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A study of a pilot sensory history questionnaire using contrasting groups

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A study of a pilot sensory history questionnaire using contrasting groups

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A STUDY OF A PILOT
»
SENSORY HISTORY QUESTIONNAIRE
USING CONTRASTING GROUPS
by
Cheryl Lanae Johnson
A Thesis Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
MASTER OF ARTS
(Occupational Therapy)
August, 1996
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UMI Number: 1381591
C op yright 1997 by
Johnson, C heryl Lanae
All rights reserved.
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UNIVERSITY O F SOUTHERN CALIFORNIA
THE GRADUATE SCHOOL
UNIVERSITY PARK
LOS ANGELES. CALIFORNIA 9 0 0 0 7
This thesis, written by
Che r y l Lanae Johnson______ _______
under the direction of hfi£ Thesis C om m ittee,
and approved by all its members, has been p re
sented to and accepted by the D ean of The
Graduate School, in partial fulfillm ent of the
requirements for the degree of
M aster o f A rts
Dtan
June 5, 1996
THESIS COMMITTEE
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ACKNOWLEDGMENTS
I am extremely grateful for the guidance, support, timeliness, and reassurance of my
thesis chair, Diane Parham, Ph.D., through this entire process. I appreciate the guidance of my
committee members, Ann NeviUe-Jan, Ph.D. and Florence Clark, Ph.D. I am also grateful for
John Morrison and Mike Carlson, who shared thier wisdom and expertise in statistics and
computer language. This thesis could not have been completed without the commitment of the
individuals and facilities who assisted with data collection: (a) in Southern California, Die
Ayres Clinic (especially Jane LaCroix), Anaheim School District (Julie Bissel), California State
University at Noithridge Day Care, Camp AMGEN, Children's Treatment Center, Center for
Developing Kids, Discovery World, Glendale Adventist Medical Center Occupational Therapy
Department and Day Care, Hyland Clinic, Irvine Therapy, Johnson and Associates, Members of
LaCanada United Methodist Church and the Children’ s Center, Maritza Hamilton, Simi Valley
Child Development Center, South Bay Adult School (Becky Maynard, Nancy Pekarek, Chris
Brown and Jennifer Duffy), Sue Swartz and Baby Steps, Therapy West, USC Day Care - HSC;
(b) in Spokane, Washington, Donna Mann, Janet Rodgers, Lori Eldridge, Deaconess/Sacred
Heart Pediatrics (Margaret Miller), Northwall Child Development Center, Spokane Guild School;
(c) in Augusta, Georgia, Pediatric Therapy Incorporation (Donna Domysiawski) and Hitchcock
Rehabilitation Center; (d) in Watertown, Massachusetts, OT Associates P.C.; (e) in Brooklyn,
New York, Lisa Burton; (f) in Miami, Florida, Ana Solis, Allied Therapy, Sunrise Rehabilitation
Hospital, Temple Beth Moshe; (g) in Phoenix Arizona, Amber's Day Care, Joan Surfos; (h) in
Minneapolis, Minnesota, Deea Gailfos, Jean Huber, Susan Olson Axelson, and Tracy Ghiloni.
Most of all, I want to thank my friends and family, who repetitively listened to details of the
thesis process. A special thanks to Chris Ecker who was incredibly supportive and understanding
when I spent more time with the computer than him.
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TABLE OF CONTENTS
ACKNOWLEDGMENTS ................................................................................ ii
LIST OF TABLES ............................................................................................ v
LIST OF FIGURES .......................................................................................... vi
ABSTRACT ........................................................................................................... vii
CHAPTER
I. THE PROBLEM ............................................................................... 1
Rationale and Significance of the S tu d y .............................................. 1
Research Approach ............................................................................ 3
Assumptions ...................................................................................... 4
Limitations .......................................................................................... 4
n. LITERATURE REVIEW ................................................................. 5
Sensory Integration: A Brief Explanation .......................................... 5
Sensory History Questionnaires ......................................................... 8
Psychometric Properties of Assessments .......................................... 15
Instrument Development ................................................................... 17
HI. METHODS .................................................................................... 19
Preliminary Study.................................................................................... 19
Participants............................................................................................ 20
Instrument .......................................................................................... 23
Procedures ........................................................................................ 23
Data Analysis ...................................................................................... 25
IV. RESULTS ........................................................................................ 26
Preliminary Study of Item Clarity........................................................ 26
Item Analysis........................................................................................ 27
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V. DISCUSSION ................................................................................. 31
Item Clarity .......................................................................................... 31
Item Analysis ........................................................................................ 32
Recommendations for Future Research................................................ 36
REFERENCES ................................................................................................ 38
APPENDIX
A. Demographic Questionnaire ............................................................. 43
B. Pilot Sensory History Questionnaire................................................... 44
C. Informed Consent for Preliminary Interview About Clarity................... 51
D. Informed Consent for Study of Pilot Instrument................................. 53
E. Responses of Item Clarity Interviews ............................................ 57
F. Pilot Questionnaire Used for Contrasting Groups................................. 75
G. Comprehensive Results..................................................................... 83
H. Suggestions for Question Changes ........................................................109
iv
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LIST OF TABLES
1 . Characteristics of the Children ................................................................... 22
2. Table of Specifications and Number of Significant Items............................... 35
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LIST OF FIGURES
1. Is your child frightened by sounds which would not normally
convey alarm for other children the same age? (Auditory
section, question 1 9 )..................................................................................... 28
2. Is your child distracted by sounds not normally noticed
by average persons? (Auditory section, question 16)................................... 29
3. Does your child have good balance? (Vestibular section, question 8)........... 30
4. Does your child show unusual dislike for having his/her hair
combed, brushed or styled? (Tactile section, question 13)............................. 33
5. Does your child not notice falling? (Proprioception section, question 8)......... 34
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Abstract
The purpose of this study was to examine the validity of a pilot sensory history
questionnaire using contrasting groups. Specifically, the goal was to identify
discriminating items in a sensory history questionnaire that previously was shown to have
strong content validity. Prior to item analysis, five parents were interviewed about the
clarity of each item. Their comments were compiled, critically reviewed, and used to
modify unclear items. Using the revised questionnaire, data were collected from 30
parents of children with sensory integration disorders and 59 parents of children without
any known disorders. Items were analyzed using a Wilcoxon Signed Rank Test to detect
the difference between 30 children with sensory integration disorders and 30 children
without dysfunction, matched for age, ethnicity, location, sex, and socio-economic status.
Eighty-four items significandy (p < .05) distinguished between children with and without
sensory integration disorders.
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CHAPTER I
THE PROBLEM
The purpose of this study was to examine the validity of a pilot sensory history
questionnaire using contrasting groups. Specifically, the goal was to identify
discriminating items in a sensory history questionnaire that previously was shown to have
strong content validity. Items that discriminated were those which statistically detected a
difference (p < .05) between subjects with and without sensory integration disorders.
This study was part of a long-term project to develop a reliable and valid sensory history
questionnaire.
Rationale and Significance of the Study
"Sensory integration has spawned more research, publication and educational
efforts in occupational therapy than any other occupational theory to date" (Miller &
Walker, 1993, p. 144). Occupational therapists use a variety of measures to identify
sensory integration problems in children, including several standardized tests and
screening tools with varying degrees of reliability and validity. Despite the availability of
these tests, many children are unable to tolerate a standardized test, leading therapists to
rely on clinical observations or create their own tests with highly questionable reliability
and validity (Campbell, 1989).
Sensory history questionnaires and surveys are checklists designed to gather
information from the parents, teachers, or other caregivers regarding the child's
responses to sensory information in the home and school environment. They are used
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often to supplement information gathered in clinical observation as well as formal testing.
Sensory history questionnaires and surveys are often developed on the basis of clinical
judgments and observations and they usually lack validity and reliability data needed for
confident interpretation. As changes are occurring in health care policy and occupational
therapy seeks professional status, many occupational therapists are identifying a need for
the development of valid, reliable, and sensitive assessments (Fisher & Short-Degraff,
1993; Gillette, 1982). Additionally, West (1989, 1990) identifies a lack of scientific
measurement instruments as one of the reasons why other fields may not value
occupational therapy services.
To initiate the process of developing a sensory history with established reliability
and validity, LaCroix (1993) developed a pilot sensory history questionnaire by
combining the items of many sensory history questionnaires. She also generated new
items through review of literature, and informal survey of therapists and parents. The
total o f679 items were reviewed by a panel of experts and statistically analyzed for
content validity. Content validity was found to be strong for 201 items. However, the
judgments of the experts were based on clinical experience and knowledge of sensory
integration theory, as opposed to empirical data that demonstrate the sensitivity of the
items to the detect sensory integration dysfunction in children. The presence of empirical
data to support the judgments of a panel of experts has been identified as a need in
instrument development (Baranek, Gutermuth & Berkson, 1995; Dunn, 1994;
Spyropolis, 1990).
Accurate and meaningful interpretation o f assessment results is essential in
identifying a child's needs and path for intervention (Carrasco, 1993; Fisher, Murray &
Bundy, 1991). Therapists make interpretations of sensory history questionnaires
assuming that they provide an accurate reflection of dysfunction. This could be
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problematic in a clinical setting. For example, assuming that an item such as, "Is your
child fearful of heights, such as escalators, glass elevators, stairs, etc.?" detects
dysfunction may lead a therapist to interpret a positive response as a sign of poor
vestibular processing or gravitational insecurity. However, if children without sensory
integration dysfunction also are commonly fearful of these conditions, the therapist's
assumption is not accurate. As a result, the diagnostic process may be in error, and
ultimately the productiveness of treatment might be limited.
Research Approach
This study was a contribution to a longer term project which will address diverse
socio-economic, ethnic, diagnostic, and age groups in order to explore the construct
validity of the sensory history questionnaire using contrasting groups. Prior to this study
information on item clarity was gathered qualitatively from five parents. As a first
attempt to assess the validity of the items in identifying sensory integration dysfunction,
the demographic characteristics of the subjects were limited. Two groups of children
were studied, one with children who have sensory integration disorders identified by
therapists with education and experience in sensory integration theory and treatment.
The other group consisted of children without sensory integration disorders or other
known neurological dysfunction. The children were matched as closely as possible on
location, socio-economic status, ethnicity, gender, and age within six months. All
children were between the ages of three years, zero months and six years, eleven months.
Parents of both groups were asked to fill out the pilot sensory history questionnaire of
193 items developed by LaCroix (1993) and revised after the preliminary study. The
groups were statistically compared in an hem analysis using a Wilcoxon signed rank test.
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Some items discriminated between the groups with and without sensory integration
problems and will be used to assist in the refinement of the sensory history questionnaire.
Assumptions
1. A child's behavior is an indicator of a response to sensory input.
2. Children with and without sensory integration disorders respond differently to sensory
information.
3. Parents and therapists are able to interpret the questions in a meaningful way.
4. Parents are capable of answering the questions to reflect accurate information about
the child's behavior in the natural environment.
Limitations
1. The participants did not reflect all ethnic groups, socio-economic groups, and ages.
As a result, generalizability may be limited.
2. The results of this study may not be generalizable to other populations with
disabilities.
3. The Hollingshead scale for determining socio-economic status was adapted because
many families had two working parents. This may have influenced the reliability of this
scale.
4. Twenty-two o f the questions had missing responses or "not applicable" responses.
These responses were eliminated, making the sample size smaller for that individual
question.
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CHAPTER II
LITERATURE REVIEW
This chapter will review literature pertinent to the development and refinement of
the sensory history questionnaire. It will briefly explain sensory integration theory, on
which the content of the sensory history is based. The relevance of the sensory history
questionnaire and research related to the reliability and validity of other sensory history
questionnaires will be summarized. Also, psychometric properties of test instruments
will be highlighted. This will precede a summary of the process for instrument
development.
Sensory Integration: A Brief Explanation
The use of the senses has been explained in many different disciplines, from a
basic science standpoint at a neuronal level to more clinically applicable behavioral
manifestations o f sensory integration. The senses addressed in this study are vision,
hearing, touch, taste, smell, vestibular, and proprioception. The vestibular sense is the
awareness of gravitational forces and head movement. Proprioception is the sense of
muscle contraction and joint position. One sense may work predominantly, such as a
person smelling coffee in the morning from the bed and becoming more aroused. More
often, the systems are working together, such as attending a lecture with a slide
presentation. In this situation, vision is used to analyze the slides, hearing to grasp
information from the lecture, and proprioceptive and tactile senses to know where the
paper and body parts, especially the hand, are in order to take notes.
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Each sensory system depends upon different levels of processing. The initial part
of the process involves the registration of sensory information. For example, in the
visual system the pathway begins in the retina of the eye where photoreceptors receive
the visual information. It is then transmitted by bipolar cells to ganglion cells, which
have axons that take the nerve impulse to the lateral geniculate nucleus of the thalamus,
which is then relayed to the visual cortex, midbrain, thalamus and hypothalamus (Barr &
Kiernan, 1988). The brain must then process the information which may involve
integration of senses. This is defined by Ayres (1972) as the interaction and coordination
of two or more functions or processes in a manner which enhances the adaptiveness of
the brain's response. Sensory integration has also been explained at a neuronal level.
For example, in a study by Stein, Meredith and Wallace (1993), in animals, visual
neurons were stimulated separately in different areas of the central nervous system and
the nerves elicited a weak response. However, when the nerves were stimulated with
two sensory modalities, such as visual and auditory input or visual and somatosensory
input, the response was significantly heightened (p<05). After registration and
processing, the brain responds by conceiving o f organizing, and carrying out a sequence
of actions which is called praxis (Ayres, 1979). For example, after a child sees a large
barrel, he may decide to turn it upside down and jump from the top of it, which is
ideation. Planning would involve figuring out how to get the barrel into the desired
position and figuring out how to climb to the top. Actually putting the barrel in position,
climbing up, and jumping off would be the execution of the plan or the final phase of
praxis.
Problems may occur in one or more areas of sensory integration including
registration, processing, and praxis. A child who does not register sensory information
properly may need more or less information than normal to support adaptive responses
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to the demands of the environment. For example, tactile information, which is a primal
source of input to the reticular formation which controls arousal, is one of the most
powerful areas for integrating systems (Ayres, 1972). A child who is hyper-responsive
to tactile input may avoid certain textures in the environment as a result. A child in
preschool who is hypersensitive to tactile input may refuse to participate in learning
activities using media such as play-dough or glue. A child who is hypo-responsive may
do things in order to get more tactual information from the environment, such as
excessively touching other people or rubbing objects on his or her skin. Such behaviors
may be socially inappropriate and may interfere with adaptive social behaviors.
Poor sensory integration may also result in poor praxis because the brain relies on
sensory information from the body, the environment, and memory of previous sensory
and movement experiences to react to novel situations. If a child has problems in the
ideation phase of praxis, the dependence upon others is noted in coming up with a way
to interact with novel things. For example, when a child is first introduced to pop beads,
he may bang or throw them because he can not conceptualize other things to do such as
taking them apart and putting them together. More typically, a child with sensory
integrative dysfunction has difficulty with planning and programming movements
resulting in the appearance of awkward or poorly executed movements (Fisher et al.,
1991). For example, when trying to join a peer on the top of a slide, the child with
dyspraxia may attempt to climb up the wrong side of the ladder or may not be able to
figure out where hands should be placed.
According to sensory integration theory, early sensory experiences afreet the
development of later higher level processes (Ayres, 1972, 1979; Fisher et al., 1991).
Consequently, sensory integration disorders affect the typical developmental sequence.
Problems with sensory integration may result in functional implications such as low self-
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esteem, poor motivation, poor learning skills, poor social skills, and poor coordination,
which ultimately impact participation in occupation (Ayres, 1979; Knickerbocker, 1980).
The sensory history questionnaire consists of questions about behaviors which are
believed to reflect a child's response to sensory information in the environment. If
unusual behaviors are detected, intervention may prevent or reduce the impact of these
problems in occupation.
Sensory History Questionnaires
A variety of tests and screenings are available to determine whether a child has a
sensory integration problem. One test with a large volume of reliability and validity data
is the Sensory Integration and Praxis Tests or SIPT (Ayres, 1989). The SIPT is a
measure that shows how well children organize and respond to sensory input. It helps
occupational therapists to identify specific problems associated with learning and
emotional disorders. Other tests which provide some information regarding responses to
sensory input are also available. One of these is a screening test, the Miller Assessment
for Preschoolers, or MAP (1980). In addition, some tests developed in other fields, such
the Bayley Scales of Infant Development, Second Edition or BSID II (1993) have items
that can be used to make inferences about sensory processing, although these tests do
not directly measure sensory integration.
Despite the availability and importance of standardized tests, occupational
therapists in many areas of practice have a lack of confidence that standardized tests fully
reflect the values that guide occupational therapy practice, such as the recognition of the
individuality of clients (Managh & Cook, 1993). The recognition of the individual needs
of a child is a part of the art of assessment and planning (Ayres, 1972; Fisher et al.,
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1991; Wilbarger, 199S) and every child has unique sensory needs (Baranek, Gutermuth
& Berkson, 1995; Williams & Shellenberger 1994). A standardized test may not detect
the individual needs of the child during everyday activities, such as the craving of tactile
and proprioceptive input which may lead to behaviors such as excessive and socially
inappropriate mouthing of toys or touching others at school and home. Additionally, a
standardized instrument assesses a child in an unnatural environment which may distort
the impression that a therapist has of a child's behaviors. For example, a standardized
item to assess the tactile system, such as stereognosis on the MAP (Miller, 1988), may
not detect a hyper-responsive tactile system because in the testing environment the child
may tolerate the sensation of the test objects or the therapist's touch in order to please
the examiner and may score in the optimal range. In contrast, the sensory history would
detect sensory integration problems in the tactile area that affect every day function, such
