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Outcome Measure: Sensory Screening Tool

Step 1 of 6

Touch Sense

Q1
Objects to washing face, hair, or body
Q2
Reacts negatively to unexpected touch
Q3
Dislikes light touch
Q4
Objects to getting haircuts
Q5
Dislikes brushing teeth
Q6
Resists nail trimming
Q7
Dislikes certain clothing fabrics
Q8
Avoids getting hands or face messy
Q9
Dislikes or insists on wearing socks
Q10
Insists on or refuses to wear shoes, sneakers, sandals, or boots
Q11
Avoids or excessively craves physical contact such as hugs, cuddles, and kisses
Q12
Frequently touches or fidgets with toys or other objects
Q13
Craves or avoids certain food textures, such as dry, slippery, chewy, crunchy, or mixed
Q14
Mouths nonfood objects such as hands, clothing, toys
Q15
Particular about pajamas and bed linens
Q16
Unusually aware or unaware of changes in temperature
Q17
Avoids or excessively craves physical contact such as hugs, cuddles, and kisses
Q18
Seem oversensitive or undersensitive to minor injuries
Q19
Engages in repetitive tactile behaviors such as tapping, rubbing, squeezing, banging
Additional notes and observations: