SP3D Demographic Survey
This survey gathers basic information about you &/or your child to compare you with similar and dissimilar people during analytics for standardization of the Sensory Processing Three Dimensions Scale (SP3D). This information is confidential and will never be used to identify you except for during the actual testing process. Please answer each question to the best of your ability.
Parent's Name (if under age 18 or guardian of adult child)
Participant's Date of Birth
City & State of Participant's Primary Residence
Prefer not to say
Participant's current grade enrollment
No longer enrolled in school
Is the participant of Hispanic, Latino, or Spanish origin?
American Indian/Alaska Native
Native Hawaiian/Pacific Islander
Language primarily spoken at home:
Head of household's highest education level:
Did not complete high school (no diploma)
High school graduate (including GED)
Some college or associate degree
Bachelor's degree or higher
Has the participant been identified by a professional as having any of the following sensory processing disorder(s)? Check all that apply.
Sensory Discrimination Disorder
None of the above
Has the participant been identified by a professional as having physical, mental, emotional, or behavioral diagnosis(es)? Check all that apply.
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Disorder (ASD), including PPD-NOS and Asperger's
Developmental Coordination Disorder
Speech and/or Language Disorder
Mood disorder (depression, anxiety, etc.)
None of the above
Does the participant receive treatment for sensory processing disorder or any of the diagnoses listed above?
Yes (please describe your treatment in the "Other" box below)
Does the participant receive special education services?
Yes (please describe your services in the "Other" box below)
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This form was created inside of The Sensory Coach.