as the child's inability to tolerate certain clothes or other textures in the natural
environment such as glue, mud, or foods.
Therapists rely on many different techniques for evaluation of sensory integration
disorders. The sensory history questionnaire or survey is a means of gathering
information from the parents, caregivers, or teachers about a child's response to sensory
information in the home, school, or other natural environment. As a result of political
influence, including the implementation of the Education of the Handicapped Act
Amendments of 1986, also known as Public Law 99-147, which supports a family-
centered model, family involvement has had increased importance in occupational
therapy. The American Occupational Therapy Association or AOTA (1986,1988)
indicated support of the family-focused approach in early intervention and preschool
services. When outlining the roles and functions of occupational therapists, the AOTA
identified that during assessment, information from the parents helps to establish an
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understanding of the functional performance of the child in the home setting. In order to
plan a sensory integration program for children that reflects the family’ s goals, a sensory
history is vital in collecting pertinent information and understanding the family's
observations and interpretations of the child's behaviors in the home.
Several studies have been conducted to analyze different areas of reliability and
validity of a variety of sensory history surveys and questionnaires. In a study by
Carrasco (1990) the Knickerbocker Sensorimotor History Questionnaire
(Knickerbocker, 1983) was tested for reliability with a small population. Cronbach's
alpha (Cronbach, 1951) reliability was computed on six subscales which included gross
motor organization, the olfactory, tactile, auditory, visual systems, and academically
related questions. Internal consistency ranged from .59 to .77 which was low to
moderate. This is possibly because of low content validity of a few items, as the results
showed that Cronbach's alpha could be increased by deleting particular items. Carrasco
also emphasized exercising caution in interpreting the results because of the small sample
of twenty school aged children.
In another study by Carrasco and Lee (1993), the Teacher Questionnaire on
Sensorimotor Behavior or TQSB (Carrasco, 1986) was determined to have internal
consistency coefficients ranging from .65 to .89 which supports questionnaire item
homogeneity. The TQSB was developed for use with preschool and school-age children
to gather information from the teacher about the child's behaviors in the classroom
related sensory processing. Its six subsections include motor organization,
somatosensory, visual, auditory, and olfactory systems, and social adjustment.
Larson (1982) conducted a study to identify sensory history items that
discriminate between developmental^ delayed children with and without tactile
defensiveness. The questionnaire she used included items that were judged by a panel of
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experts to be representative of tactile defensive behaviors. Only 16% of the items were
determined to statistically discriminate between populations. This low percentage
reinforces the importance of empirically examining clinical beliefs.
Royeen (1985) developed an instrument which included a list of behaviors which
were reviewed by a panel of experts to determine the extent to which items reflected
tactile defensiveness. Using this instrument, Royeen (1986) conducted a study to
determine the ability of items to discriminate between populations with and without
tactile defensiveness. This questionnaire used verbal responses from the children. The
results revealed that the touch scale did distinguish between children with and without
tactile defensiveness (p<01). Royeen (1987) performed a pilot study as part of a larger
project to obtain data about typical preschoolers' reactions to tactile experiences.
Analysis of internal consistency using Cronbach's alpha revealed that the item coefficient
was .88 and the standardized alpha coefficient was .89, which is above the minimal
acceptable standard of .80. (Benson and Clark, 1982; Carmines & Zeller, 1979; Crocker
& Algina, 1986). This supports the questionnaire's item homogeneity. An additional
study (Bennett & Peterson, 1995) of this questionnaire was concerning test-retest retest
reliability and mother-child correlation. Analysis results indicated a moderate to high
test-retest reliability depending upon the statistical procedure used. Mother and child
responses were considered to be moderately reliable (r = .56).
Spyropolus (1990) conducted a study to determine the relationship between
sensory responsiveness, sensory integration, and learning handicaps using the Sensory
History Survey (Clark & Parham, 1984). She addressed internal consistency, content
validity, and construct validity of the Sensory History Survey in relation to the
measurement o f sensory hypo- and hyper-responsiveness. She also examined the
potential of the sensory history survey to identify sensory integrative dysfunction. In her
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content validity study, she found that 37 of 39 items fit into subsections of
somatosensory, vestibular, or somato-vestibular with greater than 80% agreement
among a panel o f experts. The panel also identified 27 of the items as indicating hyper-
or hypo- responsiveness with greater than 80% agreement. Internal consistency,
calculated on the three subscales, using the KR-20 formula (Weiner & Stewart, 1984),
ranged from .193 to .367. The total score had an internal consistency coefficient of .507.
The small number of items in each sensory subscale and homogeneity of the sample may
have contributed to the low coefficients of internal consistency. In item analysis
assessments, 12 items, particularly those falling in the vestibular category, discriminated
between groups of those with and without learning handicaps. Eleven items, scattered
among the three subsections, discriminated between groups of those with and without
sensory integration disorders.
Provost and Oetter (1993) developed a sensory rating scale for detecting sensory
defensive behaviors in children from birth to three years of age. The questionnaire
content was drawn from literature review, existing tools and suggestions of therapists
experienced in sensory integrative disorders. This questionnaire was reviewed by health
care professionals and parents who were involved with the birth to three year old
population and suggestions were used to change questions that were thought to be
difficult to understand. The questionnaire had two forms for the older and younger age
ranges and each form had six sections of touch, movement/gravity, hearing, vision,
taste/smell, temperament, and general sensitivity. These questionnaires were given to
120 parents of children without known disorders and coefficients for internal
consistency, intrarater and interrater reliability were calculated. Internal consistencies in
the subscales ranged from .46 to .82 in which the lowest coefficients were on the
taste/smell sections. The coefficients for the total tests were .83 and .90 which are
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considered to reflect high reliability. Intrarater reliability was considered high (r > .80)
and interrater reliability between parents reflected moderate agreement (r = .43).
Dunn (1994) has developed a sensory profile that is similar to a conventional
sensory history. The questionnaire was developed by a nine member team who drew the
questions from literature related to sensory integration disorders. Categories include
auditory, visual, taste/smell, movement, touch, activity level, body position, and
emotional/social. Dunn conducted a study to identify the behaviors that are seldom or
never seen in typical children, identified as children who were not taking medications
regularly and not currently receiving special services at school. Sixty-seven completed
questionnaires on children between the ages of three and ten years were used in this
study which was meant to be part of a larger study to identify discriminating behaviors
related to responses to sensory information. Of the total 99 items, 80% or more parents
of typical children reported that their child displayed 67 of the behaviors seldom or
never. Using the same data, Dunn found that only one item showed a significant
difference between younger and older subjects and only four items showed a significant
difference for gender. An additional study (Kientz & Dunn, 1995) was conducted to
determine differentiating items between children without disorders and children with
autism, who typically have highly unusual sensory processing and related behaviors
(Allen, 1988; Ayres, 1979; Ayres & Tickle, 1980; Grandin, 1995; Grandin & Scariano,
1986; Knickerbocker, 1980). In this study, all questionnaire domains and 84 of the 99
items showed a statistically significant difference (p < .005) between the responses for
children with and without autism.
LaCroix (1993) began the development of the sensory history questionnaire
which is the focus of the proposed study because of the rigorous development of this
sensory history questionnaire. LaCroix first developed a table of specifications which
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delineated the scope and emphasis of the test by relating items to objectives. The
proposed number of hems in each subsection on the final instrument are as follows:
tactile, 25; vestibular, 22; proprioception, 17; auditory, 13; vision, 13; olfactory, 5; and
gustatory, 5. The next step involved gathering existing sensory history questionnaires,
literature, and information from therapists and parents and compiling these to make an
exhaustive collection of679 hems. Next, content validity of these items was assessed.
A panel of experts in sensory integration were asked to determine which sensory system
each item reflected and whether the hem was a "good item." Perfect agreement was
determined for the item's primary system for 257 items, and 75-80% agreement was
determined for 441 items. Items which achieved 75-80% agreement for "good item"
status were 362, and of those 190 achieved 100% agreement. The index of hem-
objective congruence (Rovinelli & Hambieton, 1977) was calculated for each of the
items to evaluate content validity. Both the tactile and auditory systems had a criterion
index of greater than or equal to .90 which is greater than the recommended acceptance
criterion of .70 (Thom & Deitz, 1989). A total o f200 items were selected as having
good content validity for a pilot instrument. Each item bad a criterion index between .70
and .95. This pilot instrument is the only sensory history that has been developed
following the procedures illustrated by Benson and Clark (1982). LaCroix and Mailloux
(1995) conducted a study using this pilot instrument in which 37 parents of three, four,
and frve year old children without any known disorders filled out the questionnaire. In
this study, 116 items were identified as those in which 75% or more parents answered
"rarely" or "never". Additionally, LaCroix and Mailloux interviewed four mothers, two
of children with sensory integration disorders and two of children without sensory
integration disorders. The parents were asked open ended questions about their opinions
on the questionnaire and the experience of filling out the questionnaire. LaCroix and
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Maiiloux observed in this process that the mothers of children with disorders felt a need
to talk and add more comments in contrast to the mothers of children without sensory
integration disorders, who felt the questions were enough.
Psychometric Properties of Assessments
Psychometric properties refer to the reliability and validity of test instruments.
Reliability is the degree of consistency or dependability with which an instrument
measures the attribute it is designed to measure (Polit & Hungler, 1991). Assessment
instruments, including sensory history questionnaires, are subject to a degree of error
whether it is a lack of agreement among scorers, failure of the instrument to measure
consistently, or failure of the respondent to follow the procedures for filling out the
questionnaire. A reliable measure is one that minimizes the error component; the
confidence in the test results is subsequently increased (Deitz, 1989). Important
components of reliability are stability or test-retest reliability, internal consistency, and
equivalence or interrater reliability. Test-retest reliability indicates the extent to which
test scores are stable over time and the degree to which they are subject to the random
daily changes in the client, the examiner, the environment, and the test instrument. This
is tested by administering the same test or providing the same questionnaire to the same
individuals on two separate occasions and then comparing the scores from each test
(Deitz, 1989). Interrater reliability refers to the consistency of test scores when they are
determined by different examiners. In relation to a sensory history questionnaire, this
would be the statistical relationship of the responses of two questionnaires filled out by
two different family members, or between a family member and the child's teacher or
other caregiver. Internal consistency is the degree to which the subparts of an
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instrument are all measuring the same variable. In the case of the sensory history it is the
degree to which the subsections such as vision or proprioception agree with the total
measurement o f the sensory responses of the child. Deitz also identifies another form of
reliability which is alternate form reliability. This refers to the consistency of test scores
for two forms of the same test.
In most cases, estimates of these components are obtained by through a reliability
coefficient which involves multiple correlation calculations. For example, Cronbach's
alpha (Cronbach, 1951) is a formula commonly used to calculate the reliability
coefficient for internal consistency (Carmines & Zeller, 1979; Crocker & Algina, 1986).
Reliability coefficients above .70 are considered satisfactory in most instances (Polit &
Hungier, 1991), which would mean that 70 percent of the variance in the test was
measuring the subject's actual ability and 30 percent was due to chance or random error
(Benson & Clark, 1982). However, Benson and Clark identify an accepted value of .80
or greater for internal consistency or parallel form testing.
Validity is the extent to which an instrument measures what it is intended to
measure. Validity is initially investigated as an instrument is being developed and
confirmed though subsequent use (Dunn, 1989; Sim & Amell, 1992). Polit and Hungier
(1991) and Dunn (1989) refer to the three categories of validity distinguished by the
American Psychological Association (1985) which include content validity, criterion-
related validity, and construct validity. Criterion-related validity is ability of the test to
systematically demonstrate a relationship to an external criterion. Construct validity
refers to the degree to which the instrument measures an abstract concept such as
sensory processing and related adaptive responses. Dunn (1989) emphasizes that an
estimate of construct validity should be obtained whenever a test intends to measure
abstract traits or theoretical characteristics about the nature of human behavior. Dunn
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also refers to five traits to be considered when establishing construct validity which
include the following: age differentiation for tests designed to evaluate children because
change occurs with development, factor analytic study which assists to determine
whether there are several theoretical domains within the same test, internal consistency
of an instrument, correlation with other tests, and differences between groups. Dunn
concludes that construct validity is enhanced if evidence demonstrates that the test
discriminates between populations with and without the dysfunction it was intended to
measure. In contrast, the extent to which items discriminate between populations is one
of the means Thom and Deitz (1989) and NunnaUy (1978) identified for estimating
content validity, which is the degree to which a test measures an intended domain.
However, Thom and Deitz (1989) highlight the use of the judgments of content experts
as a means of establishing content validity during test development.
Instrument Development
Benson and Clark (1982) discuss instrument development in four phases which
include planning, construction, quantitative evaluation and validation. Planning consists
of purpose and domain identification, review of literature, questioning the target group
and writing objectives, and selection of item format. Construction consists of
development of a table of specifications, determining an item pool, content validation,
and development of new or revised items. The quantitative evaluation refers to the pilot
administration, discussion with subjects, item analysis, and instrument revision. The final
phase, validation, consists of a second pilot administration and item analysis, repeating
the pilot testing as needed, and analysis of validation.
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LaCroix (1993), who used the format that Benson and Clark (1982)
recommended to begin development of the pilot sensory history questionnaire,
completed the first two phases of this process. The next step, preparing for and
conducting pilot testing and item analysis is also recommended by Gwyer (1989), who
emphasizes that the data gathered in this stage is essential in modifying the test and
preparing it for its final version. Gwyer also emphasizes the importance of studying test
administration procedures, analysis of items and evaluation of preliminary reliability and
validity during this phase.
According to Benson and Clark (1982), a useful part of instrument development
is a qualitative evaluation in which subjects are asked to provide feedback regarding the
clarity of each item. This was done in the present study. In addition, the adequacy of
the items to discriminate between subjects with and without sensory integration disorders
was evaluated. This reflects the degree of validity that the items have, and will enhance
the overall development of the instrument toward the specifications delineated by
LaCroix (1993) as discussed earlier. (See page 14 in this chapter.)
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CHAPTER in
METHODS
Preliminary Study o f Item Clarity
For a preliminary study of the pilot questionnaire, five parents were recruited
from the Hyland Clinic and interviewed regarding the clarity of each item. This
preliminary study was conducted because only therapists and experts have previously
reviewed the questions and they may interpret questions differently than parents. Four of
the parents had children with sensory integration disorders, and one was a parent of a
child without any known disorders. Three were parents of four year old children, one
was a parent of a five year old, and one was a parent of a three year old. English was the
second language for one parent. Four of the parents were mothers and one was a father.
Three of the parents were of girls and two of boys.
The instrument used was the pilot version of a sensory history questionnaire
(LaCroix, 1993). This questionnaire uses a Likert scale (Likert, 1932) with response
choices of always, often, sometimes, rarely, and never for each item. The subsections
include the auditory, gustatory, olfactory, proprioception, tactile, vestibular, and visual
systems. This pilot instrument (LaCroix, 1993) was rigorously developed and items
included have strong content validity as discussed in Chapter 0.
The longest interview lasted three hours and the shortest lasted one hour and
fifteen minutes. The parents were given informed consent letters which they signed. The
sensory history questionnaire was then provided. Three parents filled out the
questionnaire in advance and two parents filled out the questionnaire as they reviewed
each question with the investigator. Each parent explained verbally the reasoning behind
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the response to each question, often giving examples of the child's behavior and how it
related to the item. The parents also made additional suggestions for questionnaire
revisions. The comments were recorded on a duplicate questionnaire by the investigator.
The comments for each question were compiled and reviewed. Following discussion by
the investigator and her thesis chair, some questions were changed or eliminated. The
changed questions were reviewed with two parents again via telephone to ensure that the
revised items resulted in improved clarity, thus reducing the risk of question
misinterpretation.
Item Analysis Study - Participants
Questionnaires for a total of 89 children were used in this study. Thirty of the
children had sensory integration disorders and 59 did not have known disorders. Thirty
of the 59 children without disorders were matched with the children with sensory
integration disorders and used in the subsequent item analysis. The number of children in
the matched groups is consistent with the suggestion by Gwyer (1989) who felt that at
least 30 children should be included in each group for a study such as this. The
participants were recruited from clinics, hospitals, daycares, preschools, and parent
groups in Eastern Washington (Spokane area); Phoenix, Arizona; the Boston area of
Massachusetts; the vicinity of Minneapolis, Minnesota; the vicinity of Miami, Florida;
the vicinity of Augusta, Georgia; the vicinity of Buffalo, New York; and the Southern
California area including, Torrance, Los Angeles, East Los Angeles, Camarillo,
Glendale, Simi Valley, Santa Clarita, Anaheim, Monrovia, Pasadena, and Irvine.
Participants were not found in all of the listed areas. The locations of the children
included in the study are in Table 1 along with other descriptive information relating to
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sex, ethnicity, and socio-economic status. Socio-economic status was determined by
using the Hollingshead classification (Hollingshead, 1958) in a modified way, as
Hollingshead only recognized one working adult per family. The classification was
computed for each parent in the family, and then the two were averaged. The
Hollingshead scale was applied to the averaged number, except for three children of
single parent homes.
Children with sensory integration disorders between the ages of three years, zero
months and six years, eleven months, were identified by occupational therapists who
have knowledge of sensory integration theory and have sensory integration treatment
experience. Exclusion criteria for the children with sensory integration disorders was
that they had not yet participated in treatment sessions and were not medicated for or
known to have a developmental disability such as cerebral palsy, mental retardation,
autism, or seizures at the time of the study.
Inclusion criteria for children without disorders was that they were within the age
range of three years, zero months and six years, eleven months. Exclusion criteria for
the children without disorders was that they had no known neurological disorder or
significant soft neurological signs and that they were not on any regular medications for
diagnoses such as attention deficit disorders, hyperactivity, or seizure disorders. Two
questionnaires were excluded from the group without disorders because the parent
reported a strong suspicion that the child had Attention Deficit Hyperactivity Disorder
(ADHD) or a sensory integration disorder at the time that the investigator contacted the
parent by phone to clarify some responses. These parents were provided with names and
phone numbers of occupational therapists in their area.
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Table I
Characteristics of the Children
________________ Children___________
total matched group total
Demographic group sample with SI*
without without disorders
disorders disorders
Location
Southern California 43 24 24 67
