Research in Developmental Disabilities 32 (2011) 2636–2643

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Research in Developmental Disabilities

Sensory Processing Measure-HK Chinese version: Psychometric

properties and pattern of response across environments
Cynthia Y.Y. Lai a,*, Jenny C.C. Chung b, Chetwyn C.H. Chan c, Cecilia W.P. Li-Tsang b
a
Occupational Therapy Department, Heep Hong Society, Kowloon, Hong Kong SAR, China
b
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China
c
Department of Rehabilitation Sciences, Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon,
Hong Kong SAR, China

A R T I C L E I N F O A B S T R A C T

Article history: This study aimed to examine the psychometric properties of the Sensory Processing
Received 15 June 2011 Measure-Hong Kong Chinese version (SPM-HKC), and to study the pattern of behavioral
Accepted 16 June 2011 response of children towards sensory events across home and school settings. The two
Available online 12 July 2011
major forms of the SPM, Home Form and Main Classroom Form, were translated into
Chinese in this study. The content validity of the SPM-HKC was reviewed by 20 expert
Keywords:
panel members. A total of 547 typically developing children and 140 children with autistic
Sensory processing
spectrum disorder (ASD) were recruited for the field test on its reliability and validity. The
Psychometric properties
Children findings of this study showed that the SPM-HKC was a valid and reliable tool in the
Autistic spectrum disorders (ASD) screening for sensory processing difficulty of children aged 5–12 among the Chinese
Sensory Processing Measure (SPM) populations. But the correlation between the Home Form and the Main Classroom Form
was low. It is recommended to use separate forms and norms to measure the performance
of children across the home and school environments for more thorough understanding of
difficulty in encountering daily sensory events.
ß 2011 Elsevier Ltd. All rights reserved.

1. Introduction

Sensory processing is described as a broad term that refers to the way in which the central and peripheral nervous
systems manage incoming sensory information from the sensory organs, namely visual, auditory, tactile, taste and smell,
proprioception, and vestibular. The process includes the reception, modulation, integration, discrimination, organization of
sensory stimuli, and the behavioral responses to sensory input (Tomchek, 2001). People with sensory processing difficulty
may have problem in modulation of sensory input. They may display over- or under-reactivity to the stimuli in their
environment, or crave an unusual amount or type of sensory input (Miller, Anzalone, Lane, Cermak, & Osten, 2007). The
estimated prevalence of parent’s perceptions of sensory processing difficulty among preschool children in United States was
5.3% (Ahn, Miller, Milberger, & McIntosh, 2004).
Sensory processing difficulty could be identified through the use of standardized tests, skilled observations, and parents’
and teachers’ report (Roley, Mailloux, Miller-Kuhaneck, & Glennon, 2007). Instrument measuring sensory processing
difficulty at various environments is essential for thorough understanding of the performance of the children. In Hong Kong,
it was not uncommon to notice that the children behaved differently at home and at school. In clinical practice, especially for
school-based occupational therapist, a standardized tool providing comparable score between the performance (sensory
processing and the related functional performance) of the children at home and at school is necessary.

* Corresponding author at: Occupational Therapy Department, Heep Hong Society, G8-9 Tung Moon House, Tai Hang Tung Estate, Shek Kip Mei, Kowloon,
Hong Kong SAR, China. Tel.: +852 36186369; fax: +852 27847966.
E-mail address: [email protected] (Cynthia Y.Y. Lai).

0891-4222/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ridd.2011.06.010
 C.Y.Y. Lai et al. / Research in Developmental Disabilities 32 (2011) 2636–2643 2637

