SENSORY CHECKLIST

 

AruRA PAEDIATRIC THERAPY SERVICES

 CHILD NAME: ____________________ DATE: __________ AGE: _____

Tactile (Touch) Sensitivity

YES / NO

HOW

Avoids messy textures (e.g., sand, glue)

 

 

Reacts negatively to certain fabrics

 

 

Dislikes being touched unexpectedly

 

 

Craves touch (e.g., hugs, firm pressure)

 

 

Auditory (Hearing) Sensitivity

 

 

Overreacts to loud noises

 

 

Covers ears in noisy environments

 

 

Seeks out certain sounds

 

 

Difficulty focusing with background noise

 

 

Visual Sensitivity

 

 

Overreacts to bright lights

 

 

Difficulty maintaining eye contact

 

 

Gets distracted by visual stimuli

 

 

Seeks out visually stimulating objects

 

 

Oral Sensitivity

 

 

Avoids certain textures of food

 

 

Chews on non-food items

 

 

Prefers strong flavors (e.g., spicy, sour)

 

 

Overreacts to brushing teeth

 

 

Proprioceptive (Body Awareness) Sensitivity

 

 

Seeks deep pressure (e.g., tight hugs)

 

 

Difficulty judging personal space

 

 

Enjoys jumping, crashing, and rough play

 

 

Difficulty with fine motor tasks (e.g., buttoning)

 

 

Vestibular (Movement) Sensitivity

 

 

Dislikes swings or seesaws

 

 

Gets dizzy easily

 

 

Seeks out spinning or swinging activities

 

 

Avoids activities that require balance

 

 

Interoceptive (Internal) Sensitivity

 

 

Difficulty recognizing hunger or fullness

 

 

Difficulty recognizing the need to use the bathroom

 

 

Overreacts to pain or temperature changes

 

 

Difficulty recognizing when tired

 

 

 

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