Eastern Washington 5 I I 6
Phoenix, Arizona vicinity 2 1 1 3
Boston, Massachusetts vicinity
2
2 2 4
Miami, Florida vicinity 6 I 1 7
Minneapolis, Minnesota vicinity 1 1 1 2
ex
Male 23 16 21 44
Female 36 14 9 45
ace
Caucasian 52 28 27 79
Asian
2
1 2 4
Other or Mixed Race 5 I 1 6
ocio-Economic Status
Class 1 (highest) 5 1 7 12
Class 2 26 14 6 32
Class 3 24 13 11 35
Class 4 4
2
4 8
Class 5 0 0 0 0
Class unknown 0 0 2 2
Note. The total number of children are 89.
*SI = Sensory Integration.
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Thirty of the children in the non-disordered group were matched as closely as
possible to the children in the group with sensory integration disorders by age within six
months, location, sex, ethnicity, and socio-economic status, (see Table 1.) All of the
participant pairs were matched for location. Twenty-nine of 30 had matched ages within
six months. Twenty-five of the 30 pairs were matched for sex. Also, 25 of the 30 pairs
were matched in ethnicity. Thirteen of the pairs were matched in socio-economic status.
Nine pairs matched in all of the demographic categories.
Instrument
The instrument used was the pilot version o f a sensory history questionnaire
(LaCroix, 1993) discussed above in the preliminary study section. Also, the instrument
used for item analysis included the changes discussed in the preliminary study section.
A demographic questionnaire was attached to the back of the sensory history
questionnaire.
Procedures
Children with sensory integration disorders were identified by occupational
therapists who have knowledge of sensory integration theory and have had sensory
integration treatment experience. These therapists were either known personally by the
principal investigator or were contacted as a recommendation from occupational
therapists known by the principal investigator. Information about the procedures,
inclusion criteria, and exclusion criteria was provided verbally and in written form for the
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participating therapists. For the study of the pilot instrument, parents of children with
sensory integration disorders were given two informed consent forms and the sensory
history questionnaire by the identifying therapist. A signature of one informed consent
was considered agreement to participate in the study. The other informed consent form
was for the parent to keep. This was explained in the informed consent. One parent
gave verbal consent to the identifying therapist and moved without a forwarding address
before signing the written consent. This was discussed with the review board of human
subjects at the University of Southern California and it was determined to be acceptable
to include this one exception in the study. The therapist who referred the participant to
the study was available to answer any parent questions regarding the study or the
questionnaire. Additionally, parents had the option of contacting the investigator
directly if questions arose.
Children in the non-dysfunction group were contacted through daycares,
preschools, and one adult education center which offered parenting classes. The
facilities contacted were recommended by an occupational therapist in the area who was
participating in data collection. Parents of children without sensory integration
dysfunction were given a cover letter, a questionnaire, and two informed consent forms
by workers at the daycare or pre-school. The method of collection varied depending
upon the preferences and recommendations of the facility’s director. Three directors
requested the provision of addressed, stamped envelopes with each questionnaire so that
parents could mail the questionnaires to the investigator individually. In fourteen
facilities, the questionnaires were gathered in a main office area and mailed to the
investigator as a collection. The instructors in the adult education facility requested that
the investigator attend parent classes to provide a thirty minute presentation about
sensory integration and the questionnaire. The questionnaires were distributed and
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collected at the time of the class. Eighty-four of 520 questionnaires were returned.
Twenty-five were excluded because of exceeding the age range specified or because of
the presence o f a diagnosis specified in the exclusionary criteria.
If the questionnaires had any blank items or more than six "not applicable"
responses, the parent was contacted by the investigator except for two participants who
did not include a phone number on the demographic questionnaire. With verbal
permission, the questions and the responses were read to the parent. The parent often
asked the investigator to explain the question more clearly or give more examples. The
parent then responded with a selection from the Likert scale as well as with examples of
the child's behaviors which related to the question. Three parents were contacted by
phone and the entire questionnaire was reviewed because English was the parents'
second language.
Data Analysis
After the questionnaires were gathered, the frequency distributions, means and
standard deviations of item scores were calculated. Separate calculations were made for
the total group of children without sensory integration disorders (n = 59), the matched
sample of children without sensory integration disorders (n = 30), and the group of
children with sensory integration disorders (n = 30). Items which were unmarked and
responses of "not applicable" were excluded during the calculations. Then the
questionnaires of the matched groups were analyzed using the Wilcoxon signed rank test
for non-parametric comparison of the medians of paired samples (Pagano & Gauvreau,
1993). A non-parametric test was indicated because of the small sample sizes, ordinal
data, and lack o f normal distributions of scores for most items.
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CHAPTER IV
RESULTS
Preliminary Study of Item Clarity
In the preliminary interview, several questions were determined to be
problematic. Most of the problems were related to use of professional jargon or the
wording of the questions. Fourteen of the questions needed examples which were added
prior to further data collection, and 27 others were reworded for greater clarity. Eight
questions were eliminated because they involved professional jargon, were redundant, or
were related to clinical observations instead of a behavior that a parent might observe in
the home, for example, "Does your child demonstrate low (hypotonic) muscle tone?"
Other comments pertained to gender bias in some questions, which were subsequently
reworded to correct this flaw. All of the parents commented on the repetitiveness of the
questionnaire and three asked if the questions were meant to be trick questions.
Comments made on each question are compiled in Appendix E.
Many comments were related to the fact that the child had not experienced the
stimulus described in the question; for example, some children under the age of five had
never had hard candy, making an item in the proprioception section irrelevant. This led
to the addition of a "not applicable" column (N/A). There was concern that some
parents may use the N/A column too liberally. For example, during the interviews, for
the item "Does your child hear sounds that other people don't notice or have trouble
tuning out certain sounds, such as a clock or watch ticking?" one parent reported that
she did not know because she hadn't seen her child respond to these sounds. Without
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the interviewer present to explain, she may have used the N/A response instead of the
"never" response. To reduce the likelihood that parents would choose N/A too
frequently, a paragraph was included in a cover letter explaining that the N/A option
should only be used if the child has never been exposed to the item. For example, for the
item "Is your child bothered by loud background noise such as construction work nearby
or sounds of machinery operating?" N/A should only be marked if the child has never
been exposed to background noises such as construction work or machinery operating.
Another concern which arose during the interviews was the misinterpretation of
some items by the parent whose first language is not English. This parent
understandably had questions about more items than other parents because of limitations
in English vocabulary. For example, on the question "Is your child bothered by
background noise?" on the original questionnaire, the parent with English as the second
language interpreted "background noise" as noise which had historically (in the past)
bothered her child. During the main study, the principal investigator reviewed the
questionnaire item-by-item verbally with parents whose first language was not English
because of the potential for misinterpretation.
Item Analysis
The item analysis procedure began after conducting phone calls to parents who
left items blank or checked more than six questions as N/A The purpose of this process
was to increase the number of responses included in the statistical analysis, thus reducing
the risk for error as a result of a parent misunderstanding of the question. A total of 420
responses were clarified as a result of interviews. This also provided an opportunity to
receive additional feedback on the clarity of questionnaire hems.
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During the analysis stage, general descriptive statistics were generated first,
including the mean, standard deviation, variance, and frequency distributions. These
were calculated separately for the questionnaires filled out by the parents of children with
and without sensory integration disorders. When the Wilcoxon Signed Rank test was
computed, 84 of the items indicated a significant (p < .05) difference between the
matched groups. The significant items include: 16 items in the auditory section, 0 in the
gustatory section, 2 in the olfactory section, 10 in the proprioceptive section, 24 in the
tactile section, 19 in the vestibular section, and 13 in the visual section. Specific p-values
and distributions are detailed in Appendix G. Question 18 in the vision section was not
analyzed statistically because of the high percentage of N/A responses.
The score distributions of the group with sensory integration disorders had
greater variability with relatively flat distribution curves, in contrast to the group without
disorders. An example of score distributions is illustrated in Figure 1. In this example,
the distribution for the dysfunctional group is only slightly negatively skewed, whereas
the non-dysfunctional group is greatly skewed.
Figure 1. Is your child frightened by sounds which would
not normally convey alarm for other children the same age?
(Auditory section, question 19)
90%
80%
70%
z r n o /
S group without disorders
group without disorders.
n=59
included in the matched
40% j
30% {
20% I
study-. n=30
I group with sensory
20%
integration disorders.
c
n=30
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For some items, the distribution curves were quite different between the two
groups. For example, in the item depicted in Figure 2, scores of the non-dysfunctionai
group are highly skewed and all fall in the extreme range of "rarely" or "never", whereas
the scores for the group with sensory integration disorders are more spread out and have
a bimodal distribution.
80% t
Figure 2. Is your child distracted by sounds not normally
noticed by average persons?
(Auditory section, question 16)
50% i
30% t
10% T
group without disorders.
n=59
group without disorders
included in the matched
study-, n=30
group with sensory
integration disorders.
n=30
Another pattern of score distributions is illustrated by Figure 3. For the item
depicted here, scores of the non-dysfunctional group are positively skewed with the
majority of responses in the "always" and "often" range. In contrast, the responses of the
sensory integration group form a bell-curve type pattern (a normal distribution) with the
largest percentage of the responses in the "sometimes" response choice.
29
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Figure 3. Does your child have good balance?
(Vestibular section, question 8)
60% -f group without disorders.
n=59
group without disorders
included in the matched
study, n=30
group with sensory
integration disorders,
n=30
30
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CHAPTER V
DISCUSSION
This chapter begins with a discussion of the interviews concerning item clarity.
Following this is a discussion of the item analysis which was conducted after changing
the instrument according to the needs drawn from the interview information. To
conclude the study, recommendations for future research are suggested.
Item Clarity Interviews
Interviews concerning item clarity occurred in a preliminary study. Additionally,
during the main study, parents who left questions blank or responded by using the "not
applicable" column (N/A) six or more times were contacted by the investigator by
telephone. It was found that many of the questions were answered N/A because the
parent had never seen the child respond in the described way, a circumstance in which
"never" is the appropriate response. Also, it was found that many questions were
marked as N/A because the parent did not understand the question. Additionally, the
analysis of five questions, including the first question in the gustatory section, the fifth
question in the olfactory section, and the last three visual questions was limited because
of the large number of N/A responses. Interviews indicated that the majority of the
children in this study had not experienced the stimuli in the questions because of their
young age. As a result of these findings, it is recommended that therapists interpret
questions with a N/A response cautiously and the therapist may desire to ask the parent
for an explanation. A list of questions and suggestions for change is detailed in appendix
H. These changes were suggested because of grammatical errors in the question or in
response to comments and suggestions made by parents during the follow-up telephone
calls.
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During the process of clarifying responses, many parents volunteered additional
information about their child's behavior that was not addressed by the questionnaire, and
they provided rationales as to why they answered certain questions in a certain way.
LaCroix and Mailloux (1995) similarly found a parental need to volunteer additional
information during interviews regarding the sensory history questionnaire. Baranek et al.
(1995) and Wilbarger (1995) recommend interviews routinely be conducted along with
sensory history questionnaires because written information alone is often incomplete.
Another finding was that the questions are subject to misinterpretation when the
participant speaks English as a second language, as discussed in Chapter IV in the
preliminary study section. As a result, it is recommended that the questionnaire be given
in an interview format when English is the second language of the parent because of the
increased risk of misunderstanding the questions.
Item Analysis
Several studies (Dunn, 1995; LaCroix & Mailloux, 1995; Provost & Oetter,
1993) of sensory history questionnaires have addressed item validity by relying on
analysis of frequency distributions of children without any known dysfunction. Items
were accepted as "good items" if greater than 75% or 80% of participant responses were
in the extreme ranges of the scale, which are "rarely" and "never" or "always" and
"often" depending upon the wording of the question. However, in the present study
27% of the significant items would have been missed had they been eliminated based
solely on frequency distribution of the non-dysfunctional group. An example of an item
which would have been eliminated is shown in Figure 4, in which the scores of the group
without dysfunction are spread across all response choices with only a slight negative
3 2
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skew. The scores of this group were significantly different from those of the group with
sensory integration disorders, whose distribution was bimodal.
Figure 4. Does your child show unusual dislike for having
his/her hair combed, brushed or styled?
(Tactile section, question 13)
35% f
25% i
20% r
10% r
s group without disorders. |
n=59 I
§§ group without disorders j
included in the matched l
study'. n=30 |
I group with sensory
integration disorders,
n=30
Additionally, the use of contrasting groups made it possible to identify items that
were not good discriminators of sensory integration dysfunction even though the score
distribution of the non-dysfimctional group was highly skewed. These items would have
been identified as good items if their validity had been judged solely on the basis of the
score distribution of the non-dysfimctional children, as previous researchers have done
(Dunn, 1995; LaCroix & Mailloux, 1995; Provost & Oetter, 1993). However, when
response choices of both groups were primarily in the extreme ranges, the item did not
significantly differentiate between children with and without dysfunction. Figure 5
provides an example of an item which was not significant, even though the non-
dysfimctional group fell heavily into the "rarely" and "never" categories.
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Figure 5. Does your child not notice falling?
(Proprioception section, question 8)
80% T
20% r
30% t
70% I
50% r
10% |
0%
I
l
H group without disorders.
I group with sensory
integration disorders.
H group without disorders
study, n=30
n=30
included in the matched
n=59
The high degree of variability in scores of children with sensory integration
dysfunction may be explained by sensory integration theory. Sensory integration
dysfunction is a heterogeneous category. Not all children with sensory integration
dysfunction manifest it in the same way. A child may not have sensory processing
problems in all of the sensory systems. For example, in a sensory integration evaluation
conducted recently by this investigator, a five year old boy was determined to have hypo-
sensitivity in the proprioceptive system, slight hyper-sensitivity in the tactile system, and
perceptual problems in the visual system. Thus, on the sensory history questionnaire, he
might have scores similar to the non-dysfimctional group in the auditory, olfactory,
gustatory, and vestibular sections. The high variability in score distributions indicates the
importance of having items that detect diverse aspects of sensory processing problems
beyond defensive behaviors, which some questionnaires focus on exclusively (Royeen,
1985; Provost & Oetter, 1993).
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After analysis, the number of significant items identified and the numbers
provided on the original table of specifications for the development of this instrument
(LaCroix, 1993) were compared. LaCroix based the item distribution on the importance
of the sensory system's contribution to sensory integration as indicated in sensory
integration theory literature. The number of significant items found in the present study
is not congruent with the table of specifications and is summarized in the table below.
Table 2
Table of Specifications and Number of Significant Items
Content Domains
Number of Items on
the Table of
Specifications
Number of
Significant Items
after Item Analysis
Tactile 25 24
Vestibular 22 19
Proprioception 17 10
Auditory 13 16
Vision 13 19
Olfactory 5 2
Gustatory 5 0
Total 100 84
The tactile, vestibular, proprioception, olfactory, and gustatory systems were deficient.
The investigator proposes a revision of the Table of Specifications to a total of 70 items.
If a 70 item scale were generated with the same distributions among sensory systems as
LaCroix specified, the quantity of items in each system would be as follows: tactile, 18;
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vestibular, 15; proprioception, 12; auditory, 10; vision, 10; olfactory/gustatory, 5. It is
suggested that the olfactory and gustatory systems be combined because only 2.5 items
would fall into each of these categories. If this revised Table of Specifications scale were
adopted, the proprioception, olfactory, and gustatory systems would be deficient a few
items, and additional item generation and analysis would be necessary. However,
repetitive items on the other scales could be eliminated. For example, the questions
"Does your child seem to lack the normal awareness of being touched?" and "Does your
child appear to lack the normal awareness of being touched?" are almost identical, and
both are significant. The question with the higher p-value could be discarded. In this
case the question with "appear" would be discarded.
Recommendations for Future Research
This study identified 84 items on a pilot sensory history questionnaire which
significantly discriminated (p < .05) between groups with and without sensory
integration disorders. This questionnaire needs further evaluation before producing a
final instrument. As mentioned above, generation and clarification of items in the
proprioception, gustatory, and olfactory systems is essential for having a complete
sensory history. These new items must withstand the same scrutiny as the other items
with a repeated item analysis.
Another important step in refining the instrument includes repeated analysis with
contrasting groups and further item analysis with intercorrelations, (Crocker & Algina,
1986) simultaneously improving demographics in the data collection process such as
greater variability in ethnicity and a wider age range (Benson & Clark, 1982; Gwyer,
1989). This would also enhance the ability to analyze items such as the first gustatory
36
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question, the final three items in the vision section, and question 5 in the olfactory
section in which analysis was limited because of the high percentage of "not applicable"
responses. Additionally, item analysis should include indications of differences between
gender and age groups (Dunn, 1989).
Studies to include other psychometric properties are also needed. For example,
calculating coefficient alpha would provide information about internal consistency.
Also, developing of a scoring system needs to be addressed based on whether the
instrument is to be norm-referenced or criterion-referenced. Additional contrasting
group studies should be done, for example, a study with children known to have specific
disorders such as auditory defensiveness. This would help to disclose valuable
information about the patterns of scores, and illuminate the understanding of sensory
integration dysfunction of different types.
Predictive and concurrent validity studies would also contribute to the
understanding of the questionnaire characteristics. For example, a concurrent validity
study comparing this sensory history questionnaire with temperament scales, behavior
scales, or another sensory history would provide information about the relationship of
this questionnaire to similar instruments, and about the relationship of sensory processing
to other developmental processes.
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Appendix A
Demographic Questionnaire
Child's Name:________________________
Date of Birth: ________________________
Telephone: ________________________
Sex: Male Female_______
Race: ________________________
Occupation of Parent(s)
Mother or Step-Mother ________________________
Father or Step-Father ________________________
Highest Completed Level o f Education (please check):
Mother or Step-Mother Father or Step-Father
Other
Graduate School ______ ______
College/University (4 years) ______ ______
Partial College/University ______ ______
High School ______ ______
Partial High School (10-11th grade) ______ ______
Junior High (7-9th grade) _____ ______
Less than 7th grade ______ ______
Is your child on medications for or is your child known to have any of the following
(please check).
A known neurological disorder ______
Learning problems ______
Speech and language problems__________________ ______
Behavior problems ______
Attention Deficit Hyperactive Disorder (ADHD) ______
Hyperactivity ______
Seizures ______
Other (please specify) ______
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Appendix B
