 0 20 0 36 0
14 watches people as they move around the room 0 41 0 64 0 44 0 37 0
VISUAL Raw Score 0 48 0 65 0 45 0 38 0
15 is bothered by bright lights (e.g. hides from sunlight through car window 0 49 0 66 0 46 0 39 0
16 shows distress during grooming (e.g. fights or cries during haircutting, face washing, fingernail cutting) 0 50 0 67 0 47 0 40 0
17 becomes irritated by wearing shoes or socks 0 51 0 68 0 52 0 53 0
18 shows an emotional or aggressive response to being touched 0 55 0 70 0 69 0 54 0
19 becomes anxious when standing close to others (e.g. in a line) 0 56 0 71 0 73 0 57 0
20 rubs or scratches a part of the body that has been touched 0 60 0 72 0 77 0 62 0
TOUCH

21 touches people or objects to the point of annoying others 0 82 0 74 0 78 0 76 0

22 displays need to touch toys, surfaces, or textures (e.g. wants to get the feeling of everything) 0 83 0 75 0 84 0 79 0
23 seems unaware of pain 0 0 81 0 0 80 0
24 seems unaware of temperature changes 0 0 85 0
25 touches people and objects more than same-aged children 0 86 0
26 seems oblivious to messy hands or face 0 1
TOUCH Raw Score 0
27 pursues movement to the point it interferes with daily routines (e.g. can't sit still, fidgets) 0
28 rocks in chair, on floor, or while standing 0 Key
29 hesitates going up or down curbs or steps (e.g. is cautious, stops before moving) 0 5 - Almost always
MOVEMENT

30 becomes excited during movement tasks 0 4 - Frequently

31 takes movement or climbing risks that are unsafe 0 3 - Half the time
32 looks for opportunities to fall with no regard for own safety (e.g. falls down on purpose) 0 2 - Occassionally
33 loses balance unexpectedly when walking on an uneven surface 0 1 - Almost always
34 bumps into things, failing to notice objects or people in the way 0 0 - Does not apply
MOVEMENT Raw Score 0
35 moves stiffly 0
36 becomes tired easily, especially when standing or holding the boyd in one position 0
37 seems to have weak muscles 0
BODY POSITION

38 props to support self (e.g. holds head in hands, leans against a wall) 0
39 clings to objects, walls, or banisters more than same-aged children 0
40 walks loudly as if feet are heavy 0
41 drapes self over furniture or on other people 0
42 needs heavy blankets to sleep 0
BODY POSITION Raw Score 0
43 gags easily from certain food textures or food utensils in mouth 0
44 rejects certain tastes or food smells that are typically part of children's diets 0
45 eats only certain tastes (e.g. sweet, salty) 0
46 limits self to certain food textures 0
ORAL SENSORY

47 is a picky earter, especially about food textures 0

48 smells nonfood objects 0
49 shows a strong preference for certain tastes 0
50 craves certain foods, tastes, or smells 0
51 puts objects in mouth (e.g. pencil, hands) 0
52 bites tongue or lips more than same-aged children 0
ORAL SENSORY Raw Score 0
53 seems accident-prone 0
CONDUCT assoc. w. Sensory

54 rushes through colouring, writing, or drawing 0

55 takes excessive risks (e.g. climbs high into a tree, jumps off tall furniture) that compromise own safety 0
56 seems more active than same-aged children 0
Processing

57 does things in a harder way than is needed (e.g. wastes time, moves slowly) 0
58 can be stubborn and uncooperative 0
59 has temper tantrums 0
60 appears to enjoy falling 0
61 resists eye contact from me or others 0
CONDUCT Raw Score 0
62 seems to have low self-esteem (e.g. difficulty liking self) 0
SOCIAL EMOTIONAL Responses assoc. w. Sensory

63 needs positive suppport to return to challenging situations 0

64 is sensitive to criticisms 0
65 has definite, predictable fears 0
66 expresses feeling like a failure 0
67 is too serious 0
Processing

68 has strong emotional outbursts when ubale to complete a task 0

69 struggles to interpret body language or facial expression 0
70 gets frustrated easily 0
71 has fears that interfere with daily routines 0
72 is distressed by changes in plans, routines, or expectations 0
73 needs more protection from life than same-aged children (e.g. defenseless physically or emotionally) 0
74 interacts or participates in groups less than same-aged children 0
75 has difficulty with friendships (e.g. making or keeping friends) 0
SOCIAL EMOTIONAL Raw Score 0
76 misses eye contact with me during everyday interactions 0
ATTENTION Responses assoc. w.

77 struggles to pay attention 0

78 looks away from tasks to notice all actions in the room 0
79 seems oblivious within an active environment (e.g. unaware of activity) 0
Sensory Processing

80 stares intensively at objects 0

81 stares intensively at people 0
82 watches everyone when they move around the room 0
83 jumps from one thing to another so that it interferes with activities 0
84 gets lost easily 0
85 has a hard time finding objects in competing backgrounds (e.g. shoes in a messy room, pencil in 'junk drawer') 0
BEHAVIOURAL Raw Score 0
86 seems unaware when people come into the room 0