QUESTION: Choosing and scoring assessments?

QUESTION:

This is my first year in an early childhood center. I have been using the sensory profile for evaluating kids at an early childhood center, mostly because that is what they tell me to do. Prior to this I was in a state school setting and a 0-3-year-old home visit program. In learning to use this test, I find it a bit difficult to know to what degree of “definite difference” or “how many” results in the child’s need for sensory integration at some level. Especially frustrating to me is making decisions usually without even having set eyes on the child, but maybe this is better—less subjective.

The other difficulty is the difference in “Caregiver” and “School Companion” scores. I usually base them on the school companion, because it is needed to function in the classroom. But I feel there may be times it is a student-teacher personality conflict. In most cases, I suggest a sensory diet for them to use with the child at school. Any thoughts on this? Thanks in advance!

GWEN’S ANSWER:

In general, we should only be using sensory processing assessments to help us determine what’s causing the problems that need to be addressed, not to determine whether or not intervention is warranted. Some children score in the “definite difference” range, but the issues are not impacting their function in the school environment and therefore no intervention is warranted. I begin my assessment with getting input from the teacher and parents (depending on the setting) about the issues needing to be addressed. I then spend a little time observing and interacting with the child. If I suspect that sensory processing may be contributing to the problem, I administer the Sensory Profile or Sensory Processing Measure (or just a good sensory symptoms checklist) to help me figure out the underlying issues. Then I use the results of the assessment to help me design a sensory diet to support the problematic issues specifically. This is the primary difference between school-based OT and medically based OT. In the schools, our only job is to address the issues impacting education. In a clinic, our job is to address the deficits themselves.

Regarding assessment options: The Sensory Processing Measure–Preschool version is a little easier to understand. However, I find it doesn’t always give me enough information to determine whether a child is over- or under-responsive to each form of input, which is the information I really need to develop a sensory diet. There’s more on that in my webinar titled “Sensory Diets 101.”

I hope that helps!

Best Wishes,
Gwen