Sensory Profile Assessment: Complete Guide for Infant, Toddler & Child Evaluation

A pediatric OT receives a referral for a 6-year-old whose teacher describes him as "difficult, unfocused, and refusing to participate in group activities." His parents report that he melts down at every haircut, refuses most food textures, and covers his ears in the school cafeteria. He has no formal diagnosis.

This is not a behavior problem. It is a sensory processing pattern. And the first standardized tool most OTs reach for — the one most validated for this presentation, the one most accepted by Medicaid, IDEA programs, and commercial payers across the US — is the Sensory Profile 2.

Despite being the most widely used sensory processing measure in clinical and school-based OT practice, the SP-2 is frequently misunderstood in clinical use — forms are confused, scores are misinterpreted, the School Companion is underused, the Adolescent/Adult form is routinely omitted from clinical reference guides, and the billing and documentation context is almost never discussed.

This reference covers all of it. Every form, every score domain, the research evidence including the DSM-5 ASD criterion connection, administration options in 2026 including digital and telehealth, the CPT documentation context, and the clinical limits practitioners must communicate clearly to families and referral sources.

What Is the Sensory Profile 2 — and How Does It Differ From the Original Sensory Profile?

The Sensory Profile 2 (SP-2; Dunn, 2014) is a revised, expanded, and restandardized set of norm-referenced caregiver and teacher questionnaires that evaluate a child's sensory processing patterns from birth through 14 years, 11 months. Published by Pearson and authored by Dr. Winnie Dunn, PhD, OTR, FAOTA, the SP-2 is grounded in Dunn's Sensory Processing Framework — a model that organizes sensory processing patterns along two axes: neurological threshold (how much input the nervous system requires before registering a sensation) and behavioral response (whether the person actively responds to that threshold or passively accepts it).

The SP-2 is not simply a cosmetic update of the original 1999 Sensory Profile. The 2014 revision made four structural changes that matter clinically:

•        Expanded age coverage and form consolidation — the separate Infant/Toddler Sensory Profile (2002) and Sensory Profile School Companion (2006) were unified under one manual with a single normative framework, replacing three separately published instruments with a coherent family of five forms

•        Updated normative samples — all forms were restandardized with new normative data collected from geographically diverse US populations (Midwest, Northwest, South, West regions), with the Child SP-2 anchored to 697 children and the School Companion to 679 children

•        Revised response scale — the Infant/Toddler forms shifted from a 5-point to a simplified rating scale; the Child form retained 5-point frequency ratings (Almost Always through Almost Never) but eliminated ambiguous middle-category wording

•        Structural consistency across forms — all forms now use parallel score reporting formats, allowing direct comparisons across evaluation episodes and age transitions without re-norming adjustments

The original Sensory Profile (1999) is no longer appropriate for new clinical evaluations. It should not be used for initial evaluations or payer-required re-evaluations in 2026. The SP-2 (2014) is the current standard.

For practitioners and payers, the distinction matters practically: documentation citing 'Sensory Profile' without specifying the 2014 SP-2 revision may prompt payer questions about whether current normative standards were applied. Always specify: Sensory Profile 2 (Dunn, 2014) in evaluation reports and billing documentation.

What Are the Five SP-2 Forms — and When Should Each Be Used?

The SP-2 family consists of five distinct forms, each designed for a specific age range and rater. A sixth instrument — the Adolescent/Adult Sensory Profile — extends the SP-2 framework beyond age 14 but is sold separately and is a distinct product. Understanding when to use each form, and which can be combined for cross-setting analysis, is the foundation of competent SP-2 clinical practice.

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What Is the School Companion Sensory Profile 2 — and Why Is It Clinically Essential?

The School Companion Sensory Profile 2 (SCSP-2) is the most underused form in the SP-2 family — and the most valuable for school-based OT practice.

