Toddler Sensory Profile 2 Caregiver Questionnaire (7 to 35 months)

Toddler Sensory Profile 2 Caregiver Questionnaire (7 to 35 months)

INSTRUCTIONS

General Processing

Auditory Processing

Visual Processing

Touch Processing

Movement Processing

Oral Sensory Processing

Behavioral Responses Associated With Sensory Processing

The pages that follow contain statements that describe how children may act. Please read each phrase and select the option that best describes how often your child shows these behaviors. Please mark one option for every statement.

Use these guidelines to mark your responses:

When presented with the opportunity, my child...

5- Almost Always= responds in this manner Almost Always (90% or more of the time).

4- Frequently= responds in this manner Frequently (75% of the time).

3- Half the Time= responds in this manner Half the Time (50% of the time).

2- Occasionally= responds in this manner Occasionally. (25% of the time).

1- Almost Never= responds in this manner Almost Never. (10% or less of the time).

0- Does Not Apply= If you are unable to answer because you have not observed the behavior or believe that it does not apply to your child, please check Does Not Apply.

My Child...*

	5	4	3	2	1	0
1.) needs a routine to stay content or calm.
2.) acts in a way that interferes with family schedules and plans.
3.) resists playing among other children.
4.) takes longer that same-aged children to respond to questions or actions.
5.) withdraws from situations.
6.) has an unpredictable sleeping pattern.
7.) has an unpredictable eating pattern.
8.) is easily awakened.
9.) misses eye contact with me during everyday interactions.
10.) get anxious in new situations.

General Processing Comments:

My child...*

	5	4	3	2	1	0
11.) only pays attention if I speak loudly.
12.) only pays attention when I touch my child (and hearing is OK).
13.) startles easily at sound compared to same-aged children (for example, dog barking, children shouting).
14.) is distracted in noisy settings.
15.) ignores sounds, including my voice.
16.) becomes upset or tries to escape from noisy settings.
17.) takes a long time to respond to own name.

Auditory Processing Comments:

My child...*

	5	4	3	2	1	0
18.) enjoys looking at moving or spinning objects (for example, ceiling fans, toys with wheels).
19.) enjoys looking at shiny objects.
20.) is attracted to TV or computer screens with fast-paced, brightly colored graphics.
21.) startles at bright or unpredictable light (for example, when moving from inside to outside).
22.) is bothered by bright lights (for example, hides from sunlight through car window).
23.) is more bothered by bright lights than other same-aged children.
24.) pushes brightly colored toys away.
25.) fails to respond to self in the mirror.

**This item is not part of the Visual Raw Score**

Visual Processing Comments:

My child...*

	5	4	3	2	1	0
26.) becomes upset when having nails trimmed.
27.) resists being cuddled.
28.) is upset when moving among spaces with very different temperatures (for example, colder, warmer).
29.) withdraws from contact with rough, cold, or sticky surfaces (for example, carpet, countertops).
30.) bumps into things, failing to notice objects or people in the way.
31.) pulls at clothing or resists getting clothing on.
32.) enjoys splashing during bath or swim time.
33.) becomes upset if own clothing, hands, or face are messy.
34.) becomes anxious when walking or crawling on certain surfaces (for example, grass, sand, carpet, tile).
35.) withdraws from unexpected touch.

**This item is not part of the Touch Raw Score.**

Touch Processing Comments:

My child...*

**This is not part of the Movement Raw Score.**

Movement Processing Comments:

My child...*

	5	4	3	2	1	0
42.) shows a clear dislike for all but a few food choices.
43.) drools.
44.) prefers one texture of food (for example, smooth, crunchy).
45.) uses drinking to calm self.
46.) gags on food or drink.
47.) holds food in cheeks before swallowing.
48.) has difficulty weaning to chunky foods.

Oral Sensory Processing Comments:

My child...*

Behavioral Responses Comments:

36.) enjoys physical activity (for example, bouncing, being held up high in the air).

37.) enjoys rhythmical activities (for example, swinging, rocking, car rides).

38.) takes movement or climbing risks.

39.) becomes upset when placed on the back (for example, at changing times).

40.) seems accident-prone or clumsy.

41.) **fusses when moved around (for example, walking around, when being handed over to another person).**