One of the standardized questionnaires is the Sensory Profile (Dunn, 1999). The Sensory Profile (Dunn, 1999) has been
widely used in both Western and Eastern countries to measure sensory processing difficulty of children in home
environment. It could also be used with the School Companion which is a standardized questionnaire measuring sensory
processing difficulty of children in the school environment (Dunn, 2006). However, the structure (e.g. category of subscales)
and scoring system (e.g. scoring criteria and category of scaled scores) of these two questionnaires were different. The
information provided from the home and school thus becomes less comparable.
Another standardized questionnaire for measuring sensory processing difficulty of children is Sensory Processing
Measure, SPM (Parham, Ecker, Miller Kuhaneck, Henry, & Glennon, 2007). The SPM is designed to assess sensory processing
difficulty of children aged 5 through 12 years (Parham et al., 2007). It consists of three forms: Home Form, Main Classroom
Form and the School Environments Form. The two major forms of SPM are the Home Form and the Main Classroom Form. The
test items of SPM covered a wide range of behaviors and characteristics related to sensory processing, and functional
performance (social participation, and praxis). The SPM Home Form consists of 75 items and is completed by the child’s
parents or home-based caregiver (Parham et al., 2007). The SPM Main Classroom Form consists of 62 items and is completed
by the child’s main classroom teacher. The structure and scoring system of the Home Form and the Main Classroom Form are
identical. The advantage of the SPM is the availability of comparable scores between the performance (sensory processing
and the related functional performance) of the children at home and at school. The psychometric properties of the SPM are
proven to be good (Parham et al., 2007). But its applicability on Chinese population is not examined yet.
In this study, the two major forms (Home Form and Main Classroom Form) of SPM were translated into Chinese. This
study aimed to examine the psychometric properties of the Sensory Processing Measure-Hong Kong Chinese version (SPM-
HKC) and to study the pattern of behavioral response of children towards sensory events across home and school settings.

2. Methodology

2.1. Overview

This study consists of three phases: (1) to examine the content validity of the SPM-HKC; (2) to examine its reliability and
construct validity; (3) to study the pattern of behavioral response of children towards sensory events across home and school
settings.

2.2. Instrumentation

The SPM-HKC adopted in this study was translated from the SPM. The principles of sensory integration theory of Ayres are
embodied in the SPM. This theory suggests a brain–behavior relationship. The processing and integration of sensory inputs may
affect development, organization and performance in daily activities (Fisher, Murray, & Bundy, 1991). Therefore, there are three
key dimensions of measurement built in the structure of the SPM: (a) assessment of sensory systems, including visual, auditory,
tactile, proprioceptive and vestibular systems; (b) assessment of sensory integration vulnerabilities to provide information on
processing vulnerabilities within each sensory system, including under- and over-responsiveness, sensory-seeking behavior,
and perceptual problems; and (c) assessment across multiple environments to allow the examiner to compare the performance
of the child’s functioning in home, school and community environments (Parham et al., 2007).
The structure and scoring system of the Home Form and the Main Classroom Form of the SPM and SPM-HKC are identical.
Both Home and Main Classroom form yield 8 norm-referenced standard scale scores: Social Participation (SOC), Vision (VIS),
Hearing (HEA), Touch (TOU), Taste and Smell (TNS), Body Awareness (BOD), Balance and Motion (BAL) and Planning and
Ideas (PLA). The scale score is derived from the summation of all items of a particular scale. The Total Sensory Systems (TOT)
scale is a composite of the scale VIS, HEA, TOU, TNS, BOD and BAL (Parham et al., 2007). The scale TOT represents overall
ability in sensory processing. The scale SOC and PLA represent the functional performance related to sensory processing in
daily activities. For the scoring system, the typical behavior of a child within the past one month was recorded. Each item of
SPM is rated in terms of the frequency of the behavior on a 4-point scale: ‘‘Never’’ (score = 1; criteria: ‘‘the behavior never or
almost never happens’’), ‘‘Occasionally’’ (score = 2; criteria: ‘‘the behavior happens some of the time’’), ‘‘Frequently’’
(score = 3; ‘‘the behavior happens much of the time’’) and ‘‘Always’’ (score = 4; criteria: ‘‘the behavior always or almost
always happens’’).

3. Phase I: content validity of the SPM-HKC

3.1. Method

With the publisher’s and authors’ permission, the original SPM Home Form and Main Classroom Form were translated
from English into Chinese. Both forward and backward translations were completed. The equivalence of translation of SPM-
HKC was first reviewed by 8 expert panel members (including 7 occupational therapists and 1 speech therapist). The content
validity (the relevance and representativeness) of the SPM-HKC was then evaluated by 20 expert panel members (including
10 occupational therapists, 5 teachers and 5 parents) using a questionnaire and meeting format on their agreement to
individual items.
2638 C.Y.Y. Lai et al. / Research in Developmental Disabilities 32 (2011) 2636–2643

Table 1
Comparison of number of items of SPM and SPM-HKC.

Scale Home Form Main classroom

SPM SPM-HKC SPM SPM-HKC

Social Participation (SOC) 10 10 10 11

Vision (VIS) 11 11 7 8
Hearing (HEA) 8 8 7 8
Touch (TOU) 11 13 8 9
Taste and Smell (TNS) 5 7 4 7
Body Awareness (BOD) 10 10 7 8
Balance and Motion (BAL) 11 11 9 10
Planning and Ideas (PLA) 9 9 10 10

Total Sensory Systems (TOT) 56 60 42 50

3.2. Results and discussion

With the consensus among the expert panel members, several items were added or removed to increase the
representativeness and cultural relevance of the SPM-HKC. Five items were added to the Home Form whereas nine items
were added to the Main Classroom Form (Table 1). Most of the added items were originated from another form of the SPM-
HKC (e.g. additional items of Home TNS were originated from the Main Classroom TNS).
The five new items added to the Home Form were: (1) TOU ‘‘Seeks hot or cold temperatures by touching windows, other
surfaces’’; (2) TOU ‘‘Does not clean saliva or food from face’’; (3) TNS ‘‘Shows distress at the tastes or odors of different foods’’;
(4) TNS ‘‘Cannot distinguish between odors; does not prefer good smells to bad smells’’; and (5) TNS ‘‘Tries to taste or lick
objects or people’’.
The nine new items added to the Main Classroom Form were: (1) SOC ‘‘Does not make conflicts when playing with
peers’’; (2) VIS ‘‘Much easier to get confused with similar objects or words as compared with peers’’; (3) HEA ‘‘Easily makes
mistake or misses out the speech or instructions of others’’; (4) TOU ‘‘Likes to seek for the sense of touch by touching some
kinds of texture (e.g. rough, smooth, spiky, hard, hairy, sticky)’’; (5) TNS ‘‘Like to taste nonfood items, such as glue or paint’’;
(6) TNS ‘‘Like to smell nonfood objects and people’’; (7) TNS ‘‘Show distress at smells that other children do not notice’’; (8)
BOD ‘‘Has excessive movement (overshooting) and seems too rude when playing with peers’’; and (9) BAL ‘‘Cannot remain
on seat at class’’.
Only one original SPM-Home Item 42 (TNS ‘‘Gag at the thought of an unappealing food, such as cooked spinach’’) was
removed from the SPM-HKC. The expert panel noted that the description of ‘‘gag at the thought’’ of something was hard to be
perceived, and it is not easy to know whether the child is thinking of it. In addition, the cooking method of spinach was
different between Western and Chinese. Thus, the use of ‘‘cooked spinach’’ as an example of unappealing food may not be
cultural relevant or good enough to represent the problem in taste and smell. The finalized SPM-HKC Home and Main
Classroom Form consist of 79 and 71 items respectively.

4. Phase II: reliability and construct validity of the SPM-HKC

4.1. Method

4.1.1. Participants
Two groups of participants (typically developing and autistic spectrum disorders) were recruited. All participants were
Chinese, Hong Kong residents and aged 5–12 years. Informed consent from the parents of the participants was obtained prior
to data collection.
The typically developing (TD) group was the normative sample of the SPM-HKC as well as the key sample for validity and
reliability testing. They were recruited randomly from kindergartens and primary schools across 18 districts of Hong Kong by
a multistage cluster sampling method. The normative sample of the Home Form consisted of 542 children (Mage = 93 months;
SDage = 28 months) with 51.3% boys and 48.7% girls, whereas that of the Main Classroom Form consisted of 325 children
(Mage = 83 months; SDage = 26 months) with 48.9% boys and 51.1% girls.
The autistic spectrum disorders (ASD) group was the clinical sample consisted of children diagnosed with autism, autistic
features, and autism spectrum disorder. They were recruited by convenient sampling from special childcare centre, early
education and training centre, special school, kindergarten, primary school and self-help organization of ASD. The clinical
sample of the Home Form consisted of 100 children (Mage = 87 month; SDage = 22 months) with 78% boys and 12% girls, whereas
that of the Main Classroom Form consisted of 95 children (Mage = 86 months; SDage = 23 months) with 91% boys and 9% girls.

4.1.2. Instrumentation
The SPM-HKC Home Form (79 items) and the Main Classroom Form (71 items) were used after the content validation. To
measure the convergent validity of the SPM-HKC Home Form, the research version of the Chinese Sensory Profile, CSP
 C.Y.Y. Lai et al. / Research in Developmental Disabilities 32 (2011) 2636–2643 2639

(Cheung & Siu, 2010) was adopted. The CSP is a 100-items caregiver questionnaire measuring sensory processing difficulty
for children. The CSP was adapted from Tseng’s 100-item Chinese Sensory Profile, which was previously adapted from the
125-item research version of Dunn’s Sensory Profile (1999).

4.1.3. Procedure
The caretakers or parents and the teachers of the participants were invited to complete the SPM-HKC Home Form
and the Main Classroom Form respectively. Some of the participants had submitted SPM-HKC Home Form only, Main
Classroom Form only, or both Home Form and Main Classroom Form. If the missing data was more than 10% of the total
number of item of a form, the form was considered as invalid and not processed in the analysis of psychometric
properties.
In general, the respondents were given two weeks’ time to complete each form. For estimation of the test–retest
reliability, children (Home Form: n = 28; Main Classroom Form: n = 21) were assessed twice with the same form: an
initial assessment, and a second assessment two weeks later. For the construct validation, several procedures including
factor analysis, interscale correlation, convergent validity, and discriminant validity were conducted. For the factor
analysis and interscale correlation, the data of the normative sample of the corresponding form of the SPM-HKC collected
at the field test was studied. For the examination of convergent validity, 44 children were assessed by both SPM-HKC
Home Form and the CSP, and the date of completion of these two questionnaires was less than one week apart. For the
discriminant validation, random samples of same sample size were drawn from the TD group to match the sample size of
the ASD group at each age group by the Predictive Analytic Software (PASW, formerly SPSS) 18.0 (Home Form: n = 100;
Main Classroom Form: n = 95).

4.1.4. Data analysis

Statistical analysis for both the Home Form and the Main Classroom Form were the same. For the reliability testing,
Cronbach’s alpha was calculated to examine the internal consistency of the SPM-HKC, and the test–retest reliability was
estimated by using the intraclass correlation. For the construct validation, several procedures including factor analysis,
interscale correlation, convergent validity, discriminant validity were examined. The trait of the SPM-HKC was examined by
the exploratory factor analysis (principal component analysis), and Cronbach’s alpha was calculated to evaluate the
interscale correlations. The convergent validity was examined by calculating the Pearson’s correlation coefficient between
the score of SPM-HKC Home Form and the CSP. To examine the discriminant validity, known-groups method (Portney &
Watkins, 2000) was adopted to compare the SPM-HKC scores between TD and ASD groups by analysis of variance (ANOVA).
All analyses were conducted using the PASW 18.0, with the significance level set at .05.

4.2. Results and discussion

In the reliability study of the SPM-HKC, internal consistency and test–retest reliability had been examined. Factor
analysis, interscale correlation, convergent validity and discriminant validity had been studied to evaluate its construct
validity.

4.2.1. Internal consistency

Table 2 reported the estimates of the SPM-HKC for the normative sample (Home Form: n = 542; Main Classroom: n = 325).
The internal consistency of the SPM-HKC was good. There were 3 of 8 Home scales and 7 of 8 Main Classroom scales had
Cronbach’s alphas of .80 or greater. There were two coefficients less than .70 of the Home Form: TNS and BAL.

4.2.2. Test–retest reliability

Test–retest sample for the Home and the Main Classroom Form consisted of 28 and 21 typically developing children
respectively. Test–retest reliability of the SPM-HKC was good to excellent. The intraclass correlation coefficient (ICC) of the

Table 2
Internal consistency estimates of the SPM-HKC.

Scale Home Form (n = 542) Main Classroom Form (n = 325)

No. of items Cronbach’s alpha No. of items Cronbach’s alpha

Social Participation (SOC) 10 .861 11 .933

Vision (VIS) 11 .723 8 .822
Hearing (HEA) 8 .751 8 .823
Touch (TOU) 13 .732 9 .846
Taste and Smell (TNS) 7 .644 7 .779
Body Awareness (BOD) 10 .823 8 .898
Balance and Motion (BAL) 11 .674 10 .874
Planning and Ideas (PLA) 9 .852 10 .932

Total Sensory Systems (TOT) 60 .921 50 .957

2640 C.Y.Y. Lai et al. / Research in Developmental Disabilities 32 (2011) 2636–2643

Table 3
Two-week test–retest intraclass correlation coefficient of the SPM-HKC.