Unlike all other SP-2 forms, the SCSP-2 is completed by the classroom teacher, not the caregiver. It generates four School Factor scores — Supports, Awareness, Tolerance, and Availability — that describe how the student's sensory processing patterns affect their availability for learning, their tolerance of the school environment, and the level of support they require to access the curriculum.

The clinical power of the SCSP-2 is in cross-setting comparison. When a child scores in the Definite Dysfunction range on the School Companion but in the Typical range on the Child SP-2 (completed by parents at home), the discrepancy points to a school-environment-specific sensory burden — often the cafeteria noise, gym class sensory intensity, or classroom visual complexity — rather than a global processing difference. This is essential documentation for IDEA educational necessity arguments.

For Medicaid School Program (MSP) billing, administering both the CSP-2 (parent) and SCSP-2 (teacher) and documenting cross-rater consistency in the Definite Dysfunction range provides the strongest available evidence for medical necessity of school-based sensory OT services. Consistent findings across both raters demonstrate that the pattern is not context-specific or caregiver perception-driven — it is a neurologically consistent processing difference affecting educational access.

What Is the Adolescent/Adult Sensory Profile — and When Does Clinical Need Extend Beyond Age 14?

The Sensory Profile 2 family officially covers ages birth through 14 years, 11 months. But sensory processing differences do not resolve at age 15.

The Adolescent/Adult Sensory Profile (A/ASP; Brown and Dunn, 2002, published by Pearson) is the appropriate tool for individuals aged 11 and older. It is a self-report questionnaire (not caregiver-completed) that evaluates the same four sensory processing patterns as the SP-2: Seeking, Avoiding, Sensitivity, and Registration. Internal consistency for quadrant scores ranges from 0.639 to 0.775, with discriminative validity established through correlation with established external temperament measures.

Clinical contexts where the A/ASP is indicated: adolescent ASD evaluation (where SP-2 does not apply to individuals 15 and older), adults presenting with sensory-based anxiety or environmental hypersensitivity in mental health OT settings, workplace ergonomics evaluations for sensory-sensitive employees, and adult rehabilitation where premorbid sensory patterns inform intervention design.

The A/ASP is not included in the SP-2 Complete Kit. It must be purchased separately from Pearson. The Combination Kit (SP-2 + Adolescent/Adult Sensory Profile) is available at $500.00 from Pearson Assessments as of 2024 pricing.

How Do You Interpret Sensory Profile 2 Scores — and What Do the Four Quadrants Actually Mean Clinically?

The SP-2 generates two types of scores: Sensory System scores (auditory, visual, touch, movement, body position, oral) and Sensory Pattern scores organized within Dunn's four-quadrant model. For the Child and School Companion forms, Behavioral scores (Conduct, Social-Emotional, Attentional) are also generated.

All scores are reported as percentile ranks compared to the same-age normative sample, with descriptive classification categories:

•        Much More Than Others (>98th percentile): Significantly elevated; warrants clinical attention and typically justifies intervention

•        More Than Others (84th–98th percentile): Above average; monitor for functional impact on daily participation

•        Just Like the Majority (16th–84th percentile): Within normal limits for age

•        Less Than Others (2nd–16th percentile): Below average; may warrant monitoring depending on functional context

•        Much Less Than Others (<2nd percentile): Significantly low; clinically meaningful in sensory-seeking and sensory registration domains

What Does Each Quadrant Pattern Mean — and How Should It Drive Intervention Planning?

The four SP-2 quadrant patterns are not diagnostic categories. They are behavioral profiles that describe the relationship between a child's neurological threshold and their response strategy. Intervention effectiveness depends on correctly identifying which pattern or combination of patterns is driving the child's functional challenges.

Seeking Pattern (High Threshold + Active Response): The child's nervous system requires more sensory input than typical before registering a sensation — and the child actively seeks additional input to meet that need. Clinical presentations: constantly moving, touching objects and people, making noise, taking sensory risks. Intervention focus: provide structured, safe sensory input through occupational roles (heavy work, resistive activities, proprioceptive input embedded in functional tasks). This pattern does not indicate sensory problems in isolation — it describes an energetic, sensation-seeking style that becomes disruptive only when environments cannot accommodate it.

Avoiding Pattern (Low Threshold + Active Response): The child's threshold is low — the nervous system registers sensations quickly and intensely — and the child actively creates rules, routines, and limits to minimize exposure. Clinical presentations: rigid routines, refusal of messy activities, withdrawal from crowded or noisy environments, sensitivity to clothing textures. Intervention focus: graded exposure, predictability, advance warning of sensory events, environmental modification to reduce unnecessary sensory demands. Avoid forcing exposure — the avoidance behavior is functional self-regulation, not behavioral defiance.

Sensitivity Pattern (Low Threshold + Passive Response): Low threshold (high sensory awareness) but passive response style — the child notices sensory details and is affected by them but does not actively avoid. Clinical presentations: easily distracted by background stimuli, overwhelmed in busy environments, complains about sensations that others do not notice. Intervention focus: environmental modification to reduce competing sensory input, sensory diets that reduce distractors in functional contexts, self-regulation strategy training.

Registration Pattern (High Threshold + Passive Response): The child's nervous system requires significant input before registering sensations, and the child does not actively seek additional input. Clinical presentations: appears not to notice sensory input, slow to respond to name or instructions, misses social cues, seems inattentive or 'in own world.' Intervention focus: alerting sensory activities at transitions, environmental enhancement of sensory signal strength, auditory and visual cuing strategies. This pattern is frequently misidentified as attention deficit — SP-2 scores differentiate sensory registration patterns from behavioral ADHD presentations.

Critical clinical note: Mixed quadrant patterns — where a child scores in the Definite Dysfunction range on multiple quadrants simultaneously — are common in ASD and require intervention planning that addresses both the seeking and avoiding patterns operating in different sensory domains. A child can be a seeker for proprioceptive and vestibular input while simultaneously being an avoider for auditory and tactile input. Intervention must be domain-specific, not pattern-wide.

What Does the Research Evidence Show About the SP-2 in ASD, ADHD, and Anxiety?

The SP-2's clinical relevance is not purely psychometric. It is anchored in a robust research literature that directly connects sensory processing assessment to diagnostic populations, treatment outcomes, and in the case of ASD, formal diagnostic criteria.

Sensory Processing and ASD: The DSM-5 Connection

95% of children with ASD — demonstrate some degree of sensory processing dysfunction on the Short Sensory Profile, with greatest differences in Underresponsive/Seeks Sensation, Auditory Filtering, and Tactile Sensitivity domains — Tomchek & Dunn, AJOT, 2007

Tomchek and Dunn (2007) — the landmark AJOT study of 281 children with ASD compared to age-matched typically developing peers using the Short Sensory Profile — established the prevalence and pattern of sensory processing differences in autism at a scale that influenced diagnostic nosology directly.

The DSM-5 (APA, 2013) formalized this evidence by including sensory reactivity as a component of Criterion B for ASD diagnosis: hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment is now explicitly recognized under Criterion B4, within the restricted and repetitive behaviors domain. The DSM-5-TR (2022) maintained this criterion unchanged.

This has two direct clinical implications. First, an SP-2 evaluation documenting Definite Dysfunction in sensory domains is directly relevant to ASD diagnostic evaluations — not as a diagnostic instrument, but as behavioral documentation of Criterion B4 phenotype. Second, sensory-based OT interventions for ASD patients are documentarily supported by the diagnostic criterion itself, providing the medical necessity foundation that payers require.

Research from the SP-2 specifically in ASD populations has further refined the picture. A study using the SSP-2 identified two distinct ASD sensory subtypes: a Uniformly Elevated group (67% of ASD children, showing high scores across all quadrants) and a Raised Avoiding and Sensitivity group (33%, with elevated scores specifically in avoiding and sensitivity quadrants). These subtypes show different intervention response patterns, underscoring the clinical value of quadrant-level score interpretation rather than relying on composite scores alone.

