SENSORY PROFILE

ADOLESCENTS AND ADULTS

Catana Brown, Ph.D., OTR, FAOTA
Winnie Dunn, Ph.D., OTR, FAOTA

Self Questionnaire
Nombre:______________________________________________Edad:________Fecha:_________
Fecha de nacimiento: _________________________________Género: masculino
female
Are there aspects of your daily life that do not satisfy you? If yes, please explain them _____________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

INSTRUCTIONS
Please check the box that best describes the frequency with which you engage in the following behaviors.
If you do not know it since you have no experience in that particular behavior,
please draw an X over the item number. You can write any comments at the end of each section.

Please respond to all statements. Use the following references to mark your answer.
ALMOST NEVERWhen the opportunity arises, you almost never respond that way.
(approximately 5% or less of the time).
RARELY When the opportunity arises, you rarely respond that way.
(approximately 25% of the time).
SOMETIMES When the opportunity arises, you sometimes respond that way.
(approximately 50% of the time).
FREQUENTLY When the opportunity arises, you often respond that way.
(approximately 75% of the time).
ALMOST ALWAYS When the opportunity arises, you almost always respond that way.
(approximately 95% or more of the time).
 F

ITEM A. Taste/Olfaction Processing

1 I leave or run to another place when I smell odors in a
store (for example, bath products, candles, or perfumes).
2 I add seasonings/spices to my food.

3 I don't smell things that other people say smell.

4 I enjoy being close to people who wear perfumes or

lotions.
5 Only eat familiar/known foods.

6 Many foods have no flavor for me (in other words,

they don't have much taste or are bland.
7 I don't like strong mint or sweet flavors.
example, spicy/cinnamon or sour candies.
8 I am going to smell fresh flowers when I see them.

Comentarios:

ITEM B. Movement Processing

9 I am afraid of heights.

10 I enjoy how I feel when I move (for example,

dancing, running.
11 I avoid elevators and/or escalators because I do not
likes the movement.
12 Tropiezo o me choco con las cosas.

13 I don't like the movement of driving a car.

14 I choose to participate in physical activities.

15 I don't feel safe when I walk down stairs.

for example, I trip, lose my balance or /and need
hold me by the handrail.
16 I get dizzy easily (for example, after bending over,
get up quickly.
Comentarios:
 F

ITEM C. Visual Processing

17 I like to go to places that have bright lights and are
colorful.
18 I keep the curtains down during the day when I am in
house
19 I like to dress in colorful clothes.

20 I feel frustrated when I try to find something in a drawer.

full of things or in a messy room.
21 I can't find the street, the building, or signs of a hall when
I am going to new places.
22 I am bothered by visual images that move quickly or are
unstable in cinema or TV.
23 I don't notice when people enter a place/room.

24 I choose to shop at small stores/shops.

Why do I feel overwhelmed in large stores.
25 It annoys me when I see a lot of people around me.
example, in a full shopping mall, parade, carnival.
26 I limit distractions when I work (for example, I close the
door, or I turn off the TV).
Comentarios:

ITEM D. Tactile Processing

27 I dislike rubbing my back.

28 I like how it feels to get my hair cut.

29 I avoid using gloves during activities that may

get my hands dirty.
30 I touch others when I am talking (for example, I put my
hand on his shoulder or I hold his hand.
31 It bothers me the feeling in my mouth when I wake up in the
tomorrow.
32 I like to go barefoot.

33 I am uncomfortable using certain fabrics (for example, wool,

silk, corduroy, labels on clothing.
34 I don't like certain textures of foods (for example, skin of the
peach, apple juice, cottage cheese, chunky peanut butter.
35 I move away when others get too close to me.

36 I don't notice when my hands or face are dirty.

37 I have scratches or bruises, but I don't remember how I got them.

I did.
38 I avoid standing in lines or standing close to other people because I don't
I like to be very close to others.
39 I don't notice when someone touches my arm or my back.

Comments
 F

ITEM E. Level of Activity

40 I work on two or more tasks at the same time.

41 It takes me longer than other people to wake up in the

mornings.
42 I do things on impulse or in the moment (in other words,
I do things without having a plan in mind.
43 I find time to step away from my busy life and spend
time alone.
44 I seem slower than others when I try to do an activity.
or a task.
45 I don't understand jokes as quickly as others.

46 I stay away from crowds.

47 I find activities to do in front of others (e.g. music,

sports, acting, public speaking, and answering questions in class.
48 I find it difficult to concentrate all the time when
I am sitting in a class or a large meeting.
49 I avoid situations where unexpected things can happen (e.g. going
to unknown places or being surrounded by people I don't know)
Comentarios:

ITEM F. Auditory Processing

50 I hum, whistle, sing or make noises.

51 I am easily startled by unexpected or loud noises (e.g.

vacuum cleaner, dog barks, phone calls.
52 I have trouble following what people are saying when
they speak quickly or they are subjects little known to me.
53 I leave spaces where others are watching TV, or I ask them to
turn down the volume.
54 I get distracted if there is too much noise around me.

55 I don't realize when they call my name.

56 I use strategies to cover the sound (e.g. I close the door, I cover my
ears, I use ear plugs.
57 I stay away from noisy places.

