The purpose of this "SPD Symptom Checklist For Infants and Toddlers" is to help parents and professionals who interact with children become educated about particular signs of sensory processing disorder in the youngest children and babies.
It is not to be used as the absolute diagnostic criteria for labeling children with sensory processing disorder. But rather, as an educational tool and checklist for your own knowledge. Professionals who can diagnose this disorder have their own tools in addition to checklists to observe and test for SPD (formerly called SID or Sensory Integration Dysfunction).
As you go through this list, you may say,
"Wow, my child has so many of these characteristics/behaviors, he must have a sensory processing disorder!!"
That MAY be true, and I want you to take it very seriously if you find a host of these to be characteristic of your child. But, then use this as a guide to speak with your doctor and an Occupational Therapist so you can clearly explain why you think your child may need help.
Or, you may go through the list and say,
"No big deal, so my child has some of these behaviors/characteristics, doesn't every child?"
Well, this may be true too and your child's behavior may fluctuate from day to day.
What we need to be concerned with is WHICH symptoms your child shows, how much these symptoms interfere with their or other's lives, and what kind of impact it is having on their level of functioning. This will help target diagnosis and treatment.
Early identification and understanding of this disorder is HUGE!
Please understand the "Five Caveats" that Carol Stock Kranowitz points out in her book, The Out-of-Sync Child about using a checklist such as this. She writes:
1. "The child with sensory dysfunction does not necessarily exhibit every characteristic. Thus, the child with vestibular dysfunction may have poor balance but good muscle tone."
2. "Sometimes the child will show characteristics of a dysfunction one day but not the next. For instance, the child with proprioceptive problems may trip over every bump in the pavement on Friday yet score every soccer goal on Saturday. "Inconsistency is A hallmark of every neurological dysfunction."
3. "The child may exhibit characteristics of a particular dysfunction yet not have that dysfunction. For example, the child who typically withdraws from being touched may seem to be hypersensitive to tactile stimulation but may, instead, have an emotional problem."
4. "The child may be both hypersensitive and hyposensitive. For instance, the child may be extremely sensitive to light touch, jerking away from a soft pat on the shoulder, while being rather indifferent to the deep pain of an inoculation."
5. "Everyone has some sensory integration problems now and then, because no one is well regulated all the time. All kinds of stimuli can temporarily disrupt normal functioning of the brain, either by overloading it with, or by depriving it of, sensory stimulation."
IF, you in fact check off many of these symptoms, an OT evaluation should be considered. IF, in your gut, you know something just isn't right... listen to it!
Take this checklist with you and go get an evaluation. We NEED to catch SPD in the earliest years of life for the treatment to be the MOST effective; while their nervous systems are still developing. The time is NOW... for you, your child, and your family!
Again, this is NOT to be used to OFFICIALLY diagnose SPD, just to indicate if further evaluation is needed.
__ Resists being held or cuddled
__ Cries and/or arches back when people try to hold him/her
__ Distressed by diaper changes
__ Distressed by baths and/or water splashing on him/her
__ Doesn't fall into a predictable sleep/wake pattern or cycle
__ Cries excessively throughout the day (more than a half hour or hour at a time)
__ Doesn't smile often, appears “sad” or “uncomfortable” much of the time
__ Has distinct preferences for adults of certain energy levels or voices (i.e., intonation, loudness, high pitched, low pitched, etc.)
__ Avoids eye contact, has difficulty focusing on objects or following them with eyes
__ Distressed when moved suddenly or whole body and/or head is tipped
__ Distressed by rocking motions
__ Distressed when moving in space (i.e., swinging around, bouncing up and down, or being “thrown” up in the air)
__ Doesn't appear to respond to name or familiar voice
__ Can't seem to calm baby down no matter what you try (or there is only ONE thing that does, i.e., a car ride)
__ Difficulty breastfeeding
__ Difficulty with sucking, chewing, or swallowing
__ Doesn't tolerate new foods well
__ Gags or vomits from textured foods or on variety of different foods (very limited diet for age)
__ Does not seem to sense when diaper is wet or dirty
__ Cries inconsolably until a wet or dirty diaper is changed
__ Prefers to be without clothing
__ Severe separation anxiety
__ Tantrums many times a day
__ Distressed by sunlight or bright lights
__ Distressed in public places, especially if crowded or noisy
__ Doesn't enjoy regular interactive movement games, i.e., peek-a-boo, pat-a-cake, etc.
__ Doesn't notice new toys/novel toys and/or resists playing with them
__ Only uses one hand to manipulate and explore toys and/or can't switch from hand to hand
__ Unable to bang toys together or clap hands (at appropriate age)
__ Keeps hands fisted and closed most of the time
__ Distressed by dirty hands or face
__ Cries inconsolably when left with strangers or less familiar people
__ Significantly late to talk, walk, gesture, smile, hold bottle, sleep through the night, manipulate/play with toys, etc.