Sensory Processing in ADHD and Anxiety: Differential Documentation

The SP-2 is widely used in ADHD evaluation contexts, where sensory processing patterns can both co-occur with ADHD and be confused with it. The SP-2's Registration quadrant — describing children who appear not to notice sensory input, seem inattentive, and miss environmental cues — is frequently endorsed for children who initially present with attention concerns. SP-2 scores in the Registration domain, when elevated in the absence of elevated Attentional behavioral scores, support a sensory-based hypothesis over a primary attention hypothesis.

For anxiety evaluations, the Sensitivity and Avoiding quadrant patterns are most relevant. Research consistently identifies SP-2 Sensitivity and Avoiding elevations co-occurring with anxiety disorder diagnoses in children. Lane et al. (2012) in AJOT documented significant relationships between sensory over-responsivity and anxiety across ASD, ADHD, and typically developing populations. Documenting sensory over-responsivity via SP-2 scores in anxious children supports sensory-based OT as a complementary intervention alongside psychotherapy — a clinical argument that strengthens multi-disciplinary collaboration and referral relationships.

How Is the Sensory Profile 2 Administered — Paper, Q-Global, and Telehealth Options in 2026?

The SP-2 can be administered in two formats: paper-and-pencil (traditional record forms) and digitally via Q-global, Pearson's online assessment platform. Both formats generate the same scores and classification outputs.

Q-Global Administration: The 2026 Clinical Standard

Q-global is Pearson's web-based scoring and administration platform and is now the dominant SP-2 delivery method in most US clinical settings. Q-global offers: online questionnaire completion (caregivers access via unique link from any device), automated scoring with immediate score report generation, score comparison across evaluation episodes for progress tracking, and Spanish-language questionnaire availability for all caregiver forms.

For practices using digital intake and PROM platforms, Q-global reports can be downloaded as PDF and uploaded directly to the patient chart. The per-administration cost (approximately $2.50–$4.50 per form as of 2024 Q-global pricing) is typically billed as part of the evaluation service and may be included in the overall evaluation CPT code billing justification.

Telehealth Administration: What Is and Is Not Permissible

Pearson has published guidance confirming that Q-global digital administration of the SP-2 is compatible with telepractice delivery — meaning the caregiver completes the questionnaire via secure web link before or during a telehealth appointment. Pearson's telepractice guidance notes that caregiver questionnaires (ISP-2, TSP-2, CSP-2, SSP-2, SCSP-2) are all administrable remotely, as they do not require in-person performance observation.

Important telehealth caveat: while the questionnaire completion is remote-compatible, clinical interpretation and family education about scores must be conducted by a licensed OT. Documentation for Medicaid and commercial payer telehealth OT claims must specify that the evaluation was conducted via synchronous telehealth, include the platform used, and confirm HIPAA-compliant delivery. The SP-2 report itself is not sufficient documentation of a complete OT evaluation for billing purposes — it must be integrated into a full evaluation report that includes clinical observation data, occupational profile, assessment findings, functional impact documentation, and intervention plan.

How Does the Sensory Profile 2 Fit Into OT Evaluation Billing and Documentation?

This is the content gap that most SP-2 reference guides completely omit — and the one most relevant to OT practitioners in clinical practice.

The SP-2 is not independently billable as a standalone CPT code. It is an assessment instrument administered as part of an OT evaluation, and its results contribute to the complexity justification for the OT evaluation CPT code selected:

•        97165 — Occupational therapy evaluation, low complexity. Typically involves a straightforward presenting problem and does not require multi-domain assessment instruments like the SP-2

•        97166 — Occupational therapy evaluation, moderate complexity. Appropriate when the SP-2 is one of two or more standardized instruments used, with moderate clinical decision-making required

•        97167 — Occupational therapy evaluation, high complexity. Indicated when the evaluation requires the full SP-2 battery (CSP-2 + SCSP-2 cross-setting analysis), multiple standardized instruments, complex payer or diagnostic context (e.g., ASD evaluation with SP-2, BOT-2, and PEDI-CAT), and extensive clinical interpretation and family education

For school-based Medicaid School Program billing, the SCSP-2 administered by the classroom teacher and the CSP-2 administered by the caregiver together provide cross-setting documentation supporting both educational necessity (IDEA) and medical necessity (MSP). Document each form administered, the rater, and the date of administration separately in the evaluation report. Score discrepancies between raters must be clinically interpreted — they are not documentation errors, they are clinically meaningful data points.

For authorization renewals, re-administration of the SP-2 (typically every 6–12 months) generates quantitative progress data: score changes from baseline to re-evaluation provide the payer-facing evidence that sensory processing patterns have changed in response to OT intervention. Document baseline scores, current scores, and the functional significance of score changes in the progress note — not just the scores themselves.

Spry's PROMs platform sends SP-2 questionnaire links automatically at scheduled intervals, tracks caregiver completion rates, stores scores longitudinally alongside session data, and generates payer-ready reports linking outcome measure scores to clinical visits — eliminating the manual tracking burden that causes most practices to skip systematic re-evaluation. Learn more at sprypt.com.

What Are the Clinical Limits of the Sensory Profile 2 Every Practitioner Must Communicate?

Using the SP-2 responsibly requires communicating its limits as clearly as its strengths. These are the limits that matter in clinical practice.

The SP-2 Does Not Diagnose Sensory Processing Disorder

This is the most important limitation to communicate to families, referral sources, and documentation reviewers. The SP-2 identifies sensory processing patterns that differ from age-expected norms. It does not establish a diagnosis of Sensory Processing Disorder. SPD is not recognized as a discrete diagnostic category in the DSM-5 or ICD-10, and SP-2 scores cannot be used to establish it as a stand-alone medical diagnosis for insurance purposes.

What SP-2 scores establish: documentation that sensory processing patterns differ meaningfully from age-expected norms, with Definite Dysfunction scores in the context of functional impact on daily participation providing the evidence base for OT intervention — not a diagnostic label.

Normative Sample Limitations in a Diverse Population

The SP-2 normative samples reflect 2014 data from four US geographic regions, with the largest Child SP-2 normative group consisting of 697 children. For practitioners working with culturally and demographically diverse populations, Licciardi and Brown's (2021) critical review of the SP-2 identified cross-cultural validity as a notable limitation. The review recommended that practitioners contextualize scores with cultural considerations and supplement questionnaire data with clinical observation in natural contexts — particularly for families from non-Western cultural backgrounds where sensory behavior norms differ.

Caregiver Report Is Not Direct Observation

All SP-2 forms except the SCSP-2 rely on caregiver report. Caregiver perception, cultural norms around child behavior, caregiver anxiety level, and the observer's familiarity with the child all influence responses. Best practice per the SP-2 manual: administer the questionnaire alongside structured clinical observation in the evaluation setting, and use discrepancies between reported patterns and observed behavior as clinical data rather than assuming one is more valid than the other.

What Is the Most Important Thing to Understand About Sensory Profile 2 in Clinical Practice in 2026?

The SP-2 is a strong, well-validated, widely accepted clinical tool — with real limits that require real clinical judgment to interpret responsibly.

Used correctly, it provides an OTPF-4-aligned occupational performance lens on sensory processing: not a deficit catalogue, but a map of how a child's sensory system affects their participation in the occupations that matter to them and their family. The quadrant pattern scores do not describe what is wrong with a child. They describe how the child's nervous system experiences the world — and what kinds of environments, tasks, and strategies will help them function in it.

For the 6-year-old from the introduction — the one whose teacher described him as difficult and whose parents dreaded every haircut — the SP-2 evaluation showed Definite Dysfunction in Auditory and Touch Processing, elevated Avoiding and Sensitivity quadrant scores, and high Attentional behavioral scores. The School Companion, completed by his teacher, confirmed Definite Dysfunction on the Supports and Tolerance school factors.

