SP2 Child Full Assessment and Planning Report Sample

1 sensory Profile 2 Child sensory Profile 2 Child sensory Profile 2 Summary ReportWinnie Dunn, PhD, OTR, FAOTAC hild's Full Name: Anna SampleChild's Preferred Name: AnnaGender: FemaleBirth Date: 02/18/2008 Service Provider Name: Mr OTService Provider's Profession: Occupational TherapistForm Completed By: Mrs SampleRelationship to Child : MotherAdministration Date: 07/30/2014 Age at Administration: 6:5 Name of School/Daycare Center: ElementarySchool Grade: KindergartenCopyright 2014 NCS Pearson, Inc. All rights , the PSI logo, PsychCorp, and sensory Profile are trademarks in the and/or other countries of Pearson Education, Inc., or itsaffiliate(s).TRADE SECRET INFORMATIONNot for release under HIPAA or other data disclosure laws that exempt trade secrets from disclosure.[ / RE1 / QG1 ]SAMPLEASSESSMENT AND Planning REPORTAnna is a 6-year-old female who lives with her Mother, Father, and Brother (3 years old).Anna attends 's strengths and interestsMrs Sample reports that Anna is really great at looking after younger children, swimming, and playing with Lego bricks alone.

2 Anna loves Lego, DQG looking after animals. Anna enjoys playing computer games, going to the park or family days out, and playing alone in her room with her small toys ( lego bricks). Anna's family likes to camp, cyclH, be outdoors and going to movies. Anna's caregiver thinks Anna's best characteristic is: making others the caregiver is asking for supportThe caregiver is asking for support so Anna can behave appropriately in social situations, for example, eating out without having temper tantrums and play with other children without adult Anna's participation looks like now in the home environmentRight now, when Anna is in a family environment she KDV IUHTXHQW WHPSHU WDQWUXPV which can lead to altercations with other families and plays alone or requires adult supervision to play. Mrs Sample says that these strategies make it difficult for Anna to SDUWLFLSDWHin social situations, for example eating out and play with other children without adult intervention. Mrs Sample reports that it can be difficult for Anna to participate in activities because she struggles with understanding the requirements of a social situation, and is often fearful in a busy environment she likes to play alone and control all play activity around the family wants Anna's participation to look likeMrs Sample reports that they would like their Child to enjoy social situations with less anxiety and share the family needs Anna to participateAnna needs to participate in these activities in/at: various public environments and DW home and/or friends/relatives 's sensory processing patternsWe conducted an Assessment of Anna's sensory processing patterns at home by asking Anna's caregiverto complete the Child sensory Profile 2.

3 This Assessment is a questionnaire for ages 3:0 to 14:11 years inwhich the caregiver marks how frequently Anna engages in the behaviors listed on the compare these reports to a national standardized Sample of reports from other raters to determinehow Anna responds to sensory situations when compared to other children the same age. A summary ofthis comparison with other children is available in the Score Profile section of this sensory Profile 2 Summary Report07/30/2014, Page 2 Anna SampleCopyright 2014 NCS Pearson, Inc. All rights to the responses on the Child sensory Profile 2, Mrs Sample reports that Anna is just like themajority of children of the same age in her interest in sensory responds to some sensory experiences just like the majority of her peers in response to visualstimuli, response to movement, and response to items in or around the is just like her peers in her ability to manage her Anna's sensory processing patterns affect her participation at homeAnna's caregiver says that Anna is already good at SOD\LQJ alone and can keep herself occupied with her toys, she is also excellent at sleeping, and has a varied diet with lots of different food textures and tastes.

4 Bedtime and mealtimes in the home are always positive experiences for the whole family. This activity providesYisual, sensitivity, seeking, DQG oral sensory processing which is consistent with Anna's sensory patterns. She will be more successful when Yisual, sensitivity, seeking, movement, oral sensory processing, and attentional are part of her routines. Anna's caregiver seems to understand this because Anna's caregiver Srovides heavy blankets and a dark room for Anna to sleep in DQG DOso provideV a calm environment at mealtimes ZLWK SOHQW\ RI GLIIHUHQW IRRG WDVWHV WR HQMR\, which incorporates Yisual,sensitivity, seeking, oral sensory processing into Anna's family we can support Anna's participation at homeAnna's caregiver asked us to support Anna to behave appropriately in social situations, for example, eating out without having temper tantrums and play with other children without adult intervention. Since sensory patterns suggest Anna does better in activities that have Yisual, sensitivity, seeking DQG oralsensory processing, and when there is less Dvoiding, registration, auditory, touch, body position, and social emotional, we need to find ways to incorporate those strategies into everyday routines.