A ALWAYS
0 OFTEN
S SOMETIMES
R RARELY
N NEVER
ITEM 1 A 1 0 s 1 R N
Auditory System
Is your child bothered by or fearful of the sound made by a toilet flushing?
Does your child startle or become distressed by loud or unexpected
sounds?
Does your child have trouble understanding what other people mean when
they sav something?
Does your child seem to hear sounds that go unnoticed by others?
Do you notice your child being bothered by any sounds which occur during
daily life tasks such as tasks of personal hygiene, dressing, eating, home
making, school work, plav/leisure?
Is your child bothered by background noise?
Does your child seem to have trouble remembering what is said to him?
Is your child bothered by the sounds of any household or ordinary items,
such as squeaky shoes, the vacuum, the blow dryer, doo barking, etc.?
Is your child able to follow oral directions?
Does your child fail to follow through to act upon a request to do
something or to understand directions?
Does your child respond negatively to loud noises?
Is your child distracted by sounds, fluorescent light bulbs, heaters, fans,
refrigerators?
Is your child bothered by the sound of the vacuum?
Is your child bothered by the sound made by certain accessories such as
bracelets and necklaces?
Does your child appear to not hear certain sounds?
Is your child distracted by sounds not normally noticed by average
persons?
Does your child mind the sound of the hairdryer?
Does your child mind the sound of squeaky shoes?
Is your child frightened of sounds which would not normally convey alarm
for other children the same age?
Does your child hear sounds other people don't notice or have trouble
tuning out certain sounds, such as, a clock or watch ticking?
Does your child ask others not to talk or sing or make noise?
Does your child appear to make noise for noise's sake?
Is your child bothered by extraneous sounds?
Compared to other children the same age does your child seem to under
react to loud noises 7
Does your child have trouble interpreting the meaning of words?
44
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ITEM A 0 S R N
Is your child bothered by or respond negatively to unexpected sounds or
noises?
Does your child seem confused as to the direction of sounds or where
sound is coming from?
Does your child have difficulty paying attention when there are other
noises nearby?
Is your child easily distracted by irrelevant or background noises (i.e., lawn
mower outside, children talking in the back of the room, crinkling paper, air
conditioners, refrigerators, fluorescent lights?)
Does your child seem too sensitive to sounds?
Does your child need to have things, especially directions repeated or says
■what" a lot?
Does your child liteto sing or dance to music?
Gustatory System
Does your child not like licking envelopes because of the taste of the glue
on the envelope?
Does your child show definite preferences for certain tastes?
Does your child act as though all foods taste the same?
Does your child complain about or dislike the taste of toothpaste or
mouthwash?
Does your child complain that foods are too bland?
Does your child like almost all foods?
Does your child season his/her food heavily?
Will your child eat already seasoned foods?
Is your child willing to season his/her food?
Does your child like very salty foods?
Does your child prefer bland foods?
Olfactory System
Does your child react negatively to or dislike smells which are not usually
recognized as offensive bv most people?
Does your child seem to have a very sensitive sense of smell?
Does your child tell you or other people they smell bad, funny or offensive?
Does your child have difficulty discriminating unpleasant odors?
Is your child able to identify smells of scratch-n-sniff stickers?
Does your child find bathroom odors and personal hygiene smells
offensive?
Does your child become bothered by household odors?
Does your child not notice smells about which others usually complain?
Does your child mind the smell of soap or cologne?
Does your child fail to notice or ignore unpleasant or strong odors?
Does your child make excessive use of smelling to explore?
Does your child explore by smelling?
45
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ITEM 1 A 1 0 1 S I R I N
Proprioception System
O o « your child grasp objects too tightly?
Does your child tire easily when holding a particular body position?
Does your child habitually assum e body positions that place joints in
extreme ends of ranoe of motion?
Does your child grind his/her teeth?
Does your child seek activities such as pushing, pulling, dragging, lifting
and iumoino?
Does your child climb high into a tree, jump off tall walls or furniture, etc.?
Does your child like giving bear hugs?
When moving to sit on a surface, step over an object, or stoop under an
obstacle, does your child seem unsure of how far to raise or lower his or
her bodv parts?
Does your child not notice falling?
Does your child like to be under heavy blankets, covers or pillows?
Is your child overly destructive with toys?
Does your child chew on pens, straws, etc.?
Does your child have a weak grasp?
Does your child chew on nonfood objects?
Does your child seem to exert too much effort for the task (sits and walks
heavily, slams doors, cupboards and drawers and presses too hard when
using pencils or cravonsl?
Does your child jump a lot?
Does your child have difficulty playing with animals appropriately, such as
petting them with too much force?
Does your child appear to have a poor understanding of where his/her body
is in space and in relation to other bodv parts?
Does your child have difficulty positioning his/herself in a chair?
Does your child demonstrate poor body awareness?
Does your child frequently hit, bump and or push other children?
Does your child seem generally weak?
Compared with other children the same age, does your child seem to really
enjoy activities that involve jumping, crashing into things, pushing or
pulling or falling?
Does your child like getting bear hugs?
Does your child taste or chew on toys, clothes, or other objects more than
other children?
Does your child crave hugging or rough playing?
Does your child like to chew on hard candy?
Does your child have difficulty sitting erect, or chooses to lie down instead
of sitting up?
Tactile System
Does your child dislike going barefoot, not like to take his/her shoes off or
insist on always wearing shoes?
Does it bother your child to play games with bare feet?
46
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ITEM A 0 S R N
Is your child irritated by certain clothing?
Ooes your child pull away from light touch?
Does your child seem to lack the normal awareness of being touched?
Does your child resist or dislike wearing clothing of certain textures?
Does your child react negatively to the feel of new clothes?
Does your child tend to prefer to wear long sleeve shirts and long pants
regardless of the weather, for instance prefers to wear long sleeves even
when it is warm outside?
Does your child seem excessively ticklish?
Does your child like to cuddle up with a blanket or stuffed animal or special
pillow?
Does your child enjoy tickling as a form of play?
Does your child avoid playing with ‘messy* things, i.e., finger paint, mud,
sand, glue, glitter, clav, etc.?
Does your child show an unusual dislike for having his/her hair combed,
brushed or styled?
Do rough bedsheets bother your child?
Does wearing turtleneck shirts bother your child?
Does your child prefer to touch rather than be touched?
Does your child seek out touching different textures?
Does your child prefer to go barefoot?
Does your child dislike wearing hats, sunglasses or other accessories?
Does wearing fuzzy shirts bother your child?
Does your child dislike wearing pants or complain about the feel of them
brushing against his/her legs?
Does your child tend to wear coats or sweaters when they are not needed?
Does your child appear to lack the normal awareness of being touched?
Does your child prefer the textures of certain clothing?
Does your child overreact to minor injuries or touch?
Does your child complain about irritating bumps on the bedsheets?
Does it bother your child to have his/her finger or toe nails cut?
Does your child struggle against being held?
Does your child dislike playing games with his/her bare feet?
Does your child have a tendency to touch things constantly?
Does your child dislike getting his/her hands messy or ask to wash his/her
hands when using things like glue and glitter?
Does your child avoid or dislike playing with gritty things?
Do tags or collars on clothing bother your child?
Does your child demonstrate an aversion to any form of clothing?
Does your child prefer certain textures of clothing or particular fabrics?
Does it bother your child to have his/her face touched?
Does it bother your child to have his/her face washed?
Does your child object to being touched by others?
Does it bother your child if he/she can not see who is touching him/her?
Does the feel of new clothes bother your child?
47
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ITEM A 0 S R N
Does your child racist or dislike wearing short sleeved shins or shon
pants?
Does your child seem to lack awareness of beino touched bv others?
Does your child ask you to take the tags and labels out of their clothing or
ontv wear clothes which have had the tags and labels removed?
Is your child irritated by tags on clothing?
Is your child bothered by hair brushing against his/her face?
Does your child dislike the feeling of certain clothing?
Does your child prefer bland foods?
Does your child have an unusually high tolerance for pain?
Does your child demonstrate an excessive need to touch?
Does your child display an unusual need for touching certain textures,
surfaces, objects or toys?
Does your child startle easily when being touched unexpectedly?
Does wearing fuzzy socks bother your child?
Does your child dislike eating messy foods with his/her hands?
Does your child tend to feel pain less than others?
Does it bother your child when someone is close by?
Does your child avoid touching different textures?
Does your child appear to resist eating certain foods because of their
texture?
Does your child strongly dislike being tickled?
Does your child avoid foods of certain textures?
Does your child avoid getting his/her hands in finger-paint, paste, sand,
clay, mud. glue, etc.?
Vestibular System
Does your child rock while sitting?
Does your child seem excessively fearful of movement, i.e. going up and
down stairs, riding swings, teeter totters, slides, or other playground
equipment?
Does your child get nausea or vomit from movement experiences?
Does your child like to swing?
Does your child demonstrate distress when he/she is moved or on moving
equipment?
Does your child's head move along with his/her eyes when reading?
Is your child frequently and easily disoriented in space (confused in parking
lots, can't find the car. gets lost in stores)?
Does your child have good balance?
Does your child have to exert more effort to move than others, tire easily
from exertion and or require more sleep than others?
Does your child demonstrate low (hypotonic) muscle tone?
Does your child avoid balance activities?
Is your child fearful of heights, such as escalators, glass elevators, stairs,
etc.?
Does your child like fast movements, such as being whirled about or
tossed in the air bv an adult?
48
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ITEM A 0 S R N
Does your child like climbing real high?
Does your child have good balance?
Does your child like fast spinning carnival rides, such as merry-go-rounds?
Is your child fearful of activities which require good balance?
When your child shifts his body does ha sometimes fall out of his chair?
Is your child sometimes unable to catch him/herseif when falling?
Does your child seem to not get dizzy when other’s usually do?
Does your child get car sick?
Does your child seem generally weak?
Ooes your child spin and whirl more than other children?
Does your child rock himself/herself when stressed?
Does your child like to be inverted or tipped upside down or enjoy doing
things like hanging upside down, somersaults, etc.?
Is your child fearful of swinging or bouncing, or was as an infant?
Does your child experience discomfort, nausea or dizziness following
movement, especially rotation?
Do movement activities tend to get your child ’going* or does your child
tend to need movement in order to *aet aaino*?
Does your child dislike sudden or quick movement?
Does your child avoid activities which challenge his/her balance or appear
to have poor balance during motor activities?
Compared with other children the same age does your child seem to ride
longer or harder on certain playground equipment (e.g., swing, merry-go-
round) ?
Does your child avoid rapid or rotary movement?
Is your child fearful of activities in which he/she moves through space?
Does your child demonstrate distress when his/her head is in any other
position than upright or vertical?
Does your child react negatively to, dislike, appear threatened by, or exhibit
a fear reaction to movement?
Does your child enjoy excessive spinning and twirling?
Visual System
Does your child demonstrate a poor understanding of spatial relationships
(for example, have difficulty differentiating the orientation of the plus sign
versus the multiplication sign?)
Did your child make reversals in words or letters when writing or copying
or read words backwards (such as reading saw for was) after the first
orade?
Is your child sensitive to or bothered by light, especially bright light (blinks,
sauints. cries or closes eves, etc.)?
Does your child have difficulty using both of his/her eyes together?
Does your child confuse the foreground and the background of a picture?
Is your child able to look at something far away?
Does your child have difficulty keeping his/her eyes on the task or activity
at hand?
Does your child have trouble maintaining his/her visual focus on one task
or object for very long?
49
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ITEM A 0 S R N
Does your child loose his/her place on a page while reading, copying,
solving problems or performing manipulations?
Do you suspect your child of having a visual acuity problem?
Does your child rub his/her eyes, complain of headaches or have eyes
which water after reading?
Does your child have difficulty with visually focusing on things far away?
Does your child become easily distracted by visual stimuli?
Does your child have trouble locating things laying on top of other things,
especially things of the same color, or have trouble finding an object when
it is amidst a orouo of other thinos?
Does your child close one eye and or tip his/her head back when looking at
something or someone?
Does your child have difficulty shifting his gaze from the board to his/her
paper makino copying from the board to paper difficult?
Does your child demonstrate a limited tolerance for any of the following:
color, busy visual environments, high contrast or low contrast
environments?
Does your child have difficulty with visually focusing on things close?
Does your child have difficulty in smooth eye tracking (following objects
with eyes, keeping place while reading or copying from blackboard to
desk?)
Compared to other children the same age does your child seem to be easily
distracted bv visual stimuli?
Does your child have trouble following objects with his eyes?
Does your child have difficulty naming, discriminating or matching colors,
shapes, sizes?
50
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Appendix C
Informed Consent tor Preliminary Interview About Clarity
INFORMED CONSENT
for
A RELIABILITY AND VALIDITY STUDY OF A SENSORY HISTORY
QUESTIONNAIRE
Principal Investigator Cheryl L Johnson. OTR
24 Hour Telephone (818) 249-2159
Purpose o f Study:
You are invited to participate in a study of a sensory history questionnaire. A sensory
history questionnaire assists a therapist in gathering valuable information about how a
child responds to sensory information in the home or other natural environments.
Information about a child's responses to sensory information gives a therapist insight into
why a child responded a certain way during testing or in the clinic environment and helps
with interpretation o f test scores if a formal test has been administered. This sensory
history questionnaire is one that has been compiled from a pool o f many sensory history
test items used across the United States. These items were statistically tested for their
ability to reflect information about the sensory categories. These categories are auditory
(hearing), gustatory (taste), olfactory (smell), proprioception (the sense o f muscle
contraction and joint position), tactile (touch), and vestibular (the awareness of
gravitational forces and head movement). The items included in this questionnaire are the
items which met the statistical criteria to be valid items, as judged by expens in the field.
We hope to learn which items need clarification. This will eventually lead to a shoner and
more efficient questionnaire. You are invited as a possible participant in this study
because your child is in the age group which will be studied.
Procedure:
If you decide to participate, you will be asked to fill out a 200 item questionnaire about
behaviors that your child may or may not have in response to sensory information. For
each item, you will indicate if your child exhibits the behavior always, often, sometimes,
rarely, or never by checking the corresponding space. After you have completed the
questionnaire, you will be asked to explain what each item means to you in a conversation
style interview with the researcher. You will be asked to give any comments you have
about the item's clarity. You may refuse to answer any questions. A total o f about one
and one half hours is expected for this entire process.
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There are no risks other than the inconvenience of spending the time to answer 200
questions and participate in the interview. Your child will not be examined or observed in
any way as part o f this study.
Benefits
No specific benefits are expected
Confidentiality Statement:
Any information that is obtained in connection with this study and that can be identified
with you will remain confidential.
Offer to Answer Questions
If you have any questions relating to the study, please feel free to contact the principal
investigator listed above. If you have any questions regarding your rights as a study
subject, you may contact the Institutional Review Board Office at (213) 223-2340 You
will be given a copy o f this form to keep.
Coercion and Withdrawal Statement
Your decision whether or not to participate will not interfere with your future care in this
facility If you decide to participate, you are free to withdraw your consent and
discontinue participation at any time.
Imurv Statement
If you require medical treatment as a result of injury arising from your participation in this
study, the financial responsibility for such care will be yours.
YOUR SIGNATURE INDICATES THAT YOU HAVE DECIDED TO PARTICIPATE
HAVING READ THE INFORMATION PROVIDED ABOVE.
Agreement:
Signature of Parent Date
Signature of Witness Relationship to Parent
D EC 151994
wn* « H f MIL
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Appendix D
Informed Consent for Study o f Pilot Instrument
INFORMED CONSENT
for
A RELIABILITY AND VALIDITY STUDY OF A SENSORY HISTORY
QUESTIONNAIRE
Principal Investigator Cheryl L. Johnson, OTR
2-4 Hour Telephone: (818) 249-2159
Purpose o f Study
You are invited to participate in a study o f a sensory history questionnaire. A sensory
history questionnaire assists a therapist in gathering valuable information about how a
child responds to sensory information in the home o r other natural environments.
Information about a child's responses to sensory information gives a therapist insight into
why a child responded a certain way during testing or in the clinic environment and helps
with interpretation o f test scores if a formal test has been administered. This sensory
history questionnaire is one that has been compiled from a pool o f many sensory history
test items used across the United States. These items were statistically tested for their
ability to reflect information about the sensory categories. These categories are auditory
(hearing), gustatory (taste), olfactory (smell), proprioception (the sense o f muscle
contraction and joint position), tactile (touch), and vestibular (the awareness of
gravitational forces and head movement). The items included in this questionnaire are the
items which met the statistical criteria to be valid items, as judged by experts in the field.
We hope to learn which items on this questionnaire actually distinguish between children
with and without sensory integration disorders. This will eventually lead to a shorter and
more efficient questionnaire. You are invited as a possible participant in this study
because your child is in the age group which will be studied.
Procedure:
If you decide to participate, you will be asked to fill out a 200 item questionnaire about
behaviors that your child may or may not have in response to sensory information. For
each item, you will indicate if your child exhibits the behavior always, often, sometimes,
rarely, or never by checking the corresponding space. You may refuse to answer any
questions. Approximately 30 minutes will be required to complete this questionnaire.
Risks:
There are no risks other than the inconvenience o f spending the time to answer 200
questions. Your child will not be examined or observed in any way as part o f this study.
53
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Benefits
No specific benefits are expected.
Confidentiality Statement:
Any information that is obtained in connection with this study and that can be identified
with you will remain confidential.
Offer to Answer Questions
If you have any questions relating to the study, please feel free to contact the principal
investigator listed above. If you have any questions regarding your rights as a study
subject, you may contact the Institutional Review Board Office at (213) 223-2340 You
will be given a copy o f this form to keep.
Coercion and Withdrawal Statement
Your decision whether or not to participate will not interfere with your future care in this
facility. If you decide to participate, you are free to withdraw your consent and
discontinue participation at any time.
Injury Statement
If you require medical treatment as a result o f injury arising from your participation in this
study, the financial responsibility for such care will be yours.
Agreement:
YOUR SIGNATURE INDICATES THAT YOU HAVE DECIDED TO PARTICIPATE
HAVING READ THE INFORMATION PROVIDED ABOVE.
Signature o f Parent Date
Signature o f Witness Relationship to Parent
n m m .
DEC 151994
CONSENT von 1 Y O U
FROM ABOVE DATE.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Informed Consent for Study o f Pilot Instrument
INFORMED CONSENT
for
A RELIABILITY AND VALIDITY STUDY OF A SENSORY HISTORY
QUESTIONNAIRE
Principal Investigator Cheryl L. Johnson. OTR
24 Hour Telephone: (818)249-2159
Purpose o f Study:
You are invited to participate in a study o f a sensory history questionnaire A sensory
history questionnaire assists a therapist in gathering valuable information about how a
child responds to sensory information in the home or other natural environments.
Information about a child's responses to sensory information gives a therapist insight into
why a child responded a certain way during testing or in the clinic environment and helps
with interpretation o f test scores if a formal test has been administered. This sensory
history questionnaire is one that has been compiled from a pool o f many sensory history
test items used across the United States These items were statistically tested for their
ability to reflect information about the sensory categories. These categories are auditory
(hearing), gustatory (taste), olfactory (smell), proprioception (the sense o f muscle
contraction and joint position), tactile (touch), and vestibular (the awareness o f
gravitational forces and head movement). The items included in this questionnaire are the
items which met the statistical criteria to be valid items, as judged by experts in the field.
We hope to leam which items on this questionnaire actually distinguish between children
with and without sensory integration disorders. This will eventually lead to a shorter and
more efficient questionnaire. You are invited as a possible participant in this study
because your child is in the age group which will be studied.
Procedure:
If you decide to participate, you will be asked to till out a 200 item questionnaire about
behaviors that your child may or may not have in response to sensory information. For
each item, you will indicate if your child exhibits the behavior always, often, sometimes,
rarely, or never by checking the corresponding space. You may refuse to answer any
questions. Approximately 30 minutes will be required to complete this questionnaire.
Risks:
There are no risks other than the inconvenience of spending the time to answer 200
questions. Your child will not be examined or observed in any way as part o f this study
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Benefits:
No specific benefits are expected.
Confidentiality Statement:
Any information that is obtained in connection with this study and that can be identified
\Mth you will remain confidential.
Oder to Answer Questions
If you have any questions relating to the study, please feel free to contact the principal
investigator listed above. If you have any questions regarding your rights as a study
subject, you may contact the Institutional Review Board Office at (213) 223-2340 You
will be given a copy o f this form to keep.
Coercion and Withdrawal Statement
Your decision whether or not to participate will not interfere with your future care in this
facility. If you decide to participate, you are free to withdraw your consent and
discontinue participation at any time.
Iniurv Statement
If you require medical treatment as a result o f injury arising from your participation in this
study, the financial responsibility for such care will be yours.
YOUR SIGNATURE INDICATES THAT YOU HAVE DECIDED TO PARTICIPATE
HAVING READ THE INFORMATION PROVIDED ABOVE.
Agreement
Signature of Parent Date
Signature of Witness Relationship to Parent
DEC 2 1 1 9 9 5
F R O M ASOIK O f ll
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Appendix E
Parent Comments on Pilot Questionniare Items
Key A = Respondent A, father of a four year old girl with sensory integration
dysfunction
B = Respondent B, mother of a four year old girl without any known disorders.
English is this mother's second language.
C = Respondent C, mother o f a five year old boy with sensory integration
dysfunction
D = Respondent D, mother of a three year old boy with sensory integration
dysfunction
E - Respondent E, mother of a four year old boy with sensory integration
dysfunction
Auditory System
1 . Is your child bothered by or fearful o f the sound made by a toilet flushing?
D: "We have a particularly loud toilet"
2. Does your child startle or become distressed by loud or unexpected sounds?
3. Does your child have trouble understanding what other people mean when they say
something?
E: "Do you mean the processing of sound or the understanding of the words and how can
you tell?"
4. Does your child seem to hear sounds that go unnoticed by others?
A "You are usually so focused on your child that you don't notice if others are reacting"
E. "What is unnoticed by others?"
5. Do you notice your child being bothered by any sounds which occur during daily life
tasks such as tasks of personal hygiene, dressing, eating, home making, school work,
play/leisure?
6. Is your child bothered by background noise?
A "Isn't this the same as question 2"
B: "Does background noise mean things that previously scared her"
D: "Do you mean loud noises like difficulty entering a classroom already in full swing or
subtle sounds like the buzzing o f lights, because the subtle sounds don't bother him"
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7. Does you child seem to have trouble remembering what is said to him?
A: "Sometimes he purposefully forgets or jokes about it" "This should say him or her"
D: "He remembers, but he is selective"
8. Is your child bothered by the sounds o f any household or ordinary items, such as
squeaky shoes, the vacuum, the blow dryer, dog barking, etc.?
B: "Just the vacuum bothers her"
D: "He isn't sensitive to those things, but he is sensitive to sound"
9. Is your child able to follow oral directions?
A: "She is able to understand, but sometimes chooses not to follow the directions"
B. "What is oral directions"
E. "Sometimes, like all normal children, he decides not to follow directions and that
doesn't mean he can't hear them. He understands."
10. Does your child fail to follow through to act upon a request to do something or to
understand directions?
A: "It depends upon her mood not because o f understanding. Sometimes the intentionally
does the opposite."
D: "Sometimes it is a selective behavior not to follow directions versus understanding"
E: "What is the clinical application? Sometimes he doesn't follow directions because he
doesn't want to"
11. Does your child respond negatively to loud noises?
A: "What is 'respond negatively1 ? Does it mean pooping in pants or crying. She will run
towards us (parents) if she is scared, but I don't think that is negative."
B: "What do you mean by 'respond negatively1 ?"
E: "Isn't that common"
12. Is your child distracted by sounds, fluorescent light bulbs, heaters, fans, refrigerators?
A: "She has gotten used to these particular sounds, but is still distracted by others"
D: "Does this question mean only subtle sounds?"
13. Is your child bothered by the sound of the vacuum?
14. Is your child bothered by the sound made by certain accessories such as bracelets and
necklaces?
15. Does your child appear to not hear certain sounds?
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16. Is your child distracted by sounds not normally noticed by average persons?
C: "Is this the same as question 4?"
0: "Isn't this the same as a lot o f the other questions?"
E: "Are these trick questions? This is so repetitive."
17. Does your child mind the sound of the hairdryer?
18. Does your child mind the sound of squeaky shoes?
19. Is your child frightened o f sounds which would not normally convey alarm for other
children the same age?
A: "How are we to know how other children react?"
D: "I don't know what alarms other children."
20. Does your child hear sounds other people don't notice or have trouble tuning out
certain sounds, such as, a clock or watch ticking?
A: "How can you tell?"
D: "This should be two separate questions."
21. Does your child ask others not to talk or sing or make noise?
E: "This really depends on his mood and personality, not on his ability to tolerate sounds"
22. Does your child appear to make noise for noise's sake?
B: "Do you mean she's doing it to block out other sounds?"
D: "What exactly do you mean?"
23. Is you child bothered by extraneous sounds?
B: "What is extraneous?"
C: "What do you mean my extraneous sounds?"
D: "Do you mean only subtle sounds like in some o f the previous questions or loud
sounds because he is bothered by extraneous loud sounds such as the machines at this
dad's office."
24. Compared to other children the same age, does your child seem to under react to loud
noises?
25. Does your child have trouble interpreting the meaning o f words?
A: "She might not understand a word the first time she heard it."
B: "Sometimes, because we are bilingual"
C: "He sometimes has trouble if he hasn't heard a lot"
D: "This is a vague question. He doesn't have trouble understanding"
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26. Is your child bothered by or respond negatively to unexpected sounds or noises?
A: "I have a problem with the word'negatively1 . What do you mean?”
D: "Do you mean is he startled by unexpected sounds?”
27. Does your child seem confused as to the directions o f sounds or where sound is
coming from?
28. Does your child have difficulty paying attention when there are other noises nearby?
A: "Do you mean for example, when she is in the clinic she is watches others instead of
her stuff because the is distracted?”
29. Is your child easily distracted by irrelevant or background noises (i.e., lawn mower
outside, children talking in the back of the room, crinkling paper, air conditioners,
refrigerators, fluorescent light bulbs?)
D: "I'm answering no because these are only little noises"
30. Does your child seem too sensitive to sounds?
A: "Is this the same as question 29?”
D: Tm answering yes because he is too sensitive to loud sounds."
31. Does your child need to have things, especially directions repeated or says "what" a
lot?
E: "Isn't this common?"
32. Does your child like to sing or dance to music?
A: "She likes dancing more than singing."
D: "This sounds like a loaded, high pressure question. He loves music but I was afraid to
answer always because it seemed threatening."
Gustatory System
33. Does youF child not like licking envelopes because o f the taste o f the glue on the
envelope?
A: "She has never licked envelopes"
B: "She hasn't tried it but I don't think she would like it"
C: "He hasn't tried it but he probably wouldn't like it because he doesn't like licking"
D: "Is this age appropriate?"
E: "This isn't age appropriate?"
34. Does your child show definite preferences for certain tastes?
35. Does your child act as though all foods taste the same?
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36. Does your child complain about or dislike the taste o f toothpaste or mouthwash?
A: "Getting her to brush her teeth is a challenge. She doesn't really dislike that taste
though"
B: "He doesn't use mouthwash"
D: "The taste o f toothpaste doesn't bother him because we use the good flavors like
bubble gum flavored toothpaste"
E: "He is picky about the particular flavors o f toothpaste"
37. Does your child complain that foods are too bland?
A: "She probably wouldn't like it, but she wouldn't complain."
B: "What is bland?"
D: "He doesn't know what bland is. He wouldn't know how to complain about this”
38. Does your child like almost all foods?
A: "What do you mean by'almost'?"
39. Does your child season his/her food heavily?
A: "This isn't age appropriate"
D: "Does ketchup and mustard apply?"
E: "This isn't age appropriate."
40. Will your child eat already seasoned foods?
41. Is your child willing to season his/her food"
A: "This isn't age appropriate"
D: "Does ketchup and mustard apply?"
42. Does your child like very salty foods?
43. Does your child prefer bland foods?
Olfactory System
44. Does your child react negatively to or dislike smells which are not usually recognized
as offensive by most people?
A: "She hasn't been around many sewers or anything."
D: "How would you know?"
45. Does your child seem to have a very sensitive sense o f smell?
46. Does your child tell you or other people they smell bad, funny or offensive?
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47. Does your child have difficulty discriminating unpleasant odors?
A: "I don't think so. I haven't noticed."
48. Is your child able to identify smells o f scratch-n-sniff stickers?
A: "What are scratch-n-sniff stickers?"
D: "He has never tried it."
49. Does your child find bathroom odors and personal hygiene smells offensive?
B: "What do you mean by 'offensive' in this question?"
50. Does your child become bothered by household odors?
A: "How can you tell? She hasn't said anything."
51. Does your child not notice smells about which others complain?
A: "I haven't noticed. How can you tell?"
D: "How can you tell?"
52. Does your child mind the smell of soap or cologne?
53. Does your child fail to notice or ignore unpleasant or strong odors?
54. Does your child make excessive use of smelling to explore?
B: "This is hard to understand."
55. Does your child explore by smelling?
B: "This is bard to understand too."
D: "What do you mean by 'explore'?"
Proprioception System
56. Does your child grasp objects too tightly?
D: "You need an example here. He holds things strongly, but I'm not sure if that means
it's too tightly."
57. Does your child tire easily when holding a particular body position?
A’ "What do you mean by a particular body position? No position comes to mind"
D: "What is a 'particular body position'? and what is 'easily1 in this question?
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58. Does your child habitually assume body positions that place joints in extreme ends o f
range of motion?
A: "What is 'extreme ends of range of motion'?"
B: "What is 'extreme ends of range of motion1 ?"
C: "What is 'extreme ends of range o f motion1 ?"
D: "What do you mean by 'extreme' and I only know the words range of motion because
we've been involved in treatment."
E: "What is 'ends o f range o f motion'?"
59. Does your child grind his/her teeth?
60. Does your child seek activities such as pushing, pulling, dragging, lifting and jumping?
61. Does your child climb high into a tree, jump off tall walls or furniture, etc.?
E: "The wording is too extreme such as'high into a tree1 and 1 3 1 1 walls'."
62. Does your child like giving bear hugs?
63: When moving to sit on a surface, step over an objects, or stoop under an obstacle,
does your child seem unsure o f how far to raise or lower his or her body parts?
E: "This is too wordy."
64. Does your child not notice M ing?
65. Does your child like to be under heavy blankets, covers or pillows?
66. Is your child overly destructive with toys?
A: "Sometimes she throws things. Does that count?"
B: "What is'destructive'?"
67. Does your child chew on pens, straws, etc.?
68. Does your child have a weak grasp?
D: "What exactly is 'weak'?"
69. Does your child chew on nonfood objects?
70. Does your child seem to exert too much effort for the task (sits and walks heavily,
slams doors, cupboards and drawers and presses too hard when using pencils or crayons)?
A' "I would answer differently to each part of this question."
71. Does your child jump a lot?
D: "This feels like a loaded question."
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72. Does your child have difficulty playing with animals appropriately, such as petting
them with too much force?
73. Does your child appear to have a poor understanding o f where his/her body is in
space and in relation to other body parts?
A: "This could be two different questions."
B: "I only know what this means because my child has been involved in treatment."
C: "This is only clear because my child has been involved in treatment."
D: "I've been told that he has trouble with this by therapists."
74. Does your child have difficulty positioning his/herself in a chair?
75. Does your child demonstrate poor body awareness?
C: "Is this the same as question 73?"
E: "This is the same as question 73."
76. Does your child frequently hit, bump and/or push other children?
D: "Do you mean excessively?"
77. Does your child seem generally weak?
D: "What do you mean by ’ generally weak’ ?"
78. Compared with other children the same age, does your child seem to really enjoy
activities that involve jumping, crashing into things, pushing or pulling or falling?
79. Does your child like getting bear hugs?
A: "It depends upon if she’ s in the mood or not, not her tolerance o f it."
80. Does your child taste or chew on toys, clothes or other objects more than other
children?
81. Does your child crave hugging or rough playing?
A "If I initiate rough play, she’ ll be upset if I stop, but it’ s not because she is craving it
the time."
B: "What i s ’ crave’ ?"
D: "Crave is such a strong word."
82. Does your child like to chew on hard candy?
A "She doesn't get hard candy."
D: "This isn't applicable. I don't give him hard candy."
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83. Does your child have difficulty sitting erect, or chooses to lie down instead o f sitting
up?
A: "Isn't this normal. It depends upon the time of day."
Tactile System
84. Does your child dislike going barefoot, not like to take his/her shoes off or insist on
always wearing shoes?
A: "She doesn't like taking her shoes off because o f the process, not because o f the
sensation."
D: "Does this mean compared to other children?"
85. Does it bother your child to play games with bare feet?
86. Is your child irritated by certain clothing?
A: "Do you mean the way it feels?"
87. Does your child pull away from light touch?
88. Does your child seem to lack the normal awareness of being touched?
89. Does your child resist or dislike wearing clothing of certain textures?
90. Does your child react negatively to the feel o f new clothes?
91. Does your child tend to prefer to wear long sleeve shirts and long pants regardless of
the weather, for instance prefers to wear long sleeves even when it is warm outside?
92. Does your child seem excessively ticklish?
A: "She is very ticklish, but I don't know if it is excessive or not."
B: "What does 'excessively ticklish' mean?"
D: "What do you mean by 'excessive'."
93. Does your child like to cuddle up with a blanket or stuffed animal or special pillow?
94. Does your child enjoy tickling as a form o f play?
95. Does your child avoid playing with "messy" things, i.e., finger paint, mud, sand, glue,
glitter, clay, etc.?
96. Does your child show an unusual dislike for having his/her hair combed, brushed or
styled?
A: "What do you mean by styled?"
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97. Do rough bed sheets bother your child?
A: "What are rough bed sheets. If we had them, she probably wouldn't like them. Who
would like rough bed sheets?”
98. Does wearing turtleneck shirts bother your child?
B: "What is a turtleneck shirt?"
99. Does your child prefer to touch rather than be touched?
100. Does your child seek out touching different textures?
C: "Does this mean they are fascinated with touching things?”
D: "What do you mean by'seek out1 ."
101. Does your child prefer to go barefoot?
102. Does your child dislike wearing hats, sunglasses or other accessories?
103. Does wearing fuzzy shirts bother your child?
B: "What is fuzzy1 ?"
104. Does your child dislike wearing pants or complain about the feel o f them brushing
against his/her legs?
B: "She dislikes it because she dislikes it touching her crotch, not because they touch her
legs. It is because she is a girl."
105. Does your child tend to wear coats or sweaters when they are not needed?
106. Does your child appear to lack the normal awareness of being touched?
B: "This is confusing."
107. Does your child prefer textures o f certain clothing?
108. Does your child overreact to minor injuries or touch?
B: "She over-reacts to get attention."
C: "This should be two different questions."
109. Does your child complain about irritating bumps on the bed sheets?
110. Does it bother your child to have his/her finger or toe nails cut?
111. Does your child struggle against being held?
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112. Does your child dislike playing games with his/her bare feet?
A: "We don't do this."
113. Does your child have a tendency to touch things constantly?
114. Does your child dislike getting his/her hands messy or ask to wash his/her hands
when using things like glue ad glitter?
1 IS. Does your child avoid or dislike playing with gritty things?
116. Do tags or collars on clothing bother your child?
117. Does your child demonstrate an aversion to any form o f clothing?
B: "What is'aversion'?"
118. Does your child prefer certain textures of clothing o r particular fabrics?
119. Does it bother your child to have his/her face touched?
120. Does it bother your child to have his/her face washed?
121. Does your child object to being touched by others?
A: "Do you mean strangers? If so, yes, it would bother her. It doesn't bother her to have
familiar people touch her."
B: "Only in very specific situations"
122. Does it bother your child if he/she can not see who is touching him/her?
A: "The word 'who' is a poor choice. O f course it would bother her if a stranger was
touching her."
B: "She likes to know who is touching her."
E: "This is difficult to answer because he has been taught about strangers and he would
need to know who is touching him."
123. Does the feel of new clothes bother your child?
124. Does your child resist or dislike wearing short sleeved shirts or short pants?
125. Does your child seem to lack awareness of being touched by others?
126. Does your child ask you to take the tags and labels out of their clothing or only wear
clothes which have had the tags and labels removed?
127. Is your child irritated by tags on clothing?
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128. Is your child bothered by hair brushing against his/her face?
A: "She doesn't like having her hair brushed."
129. Does your child dislike the feeling o f certain clothing?
130. Does your child prefer bland foods?
A: "Why is this question here?"
C: "Why is this question here?"
D: "Why is this question here?”
E: "Why is this question here?"
131. Does your child have an unusually high tolerance for pain?
A: "Compared to what?"
B: "What does lugh tolerance' mean?"
132. Does your child demonstrate an excessive need to touch?
A: "Does this include liking to be held more than she should?"
B: "To be touched?"
133. Does your child display an unusual need for touching certain textures, surfaces,
objects or toys?
134. Does your child startle easily when being touched unexpectedly?
A: "Isn't this a normal reaction?”
135. Does wearing fuzzy socks bother your child?
136. Does your child dislike eating messy foods with his/her hands?
137. Does your child tend to feel pain less than others?
138. Does it bother your child when someone is close by?
D: "He is taught to be bothered by strangers standing too close."
E: "Of course he is bothered if a stranger is standing too close."
139. Does your child avoid touching different textures?
D: "More than other kids?"
140. Does your child appear to resist eating certain foods because o f their texture?
C: "How can you tell if it is because of texture or taste?"
141. Does your child strongly dislike being tickled?
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142. Does your child avoid certain textures?
143. Does your child avoid getting his/her hands in finger-paint, paste, sand, clay, mud,
glue, etc.?
Vestibular System
144. Does your child rock while sitting?
145. Does your child seem excessively fearful o f movement, i.e. going up and down
stairs, riding swings, teeter totters, slides, or other playground equipment?
146. Does your child get nausea or vomit from movement experiences?
147. Does your child like to swing?
148. Does your child demonstrate distress when he/she is moved or on moving
equipment?
B: "Does this mean when something is moved to a different place in the house? What do
you mean by 'distress'."
E: "This question is unclear. Isn't it appropriate to dislike some movement?"
149. Does your child's head move along with his/her eyes when reading?
A: "She doesn't read, but her head doesn't move when she's looking at a book."
C: "He doesn't when we're reading a book together, but he doesn't read."
D: "This isn't age appropriate. You need a different example."
E: "This isn't age appropriate."
150. Is your child frequently and easily disoriented in space (confused in parking lots,
cant find the car, gets lost in stores)?
D: "This example is too extreme.”
E: "This isnt age appropriate."
151. Does your child have good balance?
152. Does your child have to exert more effort to move than others, tire easily from
exertion and or require more sleep than others?
D: "How do I know?"
E: "What does 'more effort to move' mean? I would answer this question differently now
because ray child has been involved in therapy because I've learned from the therapist that
he does have a problem in this area, but I wouldn't have noticed it before."
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153. Does your child demonstrate low (hypotonic) muscle tone?
A: "What is low muscle tone?"
B: "What is that?"
C: "Why did you use the word demonstrate? The only reason why I know what low
muscle tone is, is because o f my involvement in therapy."
D: "I only know about low muscle tone because IVe heard it from my therapists"
E: "What is low muscle tone?"
154. Does your child avoid balance activities?
C: "What are they? This needs an example."
155. Is your child fearful o f heights, such as escalators, glass elevators, stairs, etc.?
156. Does your child like fast movements, such as being whirled about or tossed in the
by an adult?
157. Does your child like climbing real high?