__ Major difficulties transitioning to solid foods and/or rice cereal after bottle or breast fed
__ Can not hold onto or use objects or utensils well for age
__ Regularly avoids certain foods, food categories, consistencies, temperatures of food, eliminates whole food groups, etc.
__ Difficulties with excessive reflux or allergies to foods and/or formulas
__ Doesn't seem to notice sounds others do
__ Frequent ear infections
__ Sensitive to sounds others don't seem to be bothered by
__ Difficult to engage; is an observer, doesn't interact with peers or adults
__ Apprehensive and/or distressed by playground equipment
__ Distressed by baby swings, jolly jumpers, wagon/stroller rides, car rides, etc.
__ Avoids putting toys in mouth, exploring them with her mouth
__ Baby gags or vomits when objects are placed in his mouth
__ Beyond teething stage, always has something in his/her mouth, or chewing on clothes, hands, fingers
__ Avoids categories of toys, i.e., vibrating, stuffed animals, rough textured toys, slippery/slimy toys, brightly colored objects, etc.
__ Appears overwhelmed, cries, or falls asleep when over stimulated
__ Refuses/distressed by certain positions, i.e., being on tummy, on back, sitting, etc.
__ Stays in one position and becomes uncomfortable when moving to another; if moving on own has significant difficulty transitioning to another position (hard to do, awkward)
__ You find you are always trying to be one step ahead of baby; trying to control his environment and “warning” people what to do/not to do so baby is comfortable
__ Difficulty staying asleep for more than 30 minutes at a time, or wakes up frequently throughout the night, unable to soothe himself back to sleep
__ Seems to get too much sleep, very short time when he is alert, playing, responding, and interacting
__ Has significant difficulty waking up
__ Needs a particular sound to stay asleep, i.e., fan, nature tape, white noise, music, etc.
__ Will not sleep if there is any noise
__ Wakes with the sun
__ Can not fall asleep anywhere but home, in familiar environment
__ Needs excessive help to fall asleep...rocking, bouncing, singing, rubbing back, etc. for long periods of time
__ Uncomfortable if not swaddled tightly; or, if older, needs heavy blankets, stuffed animals, or tighter pajamas for weight and pressure on them to fall asleep well
__ Able to switch moods effectively and relatively quickly... easily distracted if upset, “gets over it” within a reasonable amount of time, a favorite toy/face/sound will soothe him/her
__ Excessively attached to a pacifier
__ Never attached to any comfort object, i.e., blanket, stuffed animal, rubbing something, pacifier, thumb, etc.
__ Doesn't reach for or hold toys (especially textured toys) at appropriate age
__ Closes hand if toy coming near it, or drops it immediately if placed in hand
__ When begins to walk, walks on tip toes only, will not put bare feet on ground/floor
__ Distressed by textured materials under themselves
__ Appears distressed by movement; i.e., a startled response, arches back, frightened look in eyes, etc.
__ Does not crawl before walks (or limited/different type of crawl)
__ Craves movement, distressed if not moving, being swung, rocking, bouncing, rocks self constantly
__ Does not play reciprocally with caregivers or familiar people
__ Frequently engages in repetitive, non-purposeful play with one or two objects
__ Can not switch activities or participate in daily routines without distress when transitioning from one to another
__ Baby is not understood using language, cues, gestures, etc. and becomes frustrated frequently
__ Frequent head banging, hitting, biting, pinching, or hurting self or others
__ Breaks toys frequently
__ Unable to be gentle with animals
__ Appears uncoordinated, frequently bumps into things
__ Can not focus attention on play, caregiver, or toy long enough to interact (for age level)
__ Wanders around aimlessly or engages in non-purposeful activities in excess, i.e., spinning, rocking, staring at certain objects, etc... not interested in play or doesn't use objects for purposeful play.
Sensory Stimulation For Infants - Why is sensory stimulation for infants so critical to the normal development of our children? Check out this in depth article and top recommended sensory products for infants, babies, and toddlers.
Infant Fine Motor Activities - Use this great list of preschool, toddler, and infant fine motor activities to build, enhance, and improve your child's fine motor skills.
Gross Motor Activities For Toddlers - Use these fun gross motor activities for toddlers every day to help build their skills and keep them developmentally on target.
Child Developmental Checklist - Use this child developmental checklist for children ages 0-3 to find out whether your child is in need of an early intervention/developmental therapy referral.
Getting Rid Of The Pacifier - Here's one trick we used for getting rid of the pacifier that might work.
Helping Baby Sleep - Helping baby sleep with unique, soothing heartbeat sound toys, vibrating/rocking/musical bassinets, vibrating mattresses, etc.
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