That data did not diagnose him. But it gave his OT the clinical foundation to write defensible goals, build a sensory diet, develop a classroom modification plan, and make the medical necessity argument to his insurer. It gave his parents a framework for understanding behavior that had previously been attributed to character. And it gave his teacher a reason — and a strategy — to accommodate rather than discipline.

That is what a well-administered, well-interpreted SP-2 does in clinical practice. The tool is only as good as the practitioner using it.

Spry automates SP-2 and other PROM delivery — sending secure questionnaire links to caregivers before appointments, scoring and storing results longitudinally, and generating payer-ready reports that link outcome scores to clinical visits. Eliminate the manual tracking burden and make systematic re-evaluation standard practice. Book a demo at sprypt.com.

Frequently Asked Questions: Sensory Profile 2

What is the difference between the Sensory Profile and the Sensory Profile 2?

The original Sensory Profile (Dunn, 1999) was a single caregiver questionnaire covering ages 3–10 years. The Sensory Profile 2 (Dunn, 2014) is a comprehensive revision that expands age coverage from birth through 14:11, consolidates previously separate instruments (the Infant/Toddler Sensory Profile and School Companion) into one standardized manual, updates normative data from new US population samples, and introduces the Short Sensory Profile 2 for efficient screening. The SP-2 also standardized the score reporting format across all age forms and improved cross-form consistency. The original 1999 Sensory Profile should not be used for new evaluations in 2026 — the SP-2 is the current clinical and payer-recognized standard.

Can the Sensory Profile 2 diagnose sensory processing disorder?

No. The SP-2 identifies sensory processing patterns that differ from age-expected norms — it does not establish a diagnosis. Sensory Processing Disorder (SPD) is not recognized as a discrete diagnostic category in the DSM-5, DSM-5-TR (2022), or ICD-10-CM. SP-2 Definite Dysfunction scores in combination with documented functional impact provide the evidence base for OT intervention and medical necessity documentation, but they cannot be cited as a SPD diagnosis for insurance billing purposes. The SP-2 is most effectively used as part of a comprehensive evaluation battery that includes clinical observation and functional performance measures alongside the caregiver questionnaire.

What CPT codes are used when billing an evaluation that includes the Sensory Profile 2?

The SP-2 is not independently billable. It is administered as part of an OT evaluation and contributes to the complexity justification for the evaluation CPT code: 97165 (low complexity), 97166 (moderate complexity), or 97167 (high complexity). When the evaluation requires administration of both the Child SP-2 and the School Companion SP-2 alongside additional standardized instruments — and involves complex diagnostic context such as ASD or ADHD — 97167 is typically appropriate. Always document in the evaluation report which forms were administered, who completed them, and how the scores informed the clinical assessment and plan of care. Payer reviewers increasingly scrutinize SP-2 score documentation as part of medical necessity audits for sensory-based OT services.

Can the Sensory Profile 2 be administered via telehealth?

Yes. Pearson has confirmed that SP-2 caregiver questionnaire forms are compatible with telepractice delivery via the Q-global digital platform. Caregivers access the questionnaire through a secure link and complete it remotely before or during a telehealth appointment. Clinical interpretation, score review, and family education are then conducted synchronously via video. All five SP-2 caregiver forms (ISP-2, TSP-2, CSP-2, SSP-2, SCSP-2) are administrable via Q-global. The SCSP-2 teacher form can similarly be sent digitally to the classroom teacher. Documentation for telehealth OT evaluation billing must specify the synchronous telehealth delivery format, the platform used, and confirm HIPAA-compliant administration — the Q-global report alone is not sufficient OT evaluation documentation.

What is the Sensory Profile 2 School Companion — and when should it be used?