A: "What do you mean by'real'?"
D: "How high is 'real high'?"
158. Does your child have good balance?
Exactly the same as 151.
159. Does your child like fast spinning carnival rides, such as merry-go-rounds?
160. Is your child fearful of activities which require good balance?
161. When your child shifts his body does he sometimes fall out of his chair?
162. Is your child sometimes unable to catch him/herself when falling?
E: "This is unclear, children always fall a lot."
163. Does your child seem to not get dizzy when other's usually do?
164. Does your child get car sick?
165. Does your child seem generally weak?
D: "Even though this is exactly the same question as in the proprioception section, the
context of the question changed my answer."
166. Does your child spin and whirl more than other children?
A "How do I know if other children do it more or less?"
70
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167. Does your child rock himseltfherseif when stressed?
168. Does your child like to be inverted or tipped upside down or enjoy doing things like
hanging upside down, somersaults, etc.?
E: "Too wordy."
169. Is your child fearful of swinging or bouncing, or was as an infant?
170. Does your child experience discomfort, nausea or dizziness following movement,
especially rotation?
171. Do movement activities tend to get your child "going" or does your child tend to
need movement in order to "get going"?
A: "Do you mean in the morning?"
B: "What does this mean?"
C: "This should be two different questions. He doesn't need movement to 'get going', but
movement would get him 'going'."
D: "Does the first part mean movement gets him wired? This should be two separate
questions."
E: "This is unclear. What is'get going1 ?"
172. Does your child dislike sudden or quick movement?
D: "Vague"
173. Does your child avoid activities which challenge his/her balance or appear to have
poor balance during motor activities?
C: "This is two different questions. He cant roller-skate, but he isn't fearful o f trying it."
174. Compared to other children the same age, does your child seem to ride longer or
harder on certain playground equipment (e.g.,. swing, merry-go-round)?
175. Does your child avoid rapid or rotary movement?
B: "Does this mean to do a movement over and over again?"
C: "This needs an example."
D: "More than others?"
176. Is your child fearful of activities in which he/she moves through space?
177. Does your child demonstrate distress when his/her head is in any other position than
upright or vertical?
B : "What is a position other than upright?"
E: "I need examples of what positions."
71
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178. Does your child react negatively to, dislike, appear threatened by, or exhibit a fear
reaction to movement?
179. Does your child enjoy excessive spinning and twirling?
B: "Spinning what?"
C: "Does my son do it excessively because he sticks with it longer than others?"
Visual System
180. Does your child demonstrate a poor understanding o f spatial relationships (for
example, have difficulty differentiating the orientation o f the plus sign versus the
multiplication sign)?
A: "This is too advanced."
B: "It's difficult to understand this example."
D: "This needs an age appropriate example."
E: "This is an inappropriate example."
181. Did your child make reversals in words or letters when writing or copying or read
words backwards (such as reading saw for was) after the first grade?
A-E: not age appropriate.
182. Is your child sensitive to or bothered by tight, especially bright tight (blinks, squints,
cries or closes eyes, etc.)?
183. Does your child have difficulty using both eyes together?
D: "How would you know?"
E: "How would you know?"
184. Does your child confuse the foreground and the background of a picture?
A: "This is too analytical. What exactly do you mean?"
B: "Sometimes she holds the newspaper upside down."
D: "We don't discuss the foreground and background o f pictures with our son."
E: "How can you tell."
185. Is your child able to look at something far away?
186. Does your child have difficulty keeping his/her eyes on the task or activity at hand?
D: "Isn't this normal?"
E: "It doesn't have any clinical meaning that he sometimes gets distracted."
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
187. Does your child have trouble maintaining his/her visual focus on one task or object
for very long?
A: "It is tough to decide between attention and visual focus. I don't know which one
she's having problems with."
C: "How long is Very long'?"
D: "Isnt this normal?"
E: "This is the same as 186, but this question is worded better."
188. Does your child loose his/her place on a page while reading, copying, solving
problems or performing manipulations?
A: "This is too advanced. The correct word is lose'."
D: "It's lose' not 'loose'. This is also not age appropriate."
E: "Did you notice the type-o, It's lose'. This isn't age appropriate."
189. Do you suspect your child o f having a visual acuity problem?
A "What is'acuity1 ?"
B: "What is'acuity*?"
D: "What is ’ acuity1 ?"
E: "How can we diagnose this? It is too clinical.”
190. Does your child rub his/her eyes, complain of headaches or have eyes which water
after reading?
D: "He does not read yet."
191. Does your child have difficulty with visually focusing on things far away?
192. Does your child become easily distracted by visual stimuli?
B: "What is visual stimuli."
193. Does you child have trouble locating things laying on top of other things, especially
things of the same color, or have trouble finding an object when it is amidst a group of
other things?
194. Does your child close one eye and/or tip his/her head back when looking at
something or someone?
195. Does your child have difficulty shifting his gaze from the board to his/her paper
making copying from the board to paper difficult?
A "This is too advanced."
D: "This isnt applicable."
E: "This isnt age appropriate."
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196. Does your child demonstrate a limited tolerance for any of the following: color,
busy visual environments, high contrast or low contrast environments?
B: "I need explanation of these things."
D: "What is high contrast/low contrast?"
E: "This is too clinical and vague."
197. Does your child have difficulty with visually focusing on things close?
198. Does your child have difficulty in smooth eye tracking (following objects with eyes,
keeping place while reading or copying from blackboard to desk?)
199. Compared to other children the same age, does your child seem to be easily
distracted by visual stimuli?
200. Does your child have trouble following objects with his eyes?
201. Does your child have difficulty naming, discriminating or matching colors, shapes,
sizes?
A: "How advanced do you mean with discriminating shapes?"
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Appendix F
A A L W A Y S
0 O FTEN
S S O M E T IM E S
R RARELY
N NEVER
N /A N O T APPLICABLE
ITEM A | 0 I S I R 1 N 1 N/A
Auditory System
i . Is yo u r child b o th e re d b y or fearful of the sound m ade by a
toilet flushing?
2 . D oes yo u r child sta rtle o r b eco m e d istressed by loud o r
u n ex p ected so u n d s ?
3 . D oes y our child h a v e tro u b le u n derstanding w h a t o th e r p eople
m ean w h en th e y s a v so m eth in g ?
4 . D oes y o u r child s e e m to h e a r so u n d s th a t o th e r people te n d to
n o t notice?
5 . Oo y o u n o tice y o u r child being bothered b y an y so u n d s w hich
o c c u r during daily life ta s k s su c h a s ta sk s o f personal hy g ien e,
d ressin g , e a tin g , h o m e m aking, school w ork, play/leisure?
6 . Is yo u r child b o th e ra d b v loud background noise such a s
c o n stru ctio n w o rk n e a rb y o r so u n d s o f m achinery o perating?
7 . D oes your child se e m to hav e trouble rem em bering w h a t is said
to him /her?
8 . Is y o u r child b o th e re d b y th e so u n d s of any household or
ordinary item s, su c h a s sq u e ak y sh o e s, th e vacuum , th e blo w
dryer, dog barking, e tc .?
9 . D oes yo u r child se e m to u n d erstan d oral directions?
1 0 . D oes your child fail t o follow th ro u g h to a c t upon a re q u e st to
do so m eth in g o r to u n d e rsta n d directions?
11. D oes your child re sp o n d negatively such a s running aw ay,
crying or holding h a n d s over e a rs to loud noises?
12. Is yo u r child d istra c te d by su b tle so u n d s su c h a s . flu o rescen t
light bulb s, h e a te rs, fa n s , refrigerators?
13. Is yo u r child b o th e re d b y th e so u n d of th e vacuum ?
1 4 . Is yo u r child b o th e re d b y th e so u n d m ade by certain a c c e sso rie s
su c h a s b ra c e le ts a n d n eck laces?
15. D oes yo u r child a p p e a r to n o t h ear certain sounds? ! i
16. Is yo u r child d istra c te d by so u n d s n o t norm ally noticed by
av erag e p e rso n s?
1 7 . D oes yo u r child m ind th e so u n d of th e hairdryer?
18. D oes your child m ind th e so u n d o f squeaky sh oes?
1 9 . Is your child frig h ten ed of so u n d s w hich w ould n o t norm ally
c o n v ey alarm for o th e r children th e sam e age?
2 0 . D oes your child h e a r so u n d s o th e r people d o n 't notice o r hav e
trouble tuning o u t c e rta in so u n d s, su c h a s, a d o c k or w a tc h
ticking?
2 1 . D oes your child a sk o th e rs n o t to talk or sing or m ake noise? 1 1
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ITEM A 0 S R 1 N 1 N/A
2 2 . D oes y o u r ch ild a p p e a r to m ake noise fo r n o ise 's sake? ! i
2 3 . C om pared to o th e r children th e sa m e aQe d o e s yo u r child seem
to u n d er r e a c t to loud n o ises?
24. O oes y o u r ch ild h a v e trou b le interpreting tn e m eaning of simple
or com m o n w o rd s?
i
i
2 5 . Is y o u r child b o th e re d b y or respond negatively su c h a s running
aw ay , crying o r hold h a n d s over e a rs to u n ex p ected so u n d s or
n oises?
i
2 6 . O oes y o u r ch ild se e m co n fu se d a s to th e direction of so u n d s or
w h ere so u n d is eo m in o from ?
2 7 . D oes y o u r ch ild h a v e difficulty paying atten tio n w h en there are
o th er n o ise s n earb y ?
28. Is y o u r child e a sily d istra c te d by irrelevant o r background noises
su c h a s la w n m o w e r o u tsid e, children talking in th e b ack of th e
room , crinkling p ap er, air conditioners, refrigerators, fluorescent
liahts?
i
2 9 . O oes yo u r ch ild se e m to o sensitive to so u n d s? i i
3 0 . D oes y o u r ch ild n e e d to h av e things, especially directions
re p e a te d o r s a v s 'w h a t* a lot?
3 1 . O oes y o u r ch ild like to sing or dan ce to m usic?
. 1
Gustatory Systam
i . O oes y o u r ch ild n o t like licking envelopes b e c a u se of th e ta s te
of th e glue o n th e envelope?
2. O oes y o u r ch ild s h o w definite p referen ces fo r certain ta ste s? 1
3. O oes yo u r ch ild a c t a s th o u g h all foo d s ta s te th e sam e? i
4.
I
O oes yo u r ch ild com plain ab o u t or dislike the ta s te of
to o th p a ste o r m o u th w a s h ?
j j
1 5. O oes yo u r ch ild com plain th a t foo d s are to o bland?
i 6. O oes yo u r ch ild like a lm o st all foods?
7. O oes your ch ild se a s o n h is/h er food heavily, for exam ple, using
ex cessiv e sa lt, k e tc h u p o r o th er spices?
j
8. Will yo u r child e a t alread y se a so n e d foods?
- ■ ! I -
9. Is your child w illing to se a so n h is/her food? I i
10. O oes yo u r ch ild like very salty foods? i i
11. O oes y o u r child p refe r bland foods?
i ■
!
Olfactory System
i . O oes yo u r ch ild re a c t negatively to o r dislike sm ells w hich are
n o t usually re c o g n iz e d a s offensive by m o st people?
|
2. O oes y o u r ch ild se e m to have a very sen sitiv e s e n s e of smell?
i
i i
3. O oes y o u r ch ild tell you or o th er people th ey sm ell b ad . funny
o r o ffensive? 1
4. O oes y o u r child h av e difficulty discrim inating u n p le a sa n t odors?
i
5. Is y our child a b le to identify sm ells of scratch -n -sn iff stickers?
! i ,
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ITEM A 0 S R N i N/A 1
6 . b o a s y a u r child find b ath ro o m o d o rs and personal hygiene
sm ells offen siv e?
1
7. O oes y o u r child b e c o m e b o th e re d by household odors?
_ !
8 . O oes y o u r child n o t n o tice sm ells a b o u t w hich o th e rs usually
com plain?
i
i
i
9 . O oes yo u r child m in d th e sm ell of so a p or cologne?
i
1 0 . O oes yo u r child fail to n o tice o r ignore u n p leasan t o r stro n g
odors?
1 1 . O oes y o u r child m a k e e x cessiv e u se of smelling w h en
en countering o b je c ts , p laces and people?
1 2 . O oes yo u r child in te ra c t w ith o b je c ts by smelling?
___ '
Proprioception System
i . O oes y our child g ra sp o b je c ts so tightly th a t it is difficult to u se
th e object? 1
2. O oes y our child tire easily a fte r sitting or lying in th e sa m e
position for aw hile?
3 . O oes y our child grin d h is/h e r teeth ?
4 . O oes y o u r child s e e k activities su c h a s pushing, pulling,
dragging, lifting a n d jum ping?
5 . D oes y o u r child clim b high into a tree, jum p off tall w alls or
furniture, e tc .?
6 . O oes y o u r child like giving b e a r hug s?
7 . Ooes y our child se e m u n su re o f h o w far to raise or lo w er th e
body during m o v e m e n t su c h a s sitting d o w n or step p in g ov er an
object?
8. O oes y our child n o t n o tice falling?
;
9. O oes y our child like to be u n d e r h eav y blankets, co v ers or
pillows?
■
10. Ooes y our child te n d to b reak to y s?
i i
11. O oes y o u r child c h e w on p e n s, stra w s , e tc . ?
I
1 2 . Does y our child g ra sp o b je c ts so loosely th a t it is difficult to u se
the object?
!
1 3 . O oes y our child c h e w on n o n fo o d objects? i
14. Ooes y our child se e m to e x e rt to o m u ch effo rt for th e ta s k for
exam ple, w alk s heavily, sla m s d o o rs, or p re sse s to o hard w h en
using pencils o r cra y o n s?
15. O oes y o u r child ju m p a lot?
16. Ooes your child h a v e difficulty playing w ith anim als
appropriately, su c h a s p ettin g th em w ith to o m uch force?
■■" i
1 7 . O oes y our child h a v e difficulty positioning his/herself in a chair?
1 8. Does yo u r child freq u e n tly hit. bu m p an d o r pu sh o th e r
children?
19. O oes yo u r child se e m generally w eak? 1
2 0 . C om pared w ith o th e r children th e sa m e ag e. d o es y our child
seem to really enjoy activ ities th a t involve jum ping, crashing
into things, p u sh in g o r pulling or falling?
'
1
1
77
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ITEM A 0 S R N 1 N/A
2 1 . D oes your child like g e n in g b ear hugs?
1
2 2 . Ooes y our child ta s te o r c h e w o n to y s, c lo th es, o r o th e r o b je c ts
m ors th an o th e r children?
!
2 3 . Does y our child crav e hu g g in g o r rough playing? •
2 4 . D oes yo u r child like to c h e w on hard candy? *
2 5 . Does your child h av e difficulty sitting ere c t, or c h o o s e to lie
dow n in stead o f sitting up?
Tactile System
i . Does your child dislike going barefo o t, n o t like to ta k e h is/h er
shoes off or in sist o n alw ay s w earing sh o e s?
2. Does it b o th er y o u r child to play g am es w ith b are feet?
3. Is your child irritated by th e feel of certain clothing?
4. Does your child pull a w a y from light to uch?
5. Does your child se em to lack th e norm al a w a re n e s s o f being
touched?
6. Does yo u r child re sist o r dislike w earing clothing o f certain
textures?
7. D oes your child re a c t n egatively to th e feel o f n e w clo th es?
8. D oes your child te n d to p refe r to w ear long sle ev e sh irts and
long p a n ts reg ard le ss of th e w e a th e r, fo r in stan c e p re fe rs to
w ear Iona sle ev es ev en w h en it is w arm o u tsid e?
9 . D oes your child se em ex cessiv ely ticklish?
i
10 . D oes your child like to cuddle up w ith a blanket o r stu ffe d
animal or soecial pillow?
11. Does your child enjoy tickling a s a form of plav?
_ i ______
12. D oes your child avoid playing w ith ’ m e ssy ’ th in g s, i.e.. finger
paint, m ud. sa n d . glu e, glitter, d a y . etc.?
1 3 . Does your child s h o w an u nusual dislike for having h is/h e r hair
com bed, b ru sh ed o r stvied?
14. Do rough b e d sh e e ts b o th e r y our child? I
15. Does w earing tu rtlen e ck sh irts b o th er yo u r child?
1 6 . Does your child p refe r to to u c h rath er th a n be to u c h e d ?
i
17. Does your child se em driven to to u c h different te x tu re s?
i .
18. Does your child p refer to g o barefoot?
i
i
19. Does vour child dislike w earin g h a ts, su n g la sse s o r o th e r
accessories?
2 0 . Does w earing fuzzy sh irts b a th e r your child?
2 1 . Does your child dislike w earin g p a n ts or com plain a b o u t th e feel
of them brushing a g a in st h is/h e r legs?
2 2 . Does your child te n d to w e a r c o a ts or sw e a te rs w h e n th e y are
n o t needed?
2 3 . Does your child a p p e a r to lack th e norm al a w a re n e s s o f being
touched?
2 4 . Does vour child p refer th e te x tu re s of certain clothing? !
2 5. D oes your child o v e rre a c t to m inor injuries?
i
I
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ITEM
a r o i s R 1 N N /A 1
2 6 . O oes y o u r child com plain ab o u t irritating b u m p s on tha
b a d s h a a ts?
2 7 . O oas it b o th e r yo u r child to hav a h is/h er finger or to a nails cu t? 1
2 8 . D oas y o u r child stru g g le ag ain st being held?
2 9 . D oes y o u r child dislike playing g a m e s w ith his/her bara feet?
3 0 . O oas y o u r child hav e a ten d e n c y to to u c h th in g s constan tly ?
3 1 . O oes y o u r child dislike g e n in g h is/h er h a n d s m essy or ask to
w a s h h is /h e r h a n d s w h e n using th in g s like glue and gliner?
3 2 . O oas y o u r child avoid o r dislike playing w ith gritty things?
3 3 . Do ta g s o r co llars on clothing b o th e r y o u r child?
3 4 . O oes y o u r ch ild d e m o n stra te an aversion to an y form of
clothing?
3 5 . D oes y o u r child p refe r certain te x tu re s o f clothing or particular
fabrics?
3 6 . O oes it b o th e r y o u r child to have h is/h er face touched?
3 7 . O oes it b o th e r y our child to hav e h is/h er face w ashed7
3 8 . O oes y o u r child o b ject to being to u c h e d by familiar people?
3 9 . D oes it b o th e r y o u r child if h e /sh e c a n n o t se e w ho is touching
h im /h er w h e n am ong fam iliar people a t hom e or school?
4 0 . O oes th e feel o f n ew clo th e s b o th e r yo u r child?
4 1 . O oes y o u r child re sist o r dislike w earing sh o rt sleeved shirts o r
sh o rt o a n ts ?
4 2 . O oes v o u r child se em to lack a w a re n e s s.o f being to u ch ed by
o th e rs?
4 3 . D oes y o u r child a s k you to tak e th e ta g s an d labels o u t of
clothing o r on ly w e a r clo th e s w hich hav e had th e ta g s and
labels re m o v e d ?
4 4 . Is yo u r ch ild irritated by ta g s o n clothing?
4 5 . Is y o u r child b o th ered by hair brushing a g a in st his/her face?
4 6 . D oes y o u r child dislike th e feeling of certain clothing?
4 7 . O oes y o u r child have an unusually high to leran ce for pain?
4 8 . D oes y o u r child d e m o n stra te an e x cessiv e need to touch?
4 9 . O oes y o u r child display an u nusual n e e d fo r touching certain
te x tu re s, s u rfa c e s , o b jects or to v s?
5 0 . D oes v o u r child sta rtle easily w h en being to u ch ed
u n e x p ected ly ?
5 1 . D oes w e a rin g fuzzy so c k s b o th er yo u r child?
5 2 . D oes y o u r child dislike eating m e ssy fo o d s w ith his/her h an d s?
5 3 . D oes y o u r child ten d to feel pain le s s th a n others?
5 4 . D oes it b o th e r y o u r child w h e n a fam iliar p erso n a t hom e or
sch o o l is c lo s e by?
5 5 . D oes v o u r child avoid touching different tex tu res?
5 6 . D oes y o u r child ap p ear to re sist eating certain foods b e c a u se of
th eir te x tu re ?
5 7 . D oes y o u r child stro n g ly dislike being tickled?
5 8 . D oes y o u r child avoid fo o d s of certain tex tu res?
79
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ITEM A 0 s R N N/A
5 9 . D o ts vo u r child avo id g e n in g h is/h er hands in finger-paint.
o a ste . sa n d . d a v . m u d . glu e, e tc .? I i
6 0 . O oes your child se e k m e ssy play activities? 1 ! i
6 1 . O oes it b o th er y o u r child to h a v e his/her hair cut? |
1 !
Vestibular System
i . O oes your child ro c k w hile sitting? 1
2. O oes yo u r child se e m ex cessiv ely fearful of m ovem ent, i.e.
going up a n d d o w n sta irs , riding sw in g s, te e te r to n e rs , slid es,
o r o th e r p layground eau io m en t?
3 . O oes your child g e t n a u se a o r vom it from m ovem ent
experiences?
4. O oes your child like to sw in g ?
5. D oes your child d e m o n s tra te d istre ss w hen h e/sh e is m o v e d o r
on m oving eau io m en t?
6. O oes your c h ild 's h e a d m o v e along w ith his/her ev es in
activities su c h a s reading, follow ing along w ith a p a re n t reading
o r playing a c o m p u te r g am e?
7. Is y o u r child freq u e n tly an d easily confused ab o u t h is/h er
location fo r exam ple, g e ts lo st in sto re s, or c a n 't find th e w ay
to a fam iliar classro o m ?
S. O oes your child h a v e goo d balan ce?
9. O oes your child h a v e to e x e rt m ore effort to m ove th an o th e rs,
tire easily from exertion an d or require m ore sleep th a n 'o th e rs ?
10. O oes your child avoid b alan ce activities su ch a s w alking on
cu rb s or on u n ev en ground?
11. Is y our child fearful of h e ig h ts, su c h a s escalato rs, g la ss
elev ato rs, sta irs, e tc .?
1 2 . O oes your child like fa s t m o v e m e n ts, such a s being w hirled
ab o u t o r to s s e d in th e air b y an adult?
13. O oes your child like clim bing real high?
1
14. D oes your child like fa s t spin n in g carnival rides, such a s m erry-
go-rounds?
j
15. Is y our child fearful of activ ities w hich require good balan ce?
1
16. W hen your child s h ifts h is/h e r bod y d o es h e/sh e so m e tim es fall
o u t of his chair? i
17. Is your child so m e tim e s u nable to catch him /herself w h en
falling?
18. O oes your child se e m to n o t g e t dizzy w hen others u sually d o ? 1
19. D oes your child g e t car sick? 1
2 0 . D oes yo u r child se e m generally w eak?
1
2 1 . D oes your child sp in an d w hirl m ora th an o th er children?
1
2 2 . D oes vour child ro ck him self/herself w h en stressed ?
!
2 3 . D oes your child like to be in v erted or tipped upside d o w n o r
enjoy doing th in o s like hanging u p side dow n, so m e rsa u lts, e tc .?
2 4 . Is your child fearful of sw in g in g o r bouncing, or w as a s an
infant? I
1
80
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
ITEM A 0 S R N 1 N/A
2 5 . O oas y o u r child experien ce d isc o m fo rt, n a u se a or dizziness
follow ing m o v e m e n t, especially ro tatio n ?
2 6 . O oes y o u r child te n d to need m o v em en t in order to 'g e t g o in g '
fo r ex am p le, a fte r w aking up from a nap?
2 7 . O oas y o u r child dislike su d d e n o r quick m o v em en t su c h as
su d d e n ly sto p p in g o r going o v er a bu m p w hile hdino in the car?
2 8 . C om pared w ith o th e r children th e sa m e a g e d o e s yo u r child
se e m to ride lo n g er o r h ard er on certain playground equipm ent
fo r ex am p le, sw in g , m errv-go-round?
2 9 . O oes y o u r child avoid rapid o r spinning m ovem ent?
3 0 . Is y o u r child fearful of activities in w hich h e /sh e m oves through
sp a c e ?
3 1 . D oes y o u r child d e m o n stra te d istre ss w h e n h is/h er h ead is in
an y o th e r p o sitio n th a n u p rig h t o r vertical su c h a s having th e
h ead tilted b a c k w a rd or u p side d o w n ?
3 2 . O oes y o u r ch ild r e a c t negatively to , dislike, a p p e a r th reaten ed
by, o r ex h ib it a fe a r reaction to m o v em en t?
3 3 . D oes v o u r ch ild enjo y ex cessiv e spinning a n d twirling?
Visual System
1. O oes y o u r child h av e trouble telling th e d ifference b etw een
d ifferen t p rin te d figures th a t a p p e a r sim ilar, for exam ple,
c o n fu sin a b w ith p, o r * w ith x?
2. Is y o u r child se n sitiv e to or b o th e re d b y light, especially bright
light (blinks, sq u in ts, cries o r c lo se s e v e s, etc.)?
3. W hen looking a t p ictu res, d o e s y o u r child fo c u s on p a tte rn s or
d etails in ste a d o f th e m ain p ictu res?
4. Is y o u r child ab le to look a t so m e th in g far aw av ?
5. O oes y o u r child h av e difficulty keeping h is/h e r e y e s o n th e ta sk
or activ ity a t h an d ?
6. D oes y o u r child h av e trouble m aintaining h is/h er visual fo cu s o n
o ne ta s k o r o b je c t fo r very long?
* *
j
7. O oes y o u r child rub h is/her e y e s , com plain of h e a d a c h e s or hav e
e y es w h ich w a te r a fte r reading o r looking a t books?
8. O oes y o u r child h av e difficulty w ith visually fo cu sin g on things
far aw av ?
9. O oes y o u r child b eco m e easily d istra c te d b y visual stimuli?
I i
10. O oes y o u r child h av e trouble locating th in g s laying on to p of
o th e r th in g s, especially th in g s o f th e sa m e color, or h av e trouble
finding an o b je c t w h e n it is a m id st a g roup of o th e r things?
11. O oes y o u r child clo se o n e e y e a n d /o r tip h is/h e r head back
w h en looking a t som eth in g o r so m e o n e?
!
12 . O oes y o u r child h a v e difficulty w ith u n u su a l visual en vironm ents
su c h a s a b rig h t colorful room o r a dim lv lit room ?
13.
1
O oes y o u r child h av e difficulty w ith visually fo cu sin g o n things
close?
1
t
i
81
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
ITEM A 0 S R N 1 N /A
14. D o es yo u r child h a v e difficulty controlling ev e m ovem ents
during activities su c h a s follow ing o b jects w ith ey e s, keeping
olace w hile read in o o r copying from blackboard to desk?
|
15. C om pared to o th e r children th e sa m e age d o e s your child seem
to b e easily d istra c te d b y visual stimuli?
1
1 6 . D oes v our child h a v e tro u b le follow ing o b jects w ith his/her
ev e s?
17. D oes y our child h a v e difficulty nam ing, discrim inating or
m atch in o co lo rs, s h a p e s , sizes?
18. Did y o u r child m a k e rev ersals in w o rd s or letters w hen w riting
o r copying o r re a d w o rd s b ack w a rd s (such a s reading sa w for
w a s l a fte r th e first p rad a?
19. D oes y our child lo se h is/h e r place on a p ag e while reading,
co o v in a. solvina p ro b le m s o r perform ing m anipulations?
2 0 . D oes v our child h a v e difficulty shifting gaze from th e board to
th e p a p e r w h e n c o p y in g from th e board?
N a m e : _______________
R e la tio n s h ip to ch ild :
D a t e : _________________
82
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Appendix G
Comprehensive Table o f Results
Frequency Distributions and Wilcoxon Signed Rank Test
question
. _.P _
group A O S R N
Auditory System
1 . Is your child bothered by or fearful .736 1 0.0 3.4 5.1 3.4 88.1
of the sound made by a toilet flushing? 2 0.0 3.3 6.7 0.0 90.0
3 0.0 3.3 3.3 16.7 76.6
2. Does your child startle or become .257 1 0.0 5.1 54.2 23.7 16.9
distressed by loud or unexpected 2 0.0 3.3 56.7 30.0 10.0
sounds? 3 3.3 36.7 20.0 23.3 16.7
3. Does your child have trouble .001* I 0.0 0.0 18.6 49.2 32.2
understanding what other people mean 2 0.0 0.0 20.0 46.7 33.3
when they sav something? 3 0.0 16.7 36.7 36.7 10.0
4. Does your child seem to hear .039* 1 1.7 0.0 16.9 32.2 49.2
sounds that other people tent to not 2 3.3 0.0 23.3 23.3 50.0
notice? 3 0.0 23.3 26.7 23.3 26.7
5. Do you notice you child being .012* I 0.0 0.0 8.5 10.2 81.4
bothered by any sounds which occur 2 0.0 0.0 10.0 6.7 83.3
during daily life tasks such as tasks of 3 3.3 6.7 13.3 33.3 43.3
personal hygiene, dressing, eating,
home making, school work, play/
leisure?
6. Is your child bothered by loud .051“ lb 1.8 3.5 19.3 24.6 50.9
background noise such as construction 2C 3.4 3.4 17.2 27.6 48.3
work nearby or sounds of machinery 3 10.0 13.3 26.7 26.7 23.3
operating?
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
a Wilcoxon signed rank was performed for 29 pairs because of missing data. * > ^ = 5 1 .
® n = 2 9.
* p < .05, Wilcoxon signed rank for matched groups.
83
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A 0 S R N
7. Does your child seem to have .012* I 0.0 0.0 30.5 45.8 23.7
trouble remembering what is said to 2 0.0 0.0 20.0 46.7 33.3
him/her? 3 0.0 6.7 53.3 20.0 20.0
8. Is your child bothered by the .016* 1 0.0 8.5 18.6 20.3 52.5
sounds of any household or ordinary 2 0.0 6.7 20.0 16.7 56.7
items, such as squeaky shoes, the 3 6.7 13.3 36.7 16.7 26.7
vacuum, the blowdryer, dog barking,
etc.?
9. Does your child seem to understand <001* 1 I 55.9 40.7 3.4 0.0 0.0
oral directions? 2 63.3 33.3 3.3 0.0 0.0
3 23.3 53.3 23.3 0.0 0.0
10. Does your child fail to follow .001* 1 0.0 3.4 40.7 45.8 10.2
through to act upon a request to do 2 0.0 3.3 36.7 50.0 10.0
something or to understand directions? 3 0.0 30.0 53.3 10.0 6.7
11. Does your child respond .110 1 0.0 3.4 25.4 20.3 50.8
negatively such as running away, 2 0.0 6.7 26.7 20.0 46.7
crying or holding hands over ears to 3 6.7 13.3 26.7 26.7 26.7
loud noises?
12. Is your child distracted by subtle .074 I 0.0 0.0 3.4 16.9 79.7
sounds such as fluorescent light bulbs, 2 0.0 0.0 3.3 16.7 80.0
heaters, fans, refrigerators? 3 0.0 10.0 10.0 16.7 63.3
13. Is your child bothered by the .069 I 3.4 5.1 11.9 15.3 64.4
sound of the vacuum? 2 3.3 6.7 10.0 13.3 66.7
3 10.0 6.7 23.3 23.3 36.7
1 4. Is your child bothered by the ,I56d 1 0.0 0.0 0.0 3.4 96.6
sound made by certain accessories 2 0.0 0.0 0.0 3.3 96.7
such as bracelets and necklaces? 3 * 0.0 0.0 6.9 10.3 82.8
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
d Wilcoxon signed rank was performed on 29 pairs because o f missing data. t f n=29.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P _ _ .
group A 0 S R N
15. Does your child appear to not .140 I 0.0 0.0 3.4 18.6 78.0
hear certain sounds? 2 0.0 0.0 0.0 16.7 83.3
3 0.0 3.3 6.7 20.0 70.0
1 6 . Is your child distracted by sounds <001* 1 0.0 0.0 0.0 25.4 74.6
not normally noticed by average 2 0.0 0.0 0.0 26.7 73.3
persons? 3 0.0 13.3 30.0 20.0 36.7
1 7 . Does your child mind the sound of .0 52 * 1 8 1 .7 1.7 8.6 10.3 77.6
the hairdryer? 2h 3.4 0.0 3.4 13.8 79.3
3' 0.0 10.7 25.0 17.9 46.4
1 8. Does your child mind the sound of .7 8 1 1 lk 0.0 0.0 3.4 10.3 86.2
squeaky shoes? 2 0.0 0.0 0.0 13.3 86.7
3' 0.0 0.0 3.4 13.8 82.8
1 9 . Is your child frightened of sounds .005* 1 0.0 0.0 3.4 13.6 83.1
which would not normally convey 2 0.0 0.0 3.3 16.7 80.0
alarm for other children the same age?
- >
j 6.7 10.0 16.7 20.0 46.7
20. Does your child hear sounds ether Oil* I 0.0 0.0 3.4 13.6 83.1
people don't notice or have trouble 2 0.0 0.0 6.7 10.0 83.3
tuning out certain sounds, such as a 3 0.0 13.3 16.7 16.7 r 53.3
clock or watch ticking?
21. Does your child ask others not to .015* I 0.0 1.7 44.1 32.2 22.0
talk or sing or make noise? 2 0.0 0.0 43.3 36.7 20.0
3 3.3 13.3 53.3 20.0 10.0
22. Does your child appear to make .684 1 0.0 10.2 47.5 27.1 15.3
noise for noise's sake? 2 0.0 10.0 50.0 20.0 20.0
3 0.0 16.7 43.3 20.0 20.0
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, 0 , S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
Wilcoxon signed rank was performed on 27 pairs because of missing data. sn=58. h n=29.
'n=28. J Wilcoxon signed rank was performed on 29 pairs because o f missing data. k n=58.
>n=29.
* P £ 05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
23. Compared to other children the .109m 1 0.0 1.7 6.8 23.7 67.8
same age does your child seem to 2 0.0 3.3 6.7 20.0 70.0
under react to loud noises? 3” 0.0 7 .1 17.9 25.0 50.0
24. Does your child have trouble .002* 1 0.0 0.0 3.4 15.3 81.4
interpreting the meaning of simple or 2 0.0 0.0 0.0 20.0 80.0
common words? 3 0.0 3.3 20.0 33.3 43.3
25. Is your child bothered by or .238 1 0.0 0.0 27.1 20.3 52.5
respond negatively such as running 2 0.0 0.0 23.3 33.3 43.3
away, crying, or hold hands over ears 3 6.7 6.7 26.7 23.3 36.7
to unexpected sounds or noises?
26. Does your child seem confused as .026* 1 0.0 0.0 5.1 30.5 64.4
to the direction of sounds or where 2 0.0 0.0 0.0 30.0 70.0
sound is coming from? 3 0.0 0.0 20.0 30.0 50.0
27. Does your child have difficulty .002* 1 0.0 0.0 39.0 30.5 30.5
paying attention when there are other 2 0.0 0.0 40.0 36.7 23.3
noises nearby? 3 3.3 23.3 50.0 13.3 10.0
28. Is your child easily distracted by <001* 1 0.0 0.0 13.6 33.9 52.5
irrelevant or background noises such 2 0.0 0.0 13.3 36.7 50.0
as lawn mower outside, children 3 3.3 16.7 33.3 30.0 16.7
talking in the back of the room,
crinkling paper, air conditioners,
refrigerators, fluorescent lights?
29. Does your child seem too .002* 1 0.0 0.0 11.9 23.7 64.4
sensitive to sounds? 2 0.0 0.0 10.0 26.7 63.3
3 3.3 23.3 20.0 26.7 26.7
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group I =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
m Wilcoxon signed rank was performed on 28 pairs because of missing data. n n=28.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
30. Does your child need to have .062 1 3.4 1.7 22.0 50.8 22.0
things, especially directions repeated 2 3.3 3.3 20.0 50.0 23.3
says "what" a lot? 3 6.7 20.0 53.3 36.7 10.0
31. Does your child like to sing or .224 1 49.2 35.6 11.9 3.4 0.0
dance to music? 2 46.7 33.3 13.3 6.7 0.0
3 30.0 36.7 33.3 0.0 0.0
Gustatory System
1 . Does your child not like licking 1.00° I P 2.9 0.0 17.6 23.5 55.9
envelopes because of the taste of the 21 0.0 0.0 16.7 16.7 66.7
glue on the envelope? 3r 9.1 9.1 0.0 27.3 54.5
2. Does your child show definite .373 I 22.0 47.5 23.7 5.1 1.7
preferences for certain tastes? 2 23.3 36.7 33.3 3.3 3.3
3 30.0 23.3 26.7 3.3 16.7
3. Does your child act as though all .117 1 0.0 0.0 1.7 18.6 79.7
foods taste the same? 2 0.0 0.0 0.0 13.3 86.7
3 0.0 3.3 3.3 23.3 70.0
4. Does your child complain about or .975 1 13.6 3.4 25.4 25.4 32.2
dislike the taste of toothpaste or 2 10.0 6.7 26.7 23.3 33.3
mouthwash? 3 6.7 13.3 23.3 20.0 36.7
5. Does your child complain that .982s 1 0.0 0.0 16.9 23.7 59.3
foods are too bland? 2 0.0 0.0 6.7 23.3 70.0
3 * 3.4 3.4 0.0 17.2 75.9
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group I =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
“ Wilcoxon signed rank was performed on 5 pairs because of missing data. Pn=34. ^n=l8.
rn = ll. s Wilcoxon signed rank was performed on 29 pairs because o f missing data. ln=29.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
6. Does your child like almost all .515 I 6.8 28.8 35.6 13.6 15.3
foods? 2 10.0 36.7 33.5 6.7 13.3
3 10.0 30.0 26.7 16.7 16.7
7. Does your child season his/her food .782 1 0.0 6.8 11.9 28.8 52.5
heavily, for example, using excessive 2 0.0 10.0 10.0 30.0 50.0
salt, ketchup or other spices? 3 3.3 3.3 16.7 30.0 46.7
8. Will your child eat already seasoned .398 1 15.3 40.7 32.2 5.1 6.8
foods? 2 16.7 43.3 20.0 10.0 10.0
3 16.7 40.0 36.7 3.3 3.3
9. Is your child willing to season .584“ lv 12.1 17.2 37.9 20.7 12.1
his/her food? 2 13.3 26.7 30.0 20.0 10.0
3 W
6.9 24.1 34.5 20.7 13.8
10. Does your child like very salty .403 I 3.4 15.3 37.3 28.8 15.3
foods? 2 6.7 6.7 40.0 36.7 10.0
3 6.7 16.7 40.0 30.0 6.7
11. Does your child prefer bland .459 1 5.1 8.5 32.2 27.1 27.1
foods? 2 10.0 6.7 36.7 26.7 20.0
3 3.3 16.7 0.0 36.7 23.3
Olfactory System
1 . Does your child react negatively to .377* 1 0.0 3.4 15.3 30.5 50.8
or dislike the smells which are not 2 0.0 3.3 10.0 23.3 63.3
usually recognized as offensive by 3y 0.0 3.4 20.7 r 24.i 51.7
most people?
2. Does your child seem to have a .801 1 3.4 16.9 22.0 28.8 28.8
very sensitive sense of smell? 2 6.7 16.7 16.7 33.3 26.7
- - , ............ ................
3 3.3 16.7 30.0 10.0 40.0
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
“ Wilcoxon signed rank was performed on 29 pairs because of missing data. v n=58.
w n=29. x Wilcoxon signed rank was performed on 29 pairs because of missing data.
m=29.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A 0 S R N
3. Ooes your child tell you or other .515 I 3.4 5.1 18.6 44.1 28.8
people they smell bad, funny or 2 6.7 6.7 13.3 46.7 26.7
offensive? 3 0.0 10.0 30.0 10.0 50.0
4. Does your child have difficulty .747z I 0.0 0.0 10.2 40.7 49.2
discriminating unpleasant odors? 2 0.0 0.0 3.3 50.0 46.7
3 a a
0.0 0.0 17.2 27.6 55.2
5. Is your child able to identify smells .008*a b
]a c
34.8 54.3 10.9 0.0 0.0
of scratch-n-sniff stickers?
2 a d
41.7 58.3 0.0 0.0 0.0
3a e 11.8 41.2 41.2 5.9 0.0
6. Does your child find bathroom .143 1 5.1 18.6 33.9 33.9 8.5
odors and personal hygiene smells 2 3.3 20.0 36.7 30.0 10.0
offensive? 3 3.3 20.0 20.0 20.0 36.7
7. Does your child become bothered .508 1 0.0 5.1 23.7 44.1 27.1
by household odors? 2 0.0 6.7 23.3 43.3 26.7
3 0.0 3.3 30.0 23.3 43.3
8. Does your child not notice smells .891 1 0.0 0.0 16.9 37.3 45.8
about which others usually complain? 2 0.0 0.0 6.7 46.7 46.7
3 0.0 10.0 3.3 30.0 56.7
9. Does your child mind the smell of .087 I 1.7 0.0 3.4 25.4 69.5
soap or cologne? 2 0.0 0.0 0.0 26.7 73.3
3 0.0 0.0 16.7 23.3 60.0
1 0 . Does your child fail to notice or .064 1 0.0 3.4 10.2 27.1 59.3
ignore unpleasant or strong odors? 2 0.0 0.0 6.7 40.0 60.0
3 0.0 6.7 20.0 23.3 50.0
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
z Wilcoxon signed rank was performed on 29 pairs because of missing data. “ n=29.
“ ‘ ‘ Wilcoxon signed rank was performed on 15 pairs because of missing data. a c n=46.
ld n=24. a t f n=l7.
* p 5 05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
11. Does your child make excessive .559 I 0.0 3.4 10.2 35.6 50.8
use of smelling when encountering 2 0.0 6.7 13.3 33.3 46.7
objects, places, and people? 3 0.0 6.7 10.0 23.3 60.0
12. Does your child interact with .022* 1 0.0 6.8 30.5 39.0 23.7
objects by smelling? 2 0.0 10.0 33.3 36.7 20.0
3 0.0 6.7 16.7 23.3 53.3
Proprioception System
I. Does your child grasp objects so .020* I 0.0 0.0 5.1 30.5 69.5
tightly that it is difficult to use the 2 0.0 0.0 10.0 10.0 80.0
object? 3 3.3 10.0 13.3 26.7 46.7
2. Does your child tire easily after .009* 1 1.7 1.7 22.0 37.3 37.3
sitting or lying in the same position for 2 3.3 0.0 13.3 43.5 40.0
awhile? 3 3.3 16.7 40.0 13.3 26.7
3. Does your child grind his/her teeth? .275 1 0.0 1.7 18.6 13.6 66.1
2 0.0 3.3 23.3 16.7 56.7
3 0.0 10.0 33.3 13.3 43.3
4. Does your child seek activities such .669 1 10.2 30.5 40.7 15.3 3.4
as pushing, pulling, dragging, lifting, 2 13.3 46.7 30.0 6.7 3.3
and jumping? 3 20.0 33.3 23.3 23.3 0.0
5. Does your child climb high into a .468 1 10.2 22.0 28.8 22.0 16.9
tree, jump off tall walls, or furniture, 2 10.0 23.3 36.7 20.0 10.0
etc.? 3 13.3 20.0 26.7 13.3 26.7
6. Does your child like giving bear .006* 1 20.3 39.0 32.2 6.8 1.7
hugs? 2 26.7 40.0 26.7 6.7 0.0
3 10.0 20.0 43.3 20.0 6.7
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n~59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
7. Does your child seem unsure of <001* 1 0.0 0.0 8.5 32.2 59.3
how far to raise or lower the body 2 0.0 0.0 10.0 26.7 63.3
during movement such as sitting down 3 0.0 16.7 33.3 23.3 26.7
or stepping over an object?
8. Does your child not notice falling? .397 1 0.0 1.7 8.5 13.6 76.3
2 0.0 3.3 10.0 13.3 73.3
3 0.0 3.3 10.0 33.3 53.3
9. Does your child like to be under .791 I 1.7 8.5 30.5 30.5 28.8
heavy blankets, covers, or pillows? 2 3.3 10.0 46.7 30.0 10.0
3 0.0 30.0 26.7 26.7 16.7
10. Does your child tend to break .164 I 0.0 5.1 6.8 52.5 35.6
toys? 2 0.0 6.7 10.0 60.0 23.3
3 6.7 3.3 26.7 46.7 16.7
11. Does your child chew on pens, .795 I 0.0 11.9 28.8 30.5 28.8
straws, etc.? 2 0.0 13.3 36.7 40.0 10.0
3 10.0 23.3 23.3 10.0 33.3
12. Does your child grasp objects so .002* 1 0.0 0.0 3.4 25.4 71.2
loosely that it is difficult to use the 2 0.0 0.0 3.3 30.0 66.7
object? 3 3.3 23.3 10.0 20.0 43.3
13. Does your child chew on nonfood .879 1 0.0 11.9 28.8 27.1 32.2
objects? 2 0.0 3.3 43.3 1 30.0 23.3
3 3.3 10.0 23.3 30.0 33.3
14. Does your child seem to exert too .096 1 0.0 5.1 18.6 30.5 45.8
much effort for the task, for example, 2 0.0 3.3 23.3 36.7 36.7
walks heavily, slams doors, or presses 3 3.3 20.0 26.7 13.3 36.7
too hard when using pencils or
crayons?
15. Does your child jump a lot? .077 I 10.2 22.0 35.6 23.7 8.5
2 13.3 33.3 33.3 13.3 6.7
3 13.3 13.3 36.7 26.6 10.0
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
16. Does your child have difficulty .513 I 1.7 3.4 11.9 30.5 52.5
playing with animals appropriately, 2 3.3 3.3 13.3 30.0 50.0
such as petting them with too much 3 0.0 3.3 33.3 16.7 46.7
force?
17. Does your child have difficulty <001* 1 0.0 1.7 8.5 27.1 62.7
positioning him/herself in a chair? 2 0.0 0.0 6.7 26.7 66.7
3 3.3 13.3 16.7 43.3 23.3
18. Does your child frequently hit, .120 1 0.0 0.0 15.3 47.5 37.3
bump, and/or push other children? 2 0.0 0.0 13.3 56.7 30.0
3 6.7 6.7 20.0 40.0 26.7
19. Does your child seem generally <001* 1 1.7 1.7 0.0 11.9 84.7
weak? 2 3.3 0.0 0.0 10.0 86.7
3 6.7 13.3 13.3 13.3 53.3
20. Compared to other children the .714 1 20.3 13.6 30.5 13.6 22.0
same age, does your child seem to 2 23.3 20.0 30.0 16.7 10.0
really enjoy activities that involve 3 23.3 20.0 16.7 23.3 16.7
jumping, crashing into things, pushing
or pulling or falling?
21. Does your child like getting bear .011* I 30.5 39.0 27.1 1 .7 1.7
hugs? 2 40.0 36.7 23.3 0.0 0.0
3 10.0 40.0 40.0 6.7 3.3
22. Does your child taste or chew on .002*
laf
0.0 3.4 8.6 25.9 62.1
toys, clothes, or other objects more 2 0.0 0.0 6.7 26.7 66.7
than other children? 3 6.7 3.3 20.0 36.7 33.3
23. Does your child crave hugging or .614 1 5.1 11.9 33.9 27.1 22.0
rough playing? 2 6.7 20.0 40.0 20.0 13.3
3 3.3 23.3 26.7 33.3 13.3
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
a fn=58.
* P 5 05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Q uestion
_ . P .
group A O S R N
24. Does your child chew on hard ,836a s
[ah
7.4 20.4 24.1 27.8 20.4
candy? 2a i 7.4 22.2 18.5 25.9 25.9
3a i 10.7 10.7 28.6 42.9 7.1
25. Does your child have difficulty .002* 1 0.0 1.7 8.5 23.7 66.1
sitting erect, or choose to H e down 2 0.0 3.3 10.0 23.3 63.3
instead of sitting up? 3 3.3 10.0 30.0 36.7 20.0
Tactile System
1 . Does your child dislike going .152 1 0.0 3.4 1.7 23.7 71.2
barefoot, not like to take his/her shoes 2 0.0 3.3 0.0 33.3 63.3
off or insist on always wearing shoes? 3 0.0 6.7 13.3 30.0 50.0
2. Does it bother your child to play .330^ 1 0.0 3.4 5.1 18.6 72.9
games with bare feet? 2 0.0 3.3 3.3 26.7 66.7
3 al
0.0 10.3 3.4 31.0 55.2
3. Is your child irritated by the feel of
9013m
1 0.0 1.7 35.6 32.2 30.5
certain clothing? 2 0.0 0.0 36.7 30.0 33.3
3 an
3.4 6.9 t 27.6 27.6 34.5
4. Does your child pull away from .006* 1 0.0 0.0 5.1 16.9 78.0
light touch? 2 0.0 0.0 3.3 13.3 83.3
3 3.3 0.0 20.0 33.3 43.3
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, 0, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
asWilcoxon signed rank was performed on 26 pairs because of missing data. a h n=54.
*'n=27. a Jn=28. ^Wilcoxon signed rank was performed on 29 pairs because of missing
data. a ln=29. a m Wilcoxon signed rank was performed on 29 pairs because of missing data.
a n n=29.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P -
group A O S R N
5. Does your child seem to lack the
009*a < >
I 0.0 0.0 0.0 8.5 91.5
normal awareness of being touched? 2 0.0 0.0 0.0 10.0 90.0
3 * p 0.0 0.0 10.3 27.6 62.1
6. Does your child resist or dislike .886 1 0.0 6.8 27.1 33.9 32.2
wearing clothing of certain textures? 2 0.0 3.3 30.0 33.3 33.3
3 3.3 6.7 26.7 20.0 43.3
7. Does your child react negatively to .096 I 0.0 5.1 6.8 32.2 55.9
the feel of new clothes? 2 0.0 3.3 10.0 33.3 53.3
3 0.0 13.3 20.0 30.0 36.7
8. Does your child tend to prefer to .005* 1 1.7 1.7 3.4 11.9 81.4
wear long sleeve shirts and long pants 2 0.0 0.0 0.0 10.0 90.0
regardless of the weather, for instance 3 0.0 6.7 13.3 20.0 60.0
prefers to wear long sleeves even when
it is warm outside?
9. Does your child seem excessively .098 1 0.0 3.4 13.6 28.8 57.6
ticklish? 2 0.0 3.3 3.3 33.3 60.0
3 0.0 10.0 16.7 30.0 43.3
10. Does your child like to cuddle up .030* 1 23.7 27.1 32.2 11.9 5.1
with a blanket or stuffed animal or 2 33.3 26.7 23.3 16.7 0.0
special pillow? 3 16.7 30.0 16.7 16.7 20.0
11. Does your child enjoy tickling as a .675 1 20.3 39.0 28.8 8.5 3.4
form of play? 2 20.0 43.3 23.3 10.0 r 3.3
3 26.7 36.7 30.0 0.0 6.7
12. Does your child avoid playing .029* 1 0.0 5.1 18.6 18.6 57.6
with "messy" things, i.e., finger paint, 2 0.0 6.7 20.0 20.0 53.3
mud, sand, glue, glitter, clay, etc.? 3 10.0 13.3 20.0 30.0 26.7
13. Does your child show an unusual .049* 1 1.7 10.2 18.6 39.0 30.5
dislike for having his/her hair combed, 2 0.0 6.7 26.7 33.3 33.3
brushed or styled? 3 6.7 30.0 16.7 16.7 30.0
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
a °Wilcoxon signed rank was performed on 29 pairs because of missing data. *Pn=29.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
14. Do rough bedsheets bother your
943a q
lar 0.0 5.3 10.5 19.3 64.9
child? 2“ 0.0 3.6 14.3 7.1 75
3* 0.0 3.7 11.1 22.2 63.0
15. Does wearing tuitleneck shirts ,662a u
lav
8.6 0.0 20.7 15.5 55.2
bother your child? 2 10.0 0.0 26.7 10.0 53.3
3a
W
3.6 14.3 7.1 28.6 46.4
16. Does your child prefer to touch .025* 1 1.7 0.0 16.9 16.9 64.4
rather than be touched? 2 0.0 0.0 16.7 16.7 66.7
3 3.3 13.3 20.0 26.7 36.7
17. Does your child seem driven to .556 I 5.1 10.2 22.0 22.0 40.7
touch different textures? 2 6.7 6.7 16.7 23.3 46.7
3 3.3 3.3 36.7 20.0 36.7
18. Does your child prefer to go .518 1 15.3 28.8 37.3 11.9 6.8
barefoot? 2 10.0 36.7 36.7 16.7 0.0
3 13.3 30.0 36.7 6.7 13.3
19. Does your child dislike wearing .455 1 5.1 3.4 27.1 35.6 28.8
hats, sunglasses, or other accessories? 2 3.3 6.7 23.3 36.7 30.0
3 13.3 3.3 33.3 10.0 30.0
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
^Wilcoxon signed rank was performed on 25 pairs because of missing data. “0=57.
“0=28. "0=27. au Wilcoxon signed rank was performed on 28 pairs because of missing
data. a v n=58. a w n=28.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
20. Does wearing fuzzy shirts bother ,486ax
l*y
0.0 1.9 13.2 15.1 69.8
your child?
2az
0.0 0.0 17.2 20.7 62.1
3ba
0.0 10.7 10.7 25.0 53.6
21. Does your child dislike wearing .915 1 1.7 1.7 10.2 13.6 72.9
pants or complain about the feel of 2 3.3 0.0 10.0 23.3 63.3
them brushing against his/her legs? 3 0.0 6.7 6.7 26.7 60.0
22. Does your child tend to wear 012*<* 1 0.0 1.7 5.1 13.6 79.7
coats or sweaters when they are not 2 0.0 0.0 3.3 10.0 86.7
needed?
3bc
0.0 3.4 17.2 17.2 62.1
23. Does your child appear to lack the .047* 1 0.0 0.0 1.7 8.5 89.8
normal awareness of being touched? 2 0.0 0.0 3.3 6.7 90.0
3 0.0 3.3 1 0.0 20.0 66.7
24. Does your child prefer textures of .838 1 1.7 16.9 30.5 22.0 28.8
certain clothing? 2 3.3 10.0 26.7 26.7 33.3
3 3.3 20.0 13.3 16.7 46.7
25. Does your child overreact to .495 1 1.7 5.1 30.5 40.7 22.0
minor injuries? 2 3.3 6.7 26.7 46.7 16.7
3 6.7 13.3 13.3 26.7 40.0
26. Does your child complain about ,883M 1* 0.0 0.0 3.4 5.2 91.4
irritating bumps on the bedsheets? 2bf 0.0 0.0 6.9 6.9 86.2
3 0.0 0.0 3.3 10.0 86.7
27. Does it bother your child to have .159 1 5.1 3.4 27.1 25.4 39.0
his/her finger or toe nails cut? 2 3.3 6.7 26.7 33.3 30.0
3 16.7 13.3 23.3 13.3 33.3
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
a x Wilcoxon signed rank was performed on 27 pairs because of missing data. a ^n=53.
a z n=29. b a n=28. “’ Wilcoxon signed rank was performed on 29 pairs because of missing
data. b c n=29. M Wilcoxon signed rank was performed on 29 pairs because of missing data.
> * 1 1 = 5 8 . b fn=29.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
28. Does your child struggle against .003* 1 0.0 0.0 6.8 45.8 47.5
being held? 2 0.0 0.0 3.3 43.3 53.3
3 3.3 3.3 33.3 30.0 30.0
29. Does your child dislike playing .262 1 0.0 5.1 6.8 11.9 76.3
games with his/her bare feet? 2 0.0 3.3 6.7 13.3 76.7
3 0.0 10.0 6.7 23.3 60.0
30. Does your child have a tendency .153 1 5.1 8.5 25.4 23.7 37.3
to touch things constantly? 2 3.3 13.3 20.0 20.0 43.3
3 6.7 16.7 26.7 26.7 23.3
31. D oes your child dislike getting .129 1 3.4 8.5 16.9 30.5 40.7
his/her hands messy or ask to wash 2 0.0 10.0 23.3 23.3 43.3
his/her hands when using things like 3 6.6 10.0 36.7 16.7 30.0
glue and glitter?
32. D oes your child avoid or dislike .095 1 0.0 3.4 11.9 30.5 54.2
playing with gritty things? 2 0.0 6.7 20.0 23.3 56.7
3 3.3 6.7 26.7 30.0 33.3
33. Do tags and collars on clothing .823 I 6.8 11.9 30.5 28.8 22.0
bother your child? 2 3.3 16.7 30.0 26.7 23.3
3 6.7 16.7 23.3 33.3 20.0
34. D oes your child demonstrate an .019* I 0.0 3.4 23.7 27.1 45.8
aversion to any form of clothing? 2 0.0 0.0 16.7 26.7 r 56.7
3 3.3 13.3 23.3 20.0 40.0
35. Does your child prefer certain .925 1 1.7 8.5 32.2 18.6 39.0
textures of clothing or particular 2 3.3 6.7 26.7 20.0 43.3
