Sensory Over-Responsiveness Checklist

Tactile Defensiveness

_______ Distressed by light touch or gentle caress

_______ Overly agitated by seams and tags in clothing, as well as certain fabrics

_______ Extremely ticklish

_______ Difficulty with being touched when not able to see the person or object touching you, or when touch is unexpected

_______ Frequently rub skin firmly after it is exposed to light touch

_______ React extremely or even violently when being touched

_______ Difficulty washing face or body, being splashed, or adjusting to cold or hot water temperatures

_______ Difficulty handling changes or extremes in outside temperature

_______ Difficulty with getting hair cuts

_______ Hate the feeling of being dirty or sticky, may wash hands or body excessively

Gustatory/Oral/Olfactory Defensiveness

_______ Distressed by certain tastes and textures of food, and may hate mixing foods and textures

_______ Overactive gag reflex

_______ Extremely 'picky' or repetitive eating habits

_______ Inability to tolerate temperature extremes in foods

_______ Difficulty brushing teeth (toothpaste may burn)

_______ Difficulty trying new foods, and changing from set meal plans

_______ Difficulty tolerating certain smells

_______ Excessive reactions to some smells, may even get headaches or vomit

_______ Often notice smells others don't

_______ Very swayed by scents, may avoid people or places based on smell

Visual/Auditory Defensiveness

_______ Difficulty tolerating loud noises or bright lights

_______ Easily startled by loud noises or flashing lights

_______ Avoid situations where there will be noise and lights, such as crowded shopping centers

_______ Avoid social situations or group settings because of noise level and possibly the sounds of people's voices

_______ Irritated by appliance noises, such as vacuum cleaners and beeping timers

_______ Difficulty with changes in lighting, or going from quiet to loud, dark to bright, and vice versa

_______ Often cover or rub ears or eyes, which may hurt or water frequently

Vestibular Defensiveness

_______ Very sensitive to movements in head or body position

_______ Experience motion sickness

_______ Hate going upside down or sideways

_______ Often avoid roller coasters or other fast moving amusement park rides, especially ones that spin, drop, or go upside down

_______ Experience vertigo or 'fear of heights'

_______ Difficulty using escalators, elevators, or climbing stairs

_______ Easily made dizzy, very sensitive to dizziness, or may feel as though your body is moving even when it isn't

Proprioceptive Defensiveness

_______ Have difficulty tolerating other people moving your body and hugging you

_______ Avoid moving or stretching limbs or other body parts

_______ Often have rigid or tense posture

_______ Avoid physical activities, such as sports, that may involve lots of running, jumping, crashing, etc.

Interoceptive Defensiveness

_______ Distressed by hunger, thirst, bladder or bowel sensations

_______ May frequently go to the bathroom to avoid the sensation of a full bladder

_______ May overeat to avoid hunger sensations, which may feel painful to you

_______ Distressed by a pounding heartbeat or by the movement of the lungs while breathing

_______ Overly agitated by body heat