Scale Intraclass correlation coefficient

Home Form (n = 28) Main Classroom Form (n = 21)

Social Participation (SOC) .91 .95

Vision (VIS) .70 .89
Hearing (HEA) .95 .87
Touch (TOU) .90 .91
Taste and Smell (TNS) .85 .89
Body Awareness (BOD) .91 .97
Balance and Motion (BAL) .85 .82
Planning and Ideas (PLA) .92 .89

Total Sensory Systems (TOT) .93 .98

Home Form was found to be ranged from .70 to .95 whereas the ICC of the Main Classroom Form ranged from .82 to .98
(Table 3).

4.2.3. Factor analysis

The trait of the SPM-HKC was examined by exploratory factor analysis. For the Home Form, principal component analysis
extracted 22 factors with eigenvalue greater than 1. These factors accounted for 61.4% of total variance. Scree plot suggested
a 2- or 4-factors solution. The first factor explained 17.4% of variance while the second factor explained 5.4% of variance.
Factor loading of all items were greater than .3 except Home Item 15 (‘‘Have difficulty controlling eye movement when
following objects like a ball with his or her eyes?’’) and Home Item 69 (‘‘Seem afraid of riding in elevators or on escalators?’’).
For the Main Classroom Form, principal component analysis extracted 12 factors with eigenvalue greater than 1. These
factors accounted for 67.3% of total variance. Scree plot also suggested a 2- or 4-factors solution. The first factor explained
31.9% of variance while the second factor explained 7.3% of variance. Factor loading of all items were greater than .3.
For both Home and Main Classroom Form, the first factor of namely ‘‘sensory and praxis’’, included all items of scale
Vision (VIS), Hearing (HEA), Touch (TOU), Taste and Smell (TNS), Body Awareness (BOD), Balance and Motion (BAL), and
Planning and Ideas (PLA). The second factor, namely ‘‘social participation’’, included all items of scale Social Participation
(SOC). For both SPM-HKC Home Form and Main Classroom Form, the items of sensory domains and praxis were clustered
together. It reflected that the sensory domains and praxis items were measuring a common factor of the SPM-HKC. But the
social participation items were measuring another factor. It would be better to reconsider the value of social participation in
a questionnaire for screening sensory processing difficulty.

4.2.4. Interscale correlations

The correlations among scales within each SPM-HKC form were studied in the normative sample (Home Form: n = 426;
Main Classroom Form: n = 295). As shown in Tables 4 and 5, the correlations between SOC and other scales were low to
moderate (Home Form: a ranging from .171 to .300; Main Classroom Form: a ranging from .249 to .478) while the
correlations among other scales were moderate to high (Home Form: a ranging from .432 to .803; Main Classroom Form: a
ranging from .433 to .886). Most sensory-domain scales of each form consisted of items reflecting over-, under-responsivity,
sensory-seeking behavior and perceptual problems. These processing vulnerabilities may contribute to the correlation
among these scales.

4.2.5. Convergent validity

The correlations between similar scales across the SPM-HKC Home Form and CSP were studied in 44 typically developing
children. As shown in Table 6, significant and moderate correlations between these two questionnaires were obtained in 6

Table 4
Interscale correlations among scales of the SPM-HKC Home Form.

Scale SOC VIS HEA TOU TNS BOD BAL PLA TOT

Social Participation (SOC) –

Vision (VIS) .205 –
Hearing (HEA) .171 .589 –
Touch (TOU) .255 .581 .543 –
Taste and Smell (TNS) .194 .544 .526 .559 –
Body Awareness (BOD) .235 .498 .467 .540 .587 –
Balance and Motion (BAL) .300 .502 .482 .492 .510 .593 –
Planning and Ideas (PLA) .257 .448 .444 .464 .432 .589 .577 –

Total Sensory Systems (TOT) .293 .803 .762 .802 .760 .794 .763 .634 –

Note. n = 426.
 C.Y.Y. Lai et al. / Research in Developmental Disabilities 32 (2011) 2636–2643 2641

Table 5
Interscale correlations among scales of the SPM-HKC Main Classroom Form.

Scale SOC VIS HEA TOU TNS BOD BAL PLA TOT

Social Participation (SOC) –

Vision (VIS) .431 –
Hearing (HEA) .434 .771 –
Touch (TOU) .389 .636 .694 –
Taste and Smell (TNS) .249 .555 .622 .728 –
Body Awareness (BOD) .407 .634 .695 .591 .470 –
Balance and Motion (BAL) .400 .613 .647 .553 .433 .758 –
Planning and Ideas (PLA) .478 .661 .587 .512 .463 .536 .558 –

Total Sensory Systems (TOT) .472 .847 .886 .831 .723 .851 .831 .669 –

Note. n = 295.

Table 6
Correlations between similar scale scores of SPM-HKC Home Form and Chinese Sensory Profile.

SPM-HKC Home Form Chinese Sensory Profile r p

Social Participation (SOC) Emotional/Social Responses .357 .017

Vision (VIS) Visual Processing .601 <.001
Hearing (HEA) Auditory Processing .483 .001
Touch (TOU) Tactile Processing .506 <.001
Taste and Smell (TNS) Taste/Smell Processing .673 <.001
Body Awareness (BOD) Body Position .625 <.001
Balance and Motion (BAL) Movement .487 .001
Planning and Ideas (PLA)

Note. n = 44.

sensory scales: VIS, HEA, TOU, TNS, BOD, and BAL (r ranging from .483 to .673, p < .05). Since the rating scale of these two
forms were reversed, negative correlations was obtained.
Although the items of these 6 sensory scales of the SPM-HKC were quite similar to those of CSP, the proportion of items
representing over-, under-responsiveness and sensory seeking behavior was different. In addition, the rating on behavior of
children was based on observation in the past one month by SPM-HKC but in the past 6 months by CSP. These factors may
contribute to the moderate correlation between these two questionnaires.

4.2.6. Discriminant validity

For both Home Form and Main Classroom Form, the ASD group had significant higher scores (more undesirable) in all
eight scales of SPM-HKC (all p < .001) than their age- and gender-matched normal peers (Table 7). Previous studies showed

Table 7
Comparison of scale scores of the SPM-HKC Home Form between TD and ASD group.

Scale TD ASD p

Mean SD Mean SD

Home Form
Social Participation (SOC) 20.98 5.12 27.31 4.37 <.001
Vision (VIS) 15.32 3.63 20.29 4.67 <.001
Hearing (HEA) 11.11 2.65 15.28 4.51 <.001
Touch (TOU) 17.11 3.45 22.89 6.32 <.001
Taste and Smell (TNS) 8.65 1.83 11.65 3.22 <.001
Body Awareness (BOD) 14.02 3.63 20.57 5.36 <.001
Balance and Motion (BAL) 15.06 2.62 19.80 3.99 <.001
Planning and Ideas (PLA) 13.95 3.51 22.03 5.44 <.001
Total Sensory Systems (TOT) 81.27 14.21 110.48 22.46 <.001
Main Classroom Form
Social Participation (SOC) 25.06 7.13 35.84 5.26 <.001
Vision (VIS) 12.20 3.74 16.05 3.65 <.001
Hearing (HEA) 11.60 3.68 15.77 4.18 <.001
Touch (TOU) 12.67 4.06 15.93 3.67 <.001
Taste and Smell (TNS) 8.67 2.51 12.04 3.50 <.001
Body Awareness (BOD) 11.67 4.16 14.74 4.28 <.001
Balance and Motion (BAL) 14.50 4.54 18.27 5.01 <.001
Planning and Ideas (PLA) 16.66 6.37 27.62 6.64 <.001
Total Sensory Systems (TOT) 71.34 20.14 92.80 19.16 <.001

Note. For both group of participant, the sample size for the Home Form and the Main Classroom Form were 100 and 95 respectively.
2642 C.Y.Y. Lai et al. / Research in Developmental Disabilities 32 (2011) 2636–2643

that children with ASD had significantly more undesirable responses towards daily sensory events than their normal peers
(Ashburner, Ziviani, & Rodger, 2008; Baranek, Boyd, Poe, David, & Watson, 2007; Cheung & Siu, 2009; Leekam, Nieto, Libby,
Wing, & Gould, 2007; Tomchek & Dunn, 2007). The findings of the current study showed that the SPM-HKC was able to
differentiate children with or without ASD.