fabrics? 3 3.3 13.3 26.7 20.0 46.7
36. D oes it bother your child to have <001* t 0.0 0.0 8.5 37.3 62.7
his/her face touched? 2 0.0 0.0 10.0 20.0 70.0
3 3.3 16.7 1 30.0 20.0 30.0
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group I =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
- P
group A O S R N
37. Does it bother your child to have .035* I 1.7 8.5 20.3 40.7 28.8
his/her face washed? 2 0.0 6.7 16.7 46.7 30.0
3 3.3 26.7 33.3 13.3 23.3
38. Does your child object to being .013* 1 0.0 0.0 8.5 27.1 64.4
touched by familiar people? 2 0.0 0.0 10.0 20.0 70.0
3 3.3 0.0 26.7 30.0 40.0
39. Does it bother your child if he/she .024* 1 0.0 5.1 5.1 32.2 57.6
can not see who is touching him/her 2 0.0 6.7 0.0 33.3 60.0
when among familiar people at home 3 6.7 6.7 33.3 10.0 43.3
or school?
40. Does the feel of new clothes .427 1 0.0 3.4 10.2 28.8 57.6
bother your child? 2 0.0 0.0 16.7 30.0 53.3
3 0.0 6.7 16.7 33.3 43.3
41. Does your child resist or dislike .001* 1 0.0 0.0 5.1 15.3 79.7
wearing short sleeved shirts or short 2 0.0 0.0 0.0 10.0 90.0
pants? 3 0.0 6.7 3.3 33.3 56.7
42. Does your child seem to lack .143 1 0.0 1.7 1.7 16.9 79.7
awareness of being touched by others? 2 0.0 0.0 3.3 13.3 83.3
3 0.0 0.0 6.7 30.0 63.3
43. Does your child ask you to take .718 I 3.4 16.9 16.9 15.3 47.5
the tags and labels out of clothing or 2 0.0 23.3 20.0 13.3 43.3
only wear clothes which have had the 3 6.7 3.3 26.7 20.0 43.3
tags and labels removed?
44. Is your child irritated by tags on .875 1 3.4 16.9 15.3 37.3 27.1
clothing? 2 0.0 23.3 16.7 26.7 33.3
3 6.7 10.0 16.7 33.3 33.3
45. Is your child bothered by hair .051 1 0.0 5.1 16.9 20.3 57.6
brushing against his/her face? 2 0.0 0.0 16.7 23.3 60.0
3 6.7 16.7 6.7 26.7 43.3
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, 0, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
* p < .05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A o S R N
46. Does your child dislike the feeling .955 1 0.0 5.1 33.9 23.7 37.3
of certain clothing? 2 0.0 0.0 36.7 23.3 40.0
3 3.3 6.7 23.3 23.3 43.3
47. Does your child have an unusually .005*** 1 0.0 6.8 11.9 27.1 54.2
high tolerance for pain? 2 0.0 6.7 13.3 23.3 56.7
3h h
10.3 10.3 24.1 34.5 20.7
48. Does your child demonstrate an .013* 1 0.0 0.0 15.3 23.7 61.0
excessive need to touch? 2 0.0 0.0 13.3 26.7 60.0
3 10.0 3.3 16.71 30.0 40.0
49. Does your child display an .097 1 0.0 1.7 8.5 23.7 66.1
unusual need for touching certain 2 0.0 3.3 3.3 26.7 66.7
textures, surfaces, objects ortovs? 3 3.3 10.0 13.3 23.3 50.0
50. Does your child startle easily .008* I 0.0 3.4 8.5 44.1 44.1
when being touched unexpectedly? 2 0.0 0.0 14.0 46.7 46.7
3 6.7 13.3 16.7 26.7 36.7
51. Does wearing fuzzy socks bother .100w lb i 0.0 0.0 7.0 12.3 80.7
your child? 2 0.0 0.0 3.3 16.7 80.0
3b k
0.0 10.7 7.1 17.9 64.3
52. Does your child dislike eating .162 1 0.0 3.4 18.6 16.9 61.0
messy foods with his/her hands? 2 0.0 3.3 16.7 16.7 63.3
3 3.3 6.7 20.0 30.0 40.0
53. Does your child tend to feel pain .006*b l 1 0.0 1.7 6.8 23.7 67.8
less than others? 2 0.0 0.0 10.0 23.3 66.7
3 h n
10.3 10.3 13.8 20.7 44.8
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, 0, S, R, N" columns indicate frequency distribution percentages. Group I =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
hsWilcoxon signed rank was performed on 29 pairs because of missing data. b h n=29.
• “Wilcoxon signed rank was performed on 28 pairs because of missing data. b J ’ n=57.
b k n=28. b lWilcoxon signed rank was performed on 29 pairs because of missing data.
b n n=29.
* P < 05, Wilcoxon signed rank for matched groups.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
54. Does it bother your child when a .441 1 0.0 0.0 1.7 15.3 83.1
familiar person at home or school is 2 0.0 0.0 0.0 23.3 76.7
close by? 3 0.0 3.3 3.3 23.3 70.0
55. Does your child avoid touching .001* 1 0.0 0.0 1.7 16.9 81.4
different textures? 2 0.0 0.0 0.0 20.0 80.0
3 0.0 0.0 26.7 23.3 50.0
56. Does your child appear to resist .056 1 1.7 3.4 27.1 18.6 49.2
eating certain foods because of their 2 0.0 3.3 30.0 16.7 50.0
texture? 3 3.3 13.3 26.7 33.3 23.3
57. Does your child strongly dislike .183 1 0.0 0.0 3.4 18.6 78.0
being tickled? 2 0.0 0.0 0.0 23.3 76.7
3 0.0 6.7 3.3 26.7 63.3
58. Does your child avoid foods of .046* I 1.7 5.1 23.7 16.9 52.5
certain textures? 2 0.0 6.7 26.7 13.3 53.3
3 3.3 16.7 20.0 36.7 23.3
59. Does your child avoid getting .032* 1 0.0 1.7 13.6 20.3 64.4
his/her hands in finger-paint, paste, 2 0.0 3.3 10.0 23.3 63.3
sand, clay, mud, glue, etc.? 3 3.3 13.3 13.3 40.0 30.0
60. Does your child seek messy play .624 1 6.8 10.2 49.2 25.4 8.5
activities? 2 3.3 16.7 46.7 26.7 6.7
3 6.7 3.3 56.7 23.3 10.0
61. Does it bother your child to have <.001* lb o 1.7 1.7 17.2 19.0 60.3
his/her hair cut? 2 0.0 3.3 10.0 23.3 63.3
3 13.3 10.0 26.7 20.0 30.0
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
b o n=58.
* p < .05, Wilcoxon signed rank for matched groups.
1 0 0
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
Vestibular System
1 . Does your child rock while sitting? .283 1 0.0 0.0 10.2 25.4 64.4
2 0.0 0.0 6.7 30.0 63.3
3 0.0 3.3 10.0 36.7 50.0
2. Does your child seem excessively .002* 1 0.0 0.0 0.0 18.6 81.4
fearful of movement, i.e. going up and 2 0.0 0.0 0.0 20.0 80.0
down stairs, riding swings, teeter 3 0.0 13.3 23.3 13.3 50.0
totters, slides, or other playground
equipment?
3. Does your child get nausea or .086 1 0.0 0.0 1.7 15.3 83.1
vomit from movement experiences? 2 0.0 0.0 3.3 10.0 86.7
3 0.0 3.3 3.3 33.3 60.0
4. Does your child like to swing? .002* 1 50.8 35.6 13.6 0.0 0.0
2 63.3 26.7 10.0 0.0 0.0
3 20.0 43.3 26.7 6.7 3.3
5. Does your child demonstrate <001* 1 0.0 0.0 5.1 27.1 67.8
distress when he/she is moved or on 2 0.0 0.0 6.7 23.3 70.0
moving equipment? 3 0.0 13.3 30.0 23.3 33.3
6. Does your child's head move along .117** 1 23.7 10.2 18.6 25.4 22.0
with his/her eyes in activities such as 2 30.0 6.7 23.3 26.7 23.3
reading, following along with a parent 3*i 3.6 17.9 28.6 7.1 42.9
reading or playing computer a game?
7. Is your child frequently and easily .070* 1 1.7 0.0 5.1 33.9 59.3
confused about his/her location, for 2 3.3 0.0 0.0 36.7 63.3
example, gets lost in stores, or can't 3* 0.0 6.9 17.2 24.1 51.7
find the way to a familiar classroom?
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
b PWilcoxon signed rank was performed on 28 pairs because of missing data. I x >n=28.
*Wilcoxon signed rank was performed on 29 pairs because of missing data. ^=29.
* p < .05, Wilcoxon signed rank for matched groups.
1 0 1
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
8. Does your child have good <.001* 1 52.5 42.4 5.1 0.0 0.0
balance? 2 63.3 33.3 3.3 0.0 0.0
3 10.0 26.7 36.7 20.0 6.7
9. Does your child have to exert more <.001* I 0.0 0.0 3.4 22.0 74.6
effort to move than others, tire 2 0.0 0.0 0.0 23.3 76.7
easily from exertion and/or require 3 10.0 10.0 16.7 40.0 23.3
more sleep than others?
10. Does your child avoid balance <.001* I 0.0 0.0 3.4 8.5 88.1
activities such as walking on curbs or 2 0.0 0.01 3.3 10.0 86.7
uneven ground? 3 3.3 13.3 20.0 30.0 33.3
11. Is your child fearful of heights, .153 1 0.0 0.0 10.2 25.4 64.4
such as escalators, glass elevators, 2 0.0 0.0 6.7 30.0 63.3
stairs, etc.? 3 0.0 13.3 6.7 26.7 53.3
12. Does your child like fast .128 1 42.4 25.4 27.1 3.4 1.7
movements, such as being whirled 2 56.7 20.0 20.0 0.0 3.3
about or tossed in the air by an adult? 3 26.7 40.0 23.3 10.0 0.0
13. Does your child like climbing real .133 1 18.6 22.0 30.5 25.4 3.4
high? 2 23.3 23.3 33.3 20.0 0.0
3 13.3 26.7 23.3 26.7 10.0
14. Does your child like fast spinning .002*1 *
[b u
29.3 34.5 24.1 8.6 3.4
carnival rides such as merry-go-
2 bv
44.8 27.6 20.7 6.9 0.0
rounds? 3 16.7 30.0 23.3 16.7 13.3
15. Is your child fearful of activities <.001* 1 0.0 0.0 8.5 22.0 69.5
which require good balance? 2 0.0 0.0 6.7 16.7 76.7
3 3.3 13.3 23.3 43.3 16.7
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, 0, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
~**W ilcoxon signed rank was performed on 29 pairs because of missing data. b u n=58.
b v n=29.
* p < .05, Wilcoxon signed rank for matched groups.
102
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P ___
group A 0 S R N
16. When your child shifts his/her .020* I 0.0 1.7 8.5 39.0 50.8
body does he/she sometimes 611 out of 2 0.0 3.3 3.3 40.0 53.3
the chair? 3 0.0 16.7 6.7 46.7 30.0
17. Is your child sometimes unable to .018* 1 0.0 6.8 16.9 49.2 27.1
catch him/herself when falling? 2 0.0 6.7 16.7 50.0 26.7
3 0.0 26.7 13.3 46.7 13.3
18. Does your child seem to not get .279 1 1.7 1.7 6.8 27.1 62.7
dizzy when others usually do? 2 3.3 0.0 3.3 33.3 60.0
3 0.0 6.7 16.7 23.3 53.3
19. Does your child get car sick? .186 1 0.0 6.8 6.8 15.3 71.2
2 0.0 13.3 10.0 13.3 63.3
3 0.0 0.0 13.3 16.7 70.0
20. Does your child seem generally .005* I 1.7 0.0 1.7 5.1 91.5
weak? 2 3.3 0.0 0.0 3.3 93.3
3 3.3 16.7 10.0 16.7 53.3
21. Does your child spin ad whirl .503 1 0.0 1.7 11.9 25.4 61.0
more than other children? 2 0.0 3.3 10.0 10.0 56.7
3 3.3 6.7 6.7 33.3 50.0
22. Does your child rock him/herself .028* 1 0.0 0.0 1.7 5.1 93.2
when stressed? 2 0.0 0.0 0.0 6.7 93.3
3 0.0 0.0 13.3 16.7 70.0
23. Does your child like to be inverted
034*bw
1 22.0 37.3 35.6 1.7 3.4
or tipped upside down or enjoy doing 2 30.0 33.3 33.3 3.3 0.0
things like hanging upside down,
3b x
17.2 24.1 48.3 0.0 10.3
somersaults, etc.?
24. Is your child fearful of swinging or <.001* I 0.0 0.0 0.0 13.6 86.4
bouncing, or was as an infant? 2 0.0 0.0 0.0 10.0 90.0
3 1
0.0 16.7 13.3 26.7 43.3
Note. A = Always; O = Often; S = Sometimes; R = Rarely, N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=:30.
b w Wilcoxon signed rank was performed on 29 pairs because of missing data. b x n=29.
* p < .05, Wilcoxon signed rank for matched groups.
1 0 3
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
_ P . _
group A O S R N
25. Does your child experience .413 I 0.0 0.0 8.5 30.5 61.0
discomfort, nausea, or dizziness 2 0.0 0.0 13.3 26.7 60.0
following movement, especially 3 0.0 6.7 16.7 23.3 53.3
rotation?
26. Does your child tend to need .349 1 0.0 3.4 23.7 33.9 39.0
movement in order to "get going", 2 0.0 3.3 20.0 33.3 43.3
for example, after waking up from a 3 3.3 10.0 20.0 30.0 36.7
nap?
27. Does your child dislike sudden or .081 1 0.0 1.7 10.2 27.1 61.0
quick movement such as suddenly 2 0.0 0.0 6.7 30.0 63.3
stopping or going over a bump while 3 0.0 3.3 16.7 40.0 40.0
riding in the car?
28. Compared to other children the .938 1 1.7 5.1 28.8 25.4 39.0
same age, does your child seem to ride 2 0.0 0.0 33.3 30.0 36.7
longer and harder on certain 3 3.3 16.7 13.3 13.3 53.3
playground equipment, for example,
swing, merry-go-round?
29. Does your child avoid rapid or .013* 1 0.0 3.4 8.5 37.3 50.8
spinning movement? 2 0.0 3.3 3.3 30.0 63.3
3 0.0 16.7 20.0 30.0 33.3
30. Is your child fearful of activities in <001* 1 0.0 0.0 10.2 35.6 54.2
which he/she moves through space? 2 0.0 0.0 6.7 30.0 63.3
3 0.0 10.0 36.7 30.0 23.3
31. Does your child demonstrate <.001* I 0.0 0.0 5.1 23.7 71.2
distress when his/her head is in any 2 0.0 0.0 3.3 23.3 73.3
other position than upright or vertical 3 3.3 6.7 20.0 40.0 30.0
such as having the head tilted
backward or upside down?
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
* p < .05, Wilcoxon signed rank for matched groups.
1 0 4
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A O S R N
32. Does your child react negatively <001* I 0.0 0.0 1.7 22.0 76.3
to, dislike, appear threatened by, or 2 0.0 0.0 0.0 13.3 86.7
exhibit a fear reaction to movement? 3 0.0 3.3 40.0 23.3 33.3
33. Does your child enjoy excessive .020* 1 8.5 11.9 28.8 22.0 28.8
spinning and twirling? 2 10.0 13.3 33.3 20.0 23.3
3 6.7 6.7 10.0 36.7 40.0
Visual System
1 . Does your child have trouble .043*^
Jbz
1.8 8.8 19.3 31.6 38.6
telling the difference between different 2« 3.4 10.3 6.9 44.8 34.5
printed figures that appear similar, for 3d* 7.4 22.2 29.6 22.2 18.5
example, confusing b with p, or
+ withx?
2. Is your child sensitive to or .065 I 0.0 6.8 15.3 28.8 49.2
bothered by light, especially bright 2 0.0 3.3 13.3 30.0 53.3
light (blinks, squints, cries or closes 3 0.0 6.7 30.0 30.0 33.3
eyes, etc.)?
3. When looking at pictures, does ,180« 1 1.7 0.0 20.3 35.6 42.4
your child focus an patterns or details 2 3.3 0.0 16.7 36.7 43.3
instead ofthe main pictures? 3 « * 0.0 6.9 31.0 34.5 27.6
4. Is your child able to look at .004* I 66.1 28.8 5.1 0.0 0.0
something for away? 2 70.0 23.3 6.7 0.0 0.0
3 33.3 46.7 13.3 0.0 6.7
5. Does your child have difficulty <001* 1 0.0 1.7 25.4 40.7 322
keeping his/her eyes on the task or 2 0.0 0.0 33.3 43.3 23.3
activity at hand? 3 6.7 36.7 40.0 10.0 6.7
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=S9; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
^Wilcoxon signed rank was performed on 26 pairs because of missing data. b z n=57.
c,n=29. c b n=27. “ Wilcoxon signed rank was performed on 29 pairs because of missing
data. c d n=29.
* p < .05, Wilcoxon signed rank for matched groups.
105
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P .
group A 0 S R N
6. Does your child have trouble .002* I 1.7 1.7 35.6 30.5 30.5
maintaining his/her visual focus on one 2 3.3 0.0 40.0 33.3 23.3
task or object very long? 3 6.7 40.0 26.7 16.7 10.0
7. Does your child rub his/her eyes, .281 1 0.0 0.0 1.7 10.2 88.1
complain of headaches or have eyes 2 0.0 0.0 3.3 10.0 86.7
which water after reading or looking 3 3.3 3.3 0.0 20.0 73.3
at books?
8. Does your child have difficulty with .026*“ I 0.0 0.0 1.7 15.3 83.1
visually focusing on things for away? 2 0.0 0.0 3.3 16.7 80.0
3rf 0.0 0.0 24.1 24.1 51.7
9. Does your child become easily <001* 1 3.4 3.4 20.3 42.4 30.5
distracted by visual stimuli? 2 6.7 3.3 20.0 43.3 26.7
3 10.0 30.0 36.7 16.7 6.7
10. Does your child have trouble .084= 6 I 0.0 0.0 22.0 37.3 40.7
locating things laying on top of other 2 0.0 0.0 23.3 43.3 33.3
things, especially things of the same
3*
0.0 6.9 44.8 17.2 31.0
color, or have trouble finding an object
when it is amidst a group of other
things?
11. Does your child close one eye .007* 1 0.0 0.0 0.0 8.5 91.5
and/or tip his/her head back when 2 0.0 0.0 0.0 3.3 96.7
looking at something or someone? 3 0.0 0.0 16.7 16.7 66.7
12. Does your child have difficulty .018* 1 0.0 0.0 3.4 16.9 79.7
with unusual visual environments such 2 0.0 0.0 3.3 10.0 86.7
as a bright colorful room or a dimly lit 3 0.0 3.3 6.7 36.7 53.3
room?
Note. A = Always; 0 = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, 0, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
“ Wilcoxon signed rank was performed on 29 pairs because of missing data. c fn=29.
‘ sWilcoxon signed rank was performed on 28 pairs because of missing data. <*0=58.
* p < .05, Wilcoxon signed rank for matched groups.
106
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P
group A 0 S R N
13. Does your child have difficulty .036*d I 0.0 0.0 0.0 8.5 91.5
with visually focusing on things close? 2 0.0 0.0 0.0 6.7 93.3
39 0.0 3.4 6.9 21.0 69.0
14. Does your child have difficulty <001** 1 0.0 0.0 1.7 18.6 79.7
controlling eye movements during 2 0.0 0.0 0.0 20.0 80.0
activities such as following objects 3d 0.0 10.7 21.4 28.6 39.3
with eyes, keeping place while
reading or copying from blackboard
to desk?
IS. Compared to other children the <.001* 1 0.0 5.1 10.2 30.5 54.2
same age, does your child seem to be 2 0.0 6.7 0.0 33.3 60.0
easily distracted by visual stimuli? 3 6.7 26.7 36.7 13.3 16.7
16. Does your child have trouble <001* 1 0.0 0.0 0.0 20.3 79.7
following objects with his/her eyes? 2 0.0 0.0 0.0 13.3 86.7
3 0.0 6.7 26.7 23.3 43.3
17. Does your child have difficulty .007* 1 0.0 1.7 6.8 27.1 64.4
naming, discriminating, or matching 2 0.0 3.3 3.3 26.7 66.7
colors, shapes, sizes? 3 0.0 6.7 26.7 30.0 36.7
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, 0, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
“Wilcoxon signed rank was performed on 29 pairs because of missing data. °>n=29.
'•‘Wilcoxon signed rank was performed on 28 pairs because of missing data. dn=28.
* p < .05, Wilcoxon signed rank for matched groups.
1 0 7
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
question
P _
group A 0 S R N
18. Did your child make reversals in
.cm
I® 0.0 0.0 40.0 40.0 20.0
words or letters when writing or 2“ 0.0 0.0 0.0 50.0 50.0
copying or read words backwards 3* 0.0 66.7 0.0 0.0 33.3
(such as reading saw for was) after the
first grade?
19. Does your child lose his/her place 1.00“) 1 ® 0.0 0.0 16.7 50.0 33.3
on a page while reading, copying, 2* 0.0 0.0 20.0 50.0 30.0
solving problems or performing 3* 0.0 25.0 37.5 25.0 12.5
manipulations?
20. Does your child have difficulty .250“ lC T 0.0 0.0 0.0 15.4 84.6
shifting gaze from the board to the
2 < w
0.0 0.0 0.0 40.0 60.0
paper when copying from the board?
3«
0.0 16.7 16.7 50.0 16.7
Note. A = Always; O = Often; S = Sometimes; R = Rarely; N = Never. Numbers in
the "A, O, S, R, N" columns indicate frequency distribution percentages. Group 1 =
children without disorders, n=59; Group 2 = children without disorders included in the
matched study, n=30; Group 3 = children with sensory integration disorders, n=30.
°m Wilcoxon signed rank was not performed because of the amount of missing data. “ 0=5.
c o n=2. ^ = 3 . “tWilcoxon signed rank was performed on 4 pairs because of missing data.
an=l8. c s n=10. an=8. “ Wilcoxon signed rank was performed on 3 pairs because of
missing data. ^0=13. c w n=5. «n=6.
* p < .05, Wilcoxon signed rank for matched groups.
108
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Appendix H
Suggestions for Question Changes
Question Suggested Change
Auditory System
8. Is your child bothered by the sounds of 8. Is your child bothered by any
any household or ordinary items, such as household or ordinary sounds, such as
squeaky shoes, the vacuum, the blow squeaky shoes, the vacuum, the blow
dryer, dog barking, etc.? dryer, a dog barking, etc.?
10. Does your child fail to follow through 10. Does your child fail to act upon a
to act upon a request to do something or request to do something or fail to
to understand directions? understand directions.
25. Is your child bothered by or respond 25. Does your child appear bothered by or
negatively such as running away, crying respond negatively, such as running away,
or hold hands over ears to unexpected crying or holding hands over ears, to
sounds or noises? unexpected sounds or noises?
26. Does your child seem confused as to 26. Does your child seem confused as to
the direction of sounds or where sound is the direction from where sounds are
coming from? coming?
(table continues)
1 0 9
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Question Suggested Change
28. Is your child easily distracted by 28. Is your child easily distracted by
irrelevant or background noises such as irrelevant or background noises such as a
lawn mower outside, children talking in lawn mower outside, children talking in
the back of the room, crinkling paper, air the back or the room, crinkling paper, air
conditioners, refrigerators, fluorescent conditioners, refrigerators, fluorescent
lights? lights?
30. Does your child need to have things, 30. Does your child need to have things,
especially directions repeated or says especially directions repeated or say
"what" a lot? "what" a lot?
Gustatory System
2. Does your child show definite 2. Does your child excessively refuse to
preferences for certain tastes? eat foods of certain tastes?
5. Does your child complain that foods 5. Does your child complain that foods
are too bland? are too bland or refuse to eat bland foods?
7. Does your child season his/her food 7. Does your child season his/her food
heavily, for example, using excessive salt, heavily or indicate a desire for heavy
ketchup or other spices? seasoning such as excessive salt, ketchup
or other spices?
/table continues)
1 1 0
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Question Suggested Change
9. Is your child willing to season his/her 9. Will your child season his/her food or
food? allow a parent to season his/her food when
offered?
10. Does your child like very salty foods? 10. Does your child prefer very salty
foods?
Olfactory System
2. Does your child seem to have a very 2. Does your child seem to have an overly
sensitive sense of smell? sensitive sense of smell?
6. Does your child find bathroom odors 6. Does your child find odors such as
and personal hygiene smells offensive? bathroom cleansers and sprays or the
odors of personal hygiene such as
deodorants or hair spray offensive?
12. Does your child interact with objects 12. Does your child smell objects which
by smelling? someone would not ordinarily smell?
(table continues)
1 1 1
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Question Suggested Change
Proprioceptive System
4. Does your child seek activities such as
pushing, pulling, dragging, lifting and
jumping?
17. Does your child have difficulty
positioning his/herself in a chair?
18. Does your child frequently hit, bump
and or push other children?
20. Compared with other children the
same age, does your child seem to really
enjoy activities that involve jumping,
crashing into things, pushing or pulling or
Ming?
4. Does your child seem driven to seek
activities such as pushing, pulling,
dragging, lifting, and jumping?
17. Does your child have difficulty
positioning him/herself in a chair?
18. Does your child frequently hit, bump,
and/or push other children?
20. Compared with other children the
same age, does your child seem to
participate more in activities that involve
jumping, crashing into things, pushing,
pulling, or Ming?
(table continues)
1 1 2
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Question Suggested Change
Tactile System
12. Does your child avoid playing with 12. Does your child avoid playing with
"messy" things, i.e., finger paint, mud, "messy" things such as finger paint, mud,
sand, glue, glitter, clay, etc.? sand, glue, glitter, or clay?
19. Does your child dislike wearing hats, 19. Does your child have an unusual
sunglasses or other accessories? dislike for wearing hats, sunglasses, or
other accessories?
Vestibular System
2. Does your child seem excessively 2. Does your child seem excessively
fearful of movement, i.e. going up and fearful of movement such as going up and
down stairs, riding swings, teeter totters, down stairs, riding swings, going on teeter
slides, or other playground equipment? totters, slides, or other playground
equipment?
16. When your child shifts his/her body 16. When your child shifts his/her body,
does he/she sometimes fall out of his does he/she fall out of the chair?
chair?
17. Is your child sometimes unable to 17. Is your child unable to catch
catch him/herself when falling? him/herself when falling?
(table continues)
113
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.
Question Suggested Change
Visual
1 . Does your child have trouble telling the
difference between different printed figures
that appear similar, for example, confusing
b with p, or + with x?
14. Does your child have difficulty
controlling eye movements during
activities such as following objects with
eyes, keeping place while reading or
copying from blackboard to desk?
System
1. Does your child have trouble telling the
difference between printed figures that
appear similar, for example differentiating
between b and p, or + and x?
14. Does your child have difficulty
controlling eye movements during
activities such as following objects like a
ball with the eyes, keeping place while
reading, or copying from blackboard to
desk?
114
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

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Asset Metadata

Creator Johnson, Cheryl Lanae (author)

Core Title A study of a pilot sensory history questionnaire using contrasting groups

School Graduate School

Degree Master of Arts

Degree Program Occupational Therapy

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag health sciences, rehabilitation and therapy,OAI-PMH Harvest,psychology, developmental

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Parham Diane (committee chair), Clark, Florence (committee member), Neville-Jan, Ann (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c16-6317

Unique identifier UC11336704

Identifier 1381591.pdf (filename),usctheses-c16-6317 (legacy record id)

Legacy Identifier 1381591.pdf

Dmrecord 6317

Document Type Thesis

Rights Johnson, Cheryl Lanae

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA