Sensory Processing and Behavior Checklist

Sensory Processing and Behavior Checklist

This is a brief informal checklist to help you decide if your child may have sensory processing issues that interfere with his/her ability to function at home, at school, or in the community. Two “Yes” responses in any single category of the checklist or one “Yes” response in Behavior and two “When my child was Younger” responses in other categories may indicate that a child evaluation or parent consultation is appropriate. Please call me for a free phone consultation to help determine if the services I provide match with the needs of your child.

Key: Y =Yes N = No S = Sometimes WY = Yes (When my child was Younger)

Sensory Processing

1. Is your child picky about how things feel? Y N S WY
2. Does your child dislike the feeling of certain textures of fabric? Y N S WY
3. Does your child dislike wearing particular types of clothes such as jeans or collar shirts? Y N S WY
4. Does your child strongly object to having his/her hair combed, brushed, or washed? Y N S WY
5. Does your child strongly prefer or avoid wearing long sleeve shirts or short sleeve shirts, loose clothes or tight clothes? Y N S WY
6. Does your child dislike wearing shoes and/or socks? Y N S WY
7. Does your child dislike or crave getting his/her hands messy? Y N S WY
8. Does your child avoid or only “lean in” for hugs unless he/she has asked for one? Y N S WY
9. Is your child sensitive to sounds? Y N S WY
10. Does your child over-react to loud sounds such as sirens, vacuum cleaners, or hand dryers? Y N S WY
11. Does your child notice environmental sounds such as a truck going by, airplane over-head, or the heat or AC clicking on/off? Y N S WY
12. Does your child seem to not listen to you or frequently need you to repeat what you say? Y N S WY
13. Does your child become anxious in noisy environments or avoid them? Y N S WY
14. Is your child a picky eater? Y N S WY
15. Does your child have a strong dislike for certain textures of food? Y N S WY
16. Will your child eat only a very limited number foods or type of food? Y N S WY
17, Does your child have a strong need to control what they eat, insisting on one food or rejecting what you offer? Y N S WY

Behavior

18. Does your child seem oppositional or have a strong need to control the situation? Y N S WY
19. Does your child have a lot of difficulty with change or transitions? Y N S WY
20. Does your child get frustrated or angry very easily? Y N S WY
21. Does your child seem anxious? Y N S WY
22. Is your child impulsive? Y N S WY
23. Does your child have tantrums or “melt downs” more frequently than other children their age? Y N S WY
24. Does your child have a lot of difficulty calming down after getting upset? Y N S WY
25. Does your child have a lot of difficulty letting go of a topic, an idea, or getting what they want? Y N S WY

Sensory Seeking

26. Does your child frequently chew on the collar/cuff of their shirt, fingers, toys, or other non-food objects? Y N S WY
27. Does your child frequently talk, sing, hum, or make other sounds when the situation doesn’t call for it? Y N S WY
28. Does your child like to crash into things by running or jumping into them? Y N S WY
29. Does your child frequently spin or run around in circles? Y N S WY
30. Does your child have a strong need for movement? Y N S WY
31. Does your child have a strong need to fidget with objects in his/her hands? Y N S WY
32. Does your child have a strong need to touch objects or people? Y N S WY
33. Does your child tend to get over focused on something or jump quickly from one activity to the next? Y N S WY