5. Phase III: pattern of behavioral response across settings

5.1. Method

5.1.1. Participants
There were two groups of participants: TD (n = 227; Mage = 82.34; age range from 60 to 151 months; male = 48%,
female = 52%) and ASD (n = 87; Mage = 88.17; age range from 60 to 144 months; male = 88.5%, female = 11.5%). They were
participants of Phase II and had submitted both SPM-HKC Home Form and Main Classroom Form.

5.1.2. Procedure
The parent and teacher were required to complete the SPM-HKC Home Form and the Main Classroom Form respectively.
The date of completion of these two forms was less than one week apart.

5.1.3. Data analysis

Pearson’s correlation coefficients of identical scale scores between the Home Form and the Main Classroom were
calculated by PASW 18.0, with the significance level set at .05.

5.2. Results and discussion

For the TD group, significant but low correlations of identical scale scores were found between Home and Main
Classroom Form in three of eight scales only: SOC (correlation coefficient, r = .208, p < .005), HEA (r = .145, p < .05) and BOD
(r = .241, p < .001). For the ASD group, significant but low correlations of identical scale scores between Home and Main
Classroom Form were also found in three scales only: SOC (r = .331, p < .005), HEA (r = .292, p < .05) and PLA (r = .286,
p < .05). In this study, it was found that the correlations of identical scales scores across the Home and the Main Classroom
Form were low or insignificant in Chinese population. Similar to the study of Parham et al. (2007), the between-form
correlations (the correlations between SPM-HKC Home Form and Main Classroom Form) were smaller than the interscale
correlations (the correlations between sensory domains within a form). The differences between observers or between
environments have a stronger effect on the ratings of the instrument than the differences among the sensory systems
(Parham et al., 2007).

6. Summary and concluding discussion

In this study, SPM-HKC was adapted from the SPM. The advantage of the SPM-HKC is the availability of comparable scale
scores across environments. It could provide thorough information about the sensory profile of children. Several procedures
were adopted to examine the reliability, content validity and construct validity of the SPM-HKC. The results of this study
showed that the SPM-HKC Home and Main Classroom Form are reliable and valid tool for screening sensory processing
difficulty in children between 5 and 12 years.
Furthermore, the current study found the correlation of pattern of behavioral response of HK Chinese children towards
sensory event across settings was low or insignificant, which was even lower than that of the US population (Parham et al.,
2007). This study had no attempt to suggest a cultural difference on sensory processing. But cultural factor may have impact
on the environment and the way the children encountering daily sensory event. In Hong Kong, it was not uncommon to
notice that the children behaved differently at home and at school. Most of the HK students were required to behave properly
at school, and the school routine was highly structured. Contrastingly, the children were allowed to behave or respond more
freely at home. The sensory processing pattern have both universal qualities and context-specific qualities (Brown & Dunn,
2010). The goal-pursuit may contribute to the behavioral and emotional response unconsciously (Bargh, 2007; Papies &
Aarts, 2011). Considering the observers and environments effect, there is a clinical value to have separate forms and raters for
the home and school environments (Parham et al., 2007). It is also recommended to have separate normative data of
measuring instrument for home and school environments.
The current study had some limitations. Firstly, the sample size for the school-aged children was small. Secondly, the
intelligence of the participants were not controlled. Therefore, further research with larger sample size and intelligence
matched samples is recommended.
Moreover, the dynamics among environmental demand and responses of the children towards sensory event at home and
at school are not clearly understood, the questionnaire has a limitation on revealing the underlying mechanism in sensory
processing difficulty of the children. Therefore, the questionnaire could be applied as a screening tool of sensory processing
difficulty of children. But cautious interpretation of scores is suggested. Further investigation of tools to identify underlying
mechanism of sensory processing of children is recommended.
 C.Y.Y. Lai et al. / Research in Developmental Disabilities 32 (2011) 2636–2643 2643

Acknowledgements

We would like to thank the Western Psychological Corporation and the authors of the SPM for granting permission of
translation, offering special price on the SPM, and providing information about the development of the SPM items to us. We
also want to thank the authors of Chinese Sensory Profile for permission of use of their research version in this study. Special
thanks to the parents, teachers, schools and organizations participated in this study.

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