Do you have students who you do not know if their behavior is related to sensory components? This is a 31 question tool to HELP guide INFORMAL INTERVIEW to determine if SENSORY could be the function of behavior. This tool helps to guide WHAT is the function of behavior or WHY is the behavior occurring. Each question is broken down to explain why things are being asked and with a specific emphasis on explaining each sensory question.
Pages 3-4 are an introduction.
Pages 5-6 are the 31 questionnaire to guide an informal interview and observation.
Page 7 is an extra page for notes.
Page 8 is a place to transcribe answers and total answers. Transfer all answers here. Add up the number of each “Yes” Once you look at which has the most “yes”, this may give a clue to why the behavior is happening. If there are two close ties, there may be more than one function of behavior. However, this is only an informal tool without scoring criteria and you should use your clinical judgement, standardized measures and evaluation tools.
Pages 9 – 12 go through each question with more in depth answers at the sensory processing answers.
This is intended to be an INFORMAL TOOL to help guide an informal interview for school personnel to help determine if sensory may be the function or one of the functions of behavior. This can also be an educational tool to help explain to staff WHY they believe a behavior is occurring. This should be used along with your clinical judgement, and standardized measures,
This is perfect to help guide discussions with teachers, staff and other personnel who work with students.
This DOES NOT: diagnose or classify the function of behavior. This can only be done by trained professionals using a variety of different evaluation methods. This cannot be used for every student or every situation.
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This is perfect to supplement various social emotional (SEL) or self regulation program including RTI, MTSS, problem solving, zones of regulation, 5 point scale, whole body listening, social thinking and more.
This is perfect for general education students but also students with Autism spectrum disorder, ADHD, ADD, sensory processing disorder, and other special needs. This can be used with general education, RTI, MTSS, special education, school psychologist, school counselor, occupational therapy OT, speech language pathology SLP, and social work SW.
I am a school occupational therapist who has a doctorate in occupational therapy. I work closely with special education and general education staff adapting material. This is where I get my inspiration for this material. I have used my materials with a variety of children with different disabilities including learning disabilities, dyslexia, autism, sensory processing disorder, ADD, ADHD, visual impairments, deaf/hard of hearing, cerebral palsy, down syndrome and more.
DISCLAIMER: By using this, you agree that this activity is not intended to replace the advice of a physician or occupational therapist. Information provided should not be used for diagnostic or training purposes. Please speak with your physician or OT if you have questions. Stop any activity if you are unsure about a child’s reaction or ability. You should discontinue anything if you do not know your child’s reaction or ability.