58 I like going to events with a lot of music.

59 I have to ask people to repeat things.

60 I find it difficult to work with background noise (e.g. fan, radio).

Comentarios:
 SCORE SHEET

QUADRANT
Instructions: Transfer the raw score from the Self-Questionnaire for the item that corresponds to each item.
from the list (refer to the User Manual for instructions on how to obtain the raw score).
Add the Gross Score from the column to obtain the Total Gross Score for each quadrant.

Quadrant Quadrant Quadrant Quadrant

1 2 3 4
UNDER RECORD SENSORY SEARCH SENSORY SENSITIVITY SENSORY AVOIDANCE

ITEM Score ITEM Score ITEM Score ITEM Score

Gross Gross Gross Gross
3 2 7 1
6 4 9 5
12 8 13 11
15 10 16 18
21 14 20 24
23 17 22 26
36 19 25 29
37 28 27 35
39 30 31 38
41 32 33 43
44 40 34 46
45 42 48 49
52 47 51 53
55 50 54 56
59 58 60 57
Score Score Score Score
Gross Total Gross Total Gross Total Gross Total
Quadrant Quadrant Quadrant Quadrant

REFERENCE PUNCTUATION REFERENCE ICON

1 Almost Never UNDER RECORD

2 Rarely SENSORY SEARCH

3 Sometimes SENSORIAL SENSITIVITY

4 Frequently SENSORIAL AVOIDANCE

5 Almost Always

Translation made by Lic. TO Mariel Pellegrini from Alpha Ocupacional for educational purposes and authorized by Catana Brown, Ph.D.
OTR, FAOTA. June [Link]
 SUMMARY OF QUADRANTS
Instructions: Choose the most appropriate Quadrant Summary Chart and transfer the Total Gross Score of the Quadrant
de la página anterior al casillero que corresponda del Gráfico de Resumen de Cuadrante. Marcar estos totales con una X en la
appropriate classification column (Much less than most people, Less than most people, etc.).*

SUMMARY GRAPH OF THE QUADRANT FOR AGES 11–17 YEARS.

Much less Less than the Similar to the More than the Much more than
Score that the majority majority of the majority of majority of most of the
Quadrant Total Gross of the people people the people the people people
Quadrant

1. Low Registration /75 15 ------ 18 19 ------ 26 27 ----- 40 41 ------ 51 52 ----- 75

2. Sensory Search /75 15 ------ 27 28 ------ 41 42 ----- 58 59 ----- 65 66 ----- 75

3. Sensitivity /75 15 ------ 19 20 ----- 25 26 ----- 40 41 ----- 48 49 ----- 75

Sensory
4. Sensory Avoidance /75 15 ------ 18 19 ------ 25 26 ----- 40 41 ----- 48 49 ----- 75

Classification based on the performance of persons without disabilities (n= 193)

SUMMARY CHART OF THE QUADRANT FOR AGES 18–64.

Much less Less than the Similar to the More than the Much more than
Score that the majority majority of the majority of majority of the majority of the
Quadrant Gross Total of the people people the people the people people
Quadrant

1. Low Registration /75 15 ------ 18 19 ------ 23 24 ----- 35 36 ----- 44 45 ----- 75

2. Sensory Search /75 15 ------ 35 36 ------ 42 43 ----- 56 57 ----- 62 63 ----- 75

3. Sensitivity /75 15 ------ 18 19 ----- 25 26 ----- 41 42 ----- 48 49 ----- 75

Sensory
4. Sensory Avoidance /75 15 ------ 19 20 ------ 26 27 ----- 41 42 ----- 49 50 ----- 75

Classification based on the performance of persons without disabilities (n= 496)

SUMMARY GRAPH OF THE QUADRANT FOR AGES 68 YEARS OR OLDER
Much less Less than the Similar to the More than the Much more than
Score that the majority majority of the majority of majority of the majority of the
Quadrant Gross Total of the people people the people the people people
Quadrant

Under Registration /75 15 ------ 19 20 ------ 26 27 ----- 40 41 ----- 51 52 ----- 75

[Link] Search /75 15 ------ 28 29 ------ 39 40 ----- 52 53 ----- 63 64 ----- 75

[Link] /75 15 ------ 18 19 ------ 25 26 ----- 41 42 ----- 48 49 ----- 75

Sensory
4. Sensory Avoidance /75 15 ------ 18 19 ------ 25 26 ----- 42 43 ----- 49 50 ----- 75

Classification based on the performance of people without disabilities (n= 261).

QUADRANT PROFILE
Instructions: Transfer the information from the classification columns of the Quadrant Summary Chart (marked areas
with an X) to the Quadrant Profile. Circle the classification symbol in the quadrant that corresponds to the information of
classification for that quadrant. Finally, check the appropriate age box.

The following symbols are used to represent the classifications of the Quadrant Profile:

Much less than most people

Less than most people
Similar to most people
+ More than most people
++ Much more than most people

See Chapter 5 for more information related to interpretation and intervention.

Mark the correct age:

11–17 years
18-64 years
65 years or older

Translation made by Lic. TO Mariel Pellegrini, from Alpha Ocupacional for educational purposes and authorized by Catana Brown, Ph.D.
OTR, FAOTA. June [Link]