5 This means Anna will have a better chance to behave appropriately in social situations, for example, eating out without having temper tantrums and play with other children without adult intervention when we find ways to give Anna opportunities IRU OHVV DXGLWRU\ VWLPXOL XQH[SHFWHG WRXFK DQG PRUH YLVXDO VXSSRUW DQG FRQWURO RYHU KHU ERG\ SRVLWLRQ GXULQJ DFLWLYLWHV Anna also has a strength for visual sensory activities, by incorporating visual stimuli during play we can support Anna's interactions with other questionnaire shows that Anna can be easily overwhelmed by sensory experiences especially in the areas of auditory, touch and body position. By recognizing these differenceV when participating in social situations and playing with other children we can support Anna and her will collaborate to identify specific strategies what will work for Anna and fit into the family'sactivities and sensory Profile 2 Summary Report07/30/2014, Page 3 Anna SampleCopyright 2014 NCS Pearson, Inc.]

6 All rights INFORMATIONP resent Conditions/Diagnoses: Intellectual Disability, Autism Spectrum Disorder, and BehavioralDifficultiesCurrent Services: Regular Education, Occupational Therapy, and Speech TherapyChild's birth order within the family: 1stHave there been more than three children, between the ages of birth to 18 years, living in the Child 'shousehold during the past 12 months? NoChild sensory Profile 2 Summary Report07/30/2014, Page 4 Anna SampleCopyright 2014 NCS Pearson, Inc. All rights PROFILEQ uadrantSeeking/Seeker Anna is just as interested insensory experiences as themajority of othersAvoiding/Avoider Anna is much more likely to beoverwhelmed by sensoryexperiences than othersSensitivity/Sensor Anna detects more sensorycues than othersRegistration/Bystander Anna misses many moresensory cues than othersChild sensory Profile 2 Summary Report07/30/2014, Page 5 Anna SampleCopyright 2014 NCS Pearson, Inc. All rights SectionAUDITORYP rocessing Anna responds more tosounds than othersVISUALP rocessing Anna responds to sights justlike the majority of othersTOUCHP rocessing Anna responds much more totouch than othersMOVEMENTP rocessing Anna responds to movementjust like the majority of othersBODY POSITIONP rocessing Anna responds to bodyposition much more thanothersORAL SENSORYP rocessing Anna responds just like themajority of others to items in oraround the mouthBehavioralSectionCONDUCT associated withsensoryprocessing Anna exhibits this aspect ofconduct more than othersSOCIALEMOTIONAL responsesassociated withsensoryprocessing Anna exhibits social emotionalresponses much more thanothersATTENTIONAL responsesassociated withsensoryprocessing Anna pays attention to cuesaround her just like the majorityof othersChild sensory Profile 2 Summary Report07/30/2014, Page 6 Anna SampleCopyright 2014 NCS Pearson, Inc.

7 All rights SCORE SUMMARYSENSORY AND BEHAVIORAL SECTION SCORE SUMMARYQ uadrantRaw ScorePercentile RangeClassificationSeeking/Seeker419-84 Just like the Majority of OthersAvoiding/Avoider7297-99 Much More Than OthersSensitivity/Sensor5387-96 More Than OthersRegistration/Bystander7097-99 Much More Than OthersSensory SectionRaw ScorePercentile RangeClassificationAUDITORY Processing2786-96 More Than OthersVISUAL Processing1611-82 Just like the Majority of OthersTOUCH Processing3797-99 Much More Than OthersMOVEMENT Processing148-85 Just like the Majority of OthersBODY POSITION Processing3797-99 Much More Than OthersORAL sensory Processing158-87 Just like the Majority of OthersBehavioral SectionRaw ScorePercentile RangeClassificationCONDUCT associated with sensoryprocessing2785-96 More Than OthersSOCIAL EMOTIONAL responsesassociated with sensory processing5697-99 Much More Than OthersATTENTIONAL responses associatedwith sensory processing247-84 Just like the Majority of OthersChild sensory Profile 2 Summary Report07/30/2014, Page 7 Anna SampleCopyright 2014 NCS Pearson, Inc.

8 All rights : Pages 8 - 14 (Item Analysis Report ) are not included in this Sample for copyright SECTION COMMENTSAUDITORY ProcessingAnna becomes very distressed with loud unexpected ProcessingNo rater comments were included for this ProcessingAnna likes to touch on 'her terms' and is averse to being touched unexpectedly. She doesn't like ProcessingNo rater comments were included for this sensory ProcessingNo rater comments were included for this Associated with sensory ProcessingNo rater comments were included for this POSITION ProcessingNo rater comments were included for this EMOTIONAL Responses Associated with sensory ProcessingNo rater comments were included for this Responses Associated with sensory ProcessingNo rater comments were included for this of ReportNOTE: This and previous pages of this Report contain trade secrets and are not to be released inresponse to requests under HIPAA (or any other data disclosure law that exempts trade secretinformation from release).

9 Further, release in response to litigation discovery demands should be madeonly in accordance with your profession's ethical guidelines and under an appropriate protective sensory Profile 2 Summary Report07/30/2014, Page 15 Anna SampleCopyright 2014 NCS Pearson, Inc. All rights