Fill in the following check list. If you have checks in that category, you likely suffer that sensory issue. The more checkmarks, the more severe and handicapping is the condition.

Sensory Modulation

Sensory Avoiding

__Dislike being touched, especially unexpected light touch, and avoid crowds, lines or any situation involving close physical contact

__Startle to loud, sudden, piercing sounds; hard to shut out background noise

__Wince at bright lights like sunlight -- must wear sunglasses even on rainy day -- & fluorescent lights; bothered by TV, flickering lights, computer graphics

__Bothered by odors others don’t notice, like musty sheets, or chemical odors like chlorine bleach or perfumes

__Anxious or panicky going down an escalator, riding in an elevator, driving through a tunnel, riding on a roller coaster or spinning rides

__Low pain threshold – anxious when getting injections

__Dislike getting hit or splashed by water – taking a shower, at the ocean, caught in rain

Sensory Seeking

__Seem unaware of touch unless very intense

__Powerful need for deep pressure from hugs, contact sports (football), sex, sometimes abusive; may intrude on another’s space

__Drawn to TV, flickering lights, computer graphics

__Love loud, pounding music; blast TV

__Wear strong perfumes

__Like intensely stimulating -- malls, rock concerts, amusement parks

__Seek out intense sensations such as fast driving, roller coasters, parachuting, skiing, horseback riding, deep sea diving and so

__"Thrill-seeker," dangerous at times

__Enjoy wearing, tight, flashy clothes with rough, fuzzy, or uneven texture

__Like excessively hot or cold water or drinks

__Crave excessively spicy, sweet, sour, or salty foods

__Seek stimulants, like caffeine, nicotine, cocaine, speed

__Under-react to pain

__Self-abusive -- pinching, biting, slicing

__Mouth objects like pens or straws excessively

__Fidget constantly: with keys, change in pocket, a pen/pencil, paper clip, rubber band; twist hair; crack knuckles

__Grind teeth night and day

__Crack knuckles

Arousability(Sleep/wake cycle; ability to achieve, change, & appropriate states):

__Problemsfalling asleep; staying asleep; waking up

__Hyperactive

__Unusually sluggish and passive

__Vacillate between needing to calm down or rev up; little time in comfort zone

Rhythms

__Irregular heart rate

__Fast, shallow breathing

__Too hot, too cold, or vacillating between too hot and too cold

__Undereat or overeat

__Problem ingesting, digesting and eliminating

__Underactive or can’t sit still

__Speak too fast or too slow

Emotional Regulation

__Emotions run away or appear hidden; in relationships, inappropriately excessive

__Emotions lack range and depths and in relationships may be deficient

__Emotionally labile

__Emotionally dead

Behavioral Organization

__Messy

__Easily disorganized

__Avoid anything new or seek novelty and thrills

Sexuality

__Difficulties in sexual relationships

__Little or no sex drive, or obsessed with sex

__Sexual touch feels aversive or overstimulating or overly sexed

Sensory Discrimination

Poor Tactile Discrimination

__Seem out of touch with hands, as if unfamiliar appendages

__Unable to identify which body parts have been touched without looking

__Fearful in the dark

__Unable to identify objects by feel-- need to see keys to perceive they are in hand

__Need visual cues to zip, button and unbutton clothes and other motor tasks

__Dress messily & look disheveled with shirt half untucked, shoes untied, pants not pulled up

__Have difficulty with fine motor skills, such as buttoning, zipping, writing, or using silverware as may not always feel which finger is which or where each one is located

__Unable to tell if touch is friendly or threatening and may lash out aggressively to benign touch, e.g., perceiving a bump as a blow and feel as if being attacked

__Misjudge spatial relationships of objects in the environment, often bumping into furniture, mis-stepping on stairs and curbs, driving over a curb or hitting another car

Poor Body Awareness

__Unsure of where body parts are or how they interrelate

__Have poor difficulty orienting arms and hands, legs and feet to get dressed

__Withdraw from movement to avoid touch sensations, and may bump into things to figure out where you end and the world begins

__May feel separate from body – depersonalization

Poor Auditory Discrimination

__Difficulty attending to, understanding & remembering what is said or read & misinterpret requests

__Fail to understand or follow two sequential directions at a time

__Trouble articulating thoughts verbally or in writing

__Problem responding to others’ questions/comments; need what is said repeated

__Difficulty discerning if a sound is near of far; may be misdiagnosed with attention deficit disorder (ADD) rather than a problem with auditory discrimination