The School Companion Sensory Profile 2 (SCSP-2) is a 94-item teacher-completed rating form for children ages 3:0 to 14:11. Unlike other SP-2 forms completed by parents, the SCSP-2 is specifically designed for classroom teachers and generates four School Factor scores — Supports, Awareness, Tolerance, and Availability — that describe how the child's sensory processing patterns affect their educational performance. It should be used in every evaluation where school-based functional impact is relevant: IEP evaluations, school-based OT referrals, and Medicaid School Program documentation. Cross-setting comparison between SCSP-2 (teacher) and CSP-2 (parent) scores is the strongest documentation approach for IDEA educational necessity and MSP medical necessity — consistent Definite Dysfunction across both raters demonstrates that the sensory processing pattern is not context-specific.

How does the Sensory Profile 2 relate to ASD diagnosis?

The SP-2 does not diagnose ASD. However, its clinical relevance to ASD is directly supported by two parallel foundations. First, Tomchek and Dunn's landmark 2007 AJOT study found that 95% of children with ASD showed some degree of sensory processing dysfunction on the Short Sensory Profile, with the greatest differences in Underresponsive/Seeks Sensation, Auditory Filtering, and Tactile Sensitivity domains. Second, the DSM-5 (2013) formalized sensory reactivity as a diagnostic criterion for ASD under Criterion B4 (restricted, repetitive behaviors domain), recognizing hyper- or hypo-reactivity to sensory input as a core feature. SP-2 Definite Dysfunction scores therefore provide behavioral documentation directly relevant to DSM-5 Criterion B4 presentations — supporting both the ASD evaluation process and the medical necessity argument for sensory-based OT intervention with ASD-diagnosed patients.

References

1. Dunn W. (2014). Sensory Profile 2 User's Manual: Strengths-Based Approach to Assessment and Planning. Bloomington, IN: Pearson. [Primary instrument reference]

2. Tomchek SD, Dunn W. (2007). Sensory processing in children with and without autism: a comparative study using the short sensory profile. American Journal of Occupational Therapy, 61(2), 190–200. https://doi.org/10.5014/ajot.61.2.190

3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Arlington, VA: APA. [ASD Criterion B4 — sensory reactivity formalization]

4. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: APA. [Criterion B4 maintained unchanged]

5. Licciardi L, Brown T. (2021). An overview and critical review of the Sensory Profile – second edition. ResearchGate / Disability and Rehabilitation. [COSMIN psychometric review; cross-cultural validity limitation documented]

6. Dean E, Dunn W, Little L. (2016). Validity of the Sensory Profile 2: A Confirmatory Factor Analysis. American Journal of Occupational Therapy, 70(4 Supplement 1). https://doi.org/10.5014/ajot.2016.70S1-PO7054

7. Brown C, Tollefson N, Dunn W, Cromwell R, Filion D. (2001). The adult sensory profile: Measuring patterns of sensory processing. American Journal of Occupational Therapy, 55(1), 75–82. https://doi.org/10.5014/ajot.55.1.75 [A/ASP psychometric foundation]

8. Lane SJ, Reynolds S, Dumenci L. (2012). Sensory overresponsivity and anxiety in typically developing children and children with autism and ADHD. American Journal of Occupational Therapy, 66, 595–603. https://doi.org/10.5014/ajot.2012.004523

9. Parham LD, Ecker C, Miller Kuhaneck H, Henry DA, Glennon TJ. (2021). Sensory Processing Measure, Second Edition (SPM-2). Torrance, CA: Western Psychological Services. [SP-2 comparator tool reference]

10. Gil G, et al. (2023). Convergent Validity of Two Sensory Questionnaires in Spain: Sensory Profile-2 and Sensory Processing Measure. Children (MDPI), 10(9), 1516. https://doi.org/10.3390/children10091516

11. TSLAT. (2024). Sensory Profile 2 Clinical Summary and Autism Evidence Review. Texas School for the Blind and Visually Impaired. txautism.net/evaluations/sensory-profile-2