How to complete this questionnaire
Thank you for taking the time to complete this questionnaire. Your responses will provide Kids First’s pediatric professionals with important insights into your child’s personality, needs, strengths and challenges.
To complete this questionnaire, simply choose one option that MOST ACCURATELY describes your child’s reactions to each scenario.
Please respond to every statement.
If you are unable to comment because you have not observed the behaviour or believe that it does not apply to your child, please choose ‘Not Observed’.
Your options are:
Your child never responds in this manner to the situation described
2. Approximately 25% of the time
Your child responds in this way on about 25% of occasions
3. Approximately 50% of the time
Your child responds in this way on about 50% of occasions
4. Approximately 75% of the time
Your child responds in this way on about 75% of occasions
Your child responds in this way on about 100% of occasions
6. Not observed
You have not seen your child respond in this way at any time.
If you have additional information to share with us, please use the ‘Comments’ box at the end of each section.
All information that you provide will remain confidential and will be used solely by our therapists to better understand and meet your child's clinical needs.
Date Format: DD slash MM slash YYYY
Oral Sensory Processing
Behaviour and Emotional Responses
This field is for validation purposes and should be left unchanged.