__Problems reading (dyslexia) and especially out loud

__Difficulty identifying people's voices or instruments in the orchestra

__Problem filtering out other sounds and attending to what someone is saying

__Bothered by loud, sudden, metallic, or high-pitched sounds

__Look at others for reassurance before answering

__Often talk out of turn or "off topic"

__If not understood, have difficulty rephrasing; may get frustrated, angry, give up

Poor Visual-Spatial Discrimination

__Fail to comprehend reading or quickly lose interest

__Hard to visualize what you read

__Uncomfortable or overwhelmed by moving objects or people

__Fatigue easily when using eyes for close work

__Difficulty distinguishing foreground from background and locate items among other items -- papers on a desk, socks in a drawer, items on a grocery shelf

__See double

__Write at a slant (up or down hill) on a page

__Confuse left and right

__Difficulty perceiving depth, distance, boundaries and thus judging spatial relationships; may bump into objects or people or misstep on curbs and stairs; may fear driving

__Problem scanning visual sequences and following rapid movement with eyes, as following a tennis match or video game

__Difficulty recognizing symbols or gestures and might misinterpret facial cues

Poor Smell and Taste Discrimination

__Difficulty identifying what food you are eating without looking at it

__Difficulty distinguishing particular tastes or smells, like orange from tangerine

Movement

Motor Planning Problems (Dyspraxia)

__Difficulty with organizing, and performing activities, both novel and familiar that involve a sequence of body movements, such as hitting a tennis ball

__Poor self-help skills and reliance on others to get started

__Poor gross motor skills -- jumping, catching a ball, climbing a ladder etc.

__Poor fine motor skills & difficulty using "tools" such as pencils, silverware, combs, scissors; gripping sandals or walking barefoot; eat messily

__Poor eye-hand coordination and can’t catch a ball

Movement and Balance Problems

__Appear clumsy, awkward, and uncoordinated

__Lose balance easily when climbing stairs, riding a bicycle, jumping, standing on one foot, or standing on both feet with closed eyes

__Avoid most sports or seek intense sports with strong input into balance system (roller coasters, parachuting, bungee jumping, car racing, water or downhill skiiing), or deep pressure to body (horseback riding, deep sea diving, jumping & crashing on trampoline, rock climbing)

__Have poor body awareness: bump into things, knock things over, trip; do things with too much force -- walking, slamming doors, dressing things too hard, slamming objects down

__Get car or seasick

Poor Muscle Tone

__Have stiff muscle tone

__Have a limp, "floppy" body

__Frequently slump, lie down, and lean head on hand or arm while working at desk

__Fatigue easily

__Compensate for "looseness" by grasping objects tightly

__Have difficulty turning doorknobs, handles, opening and closing items – use an electric can opener or often ask someone to open can

__Have difficulty catching yourself if falling

Body Language Deficits

__Facial expression and body language hard to read

__Body language does not match communicative intent

Bilateral Coordination Problems

__May have never crawled as an baby

__Have poor body awareness

__Lacked an established hand preference by age four or five

__Difficulty learning exercise or dance steps – have two left feet

__Confuse left and right

__Problem crossing the midline, like using the right hand to cross over the left shoulder to scratch yourself or to burp a baby

Social/Emotional

Emotional Instability

__Disruptive or aggressive; at times violent

__Silly

__Restless

__Tense

__Edgy

__Difficult or willful

__Easily frustrated & frazzled

__Explosive

__Moody

__Hypervigilant even in safe environments

__Attention getting

Social Ineptitude

__Poor eye contact

__Slow responding

__Inappropriate or lack of initiating

__Out of sync

__Misread other’s intent

Relationship Problems

__Dependency

__False independence

__Incapacity for intimacy

Poor Self-concept

__Low self-esteem

__Feeling “crazy,” “weird”

__Negative self-talk

__Identity confusion

__Seem lazy, bored, unmotivated, depressed, stubborn, troubled

Poor Coping Skills

__Easily frustrated, aggressive, or withdrawn when failing & give up easily

__Difficulty adjusting to a new situation

__Decrease sensory input through avoidance (flight) & by lashing out (fight) to push people away

__Control sensory input by compulsively adhere to strict schedules & rigid routines for eating, waking, going to sleep, and so on

Cognition

__Distracted easily and fidgety when needing to focus and concentrate

__Impulsive

__Disorganized

__Disoriented

__Lack of use of creative skills

__Poor inner drive -- feel stuck and find it hard to pursue goals

__Short-term memory problems

__Poor communication skills and often at a loss for words

__Lack good problem solving skills

__Problems academically as a child, despite normal or above normal intelligence

__Lack of strategies to modify behavior

__Largely unaware of behavior and generally not able to modify it

Psychiatric Symptoms

__Anxiety

__Depression

__Bipolar disorder

__Eatingdisorders

__Obsessive-compulsive behavior

__Panic attack

__Phobias

__Substance Abuse

__Distorted hearing

__Depersonalization

__Dissociation

__Cutting