1

Cross Cultural Adaptation and Psychometric Properties of the Malay Version of the

Short Sensory Profile

Su Im Ee1 • Siew Yim Loh

2 • Karuthan Chinna

3 • Mary J. Marret

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1 Institute of Postgraduate Studies, University of Malaya, Kuala Lumpur, Malaysia

2. Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

3. Department of Social preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur

4. Department of Peadiatric, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

*Correspondence

Siew Yim Loh,

Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Email: syloh@um.edu.my

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ABSTRACT

Aims: This paper presents the translation, the cultural adaptation and the psychometric

properties of the Malay version Short Sensory Profile (SSP-M). Methods: Pre-testing (n=30)

of the original English SSP established its applicability for use on Malaysian children aged 3

to 10 years. This was followed by the translation and cross-cultural adaptation of the SSP-M.

Two forward and two back-translations were compared and reviewed by a committee of 10

experts who validated the content of the SSP-M, before pilot testing (n=30). The final SSP-M

questionnaire was completed by 419 parents of typically developing children aged 3 to 10

years. Results: Cronbach’s alpha of each section of the SSP-M ranged from 0.73 to 0.93 and

the intraclass correlation coefficient (ICC) indicated good reliability (0.62 to 0.93). The seven

factor model of the SSP-M had an adequate fit with evidence of convergent and discriminant

validity. Conclusions: We conclude that the SSP-M is a valid and reliable screening tool for

use in Malaysia with Malay-speaking parents of children aged 3 to 10 years. The SSP-M

enables Malay-speaking parents to answer the questionnaire with better reliability, and

provides occupational therapists with a valid tool to screen for sensory processing difficulties.

KEYWORDS. sensory processing, cross cultural adaptation, psychometric properties, short

sensory profile, validity

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Sensory processing (SP) refers to how the central and peripheral nervous systems manage

incoming sensory information, including the reception, modulation, integration, and

organization of sensory stimuli (Miller et al., 2000). Based on the work of Ayres, Dunn

( 1997; 2001) developed a model of sensory processing. According to Ayres, (1995) senses

provide information about the body and surrounding environment to the brain which then

organizes and integrates the sensory input. Well organized sensations are believed to

contribute towards the formation of perceptions that facilitate behaviour and learning

Conversely, poor organization and integration of sensation will result in learning difficulties

and behavioural problems (Bundy et al., 2002; Schaaf et al., 2010). Sensory processing

difficulty refers to a set of impairments where sensory information is not adequately

processed with consequent functional difficulties in many aspects of the daily lives of affected

individuals.

Sensory Processing Difficulty can affect more than one modality of sensation, whether

auditory, tactile, taste, olfactory, visual, proprioception or vestibular (Bar-Shalita et al., 2005;

Lane, 2002; Schaaf et al., 2010), resulting in detrimental effects on an individual’s

participation in daily activities, social interaction and play (Bar-Shalita et al., 2008; Bundy et

al., 2001; Dunn, 1997; Engel-Yeger and Ziv-On, 2011; Nadon, 2011; Reynolds et al., 2011;

Schaaf et al., 2003) as well as the development of social skills, self-confidence and self-

esteem (Parham and Mailloux, 2010). Sensory processing difficulties can ultimately reduce an

individual’s quality of life and well-being(Dunn, 2001).

Sensory processing difficulties are estimated to affect between 5% to 16% of normal

population in studies of children in the USA (Ahn et al., 2004; Ben-Sasson et al., 2009).

Studies in the USA and Australia have found that between 69% to 95% of children with

Autism Spectrum Disorder (ASD) display symptoms of sensory processing difficulties

(Baranek et al., 2006; Leekam et al., 2007; Tomchek and Dunn, 2007; Baker et al., 2008).

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Evidence of sensory processing difficulty has also been found in individuals with ADHD

(Ermer and Dunn, 1998), atopic dermatitis (Engel-Yeger et al., 2007), asthma(Engel-Yeger et

al., 2014) and selective eating (Farrow and Coulthard, 2012).

The measurement of sensory processing difficulty requires an appropriate instrument.

There are very few assessment tools that are suitable for use in children. The Short Sensory

Profile (SSP;McIntosh et al.,1999) is a useful instrument for assessment of sensory processing

difficulties in children that is commonly used by occupational therapists in Malaysia.

However without a validated version in Malay, the national language spoken by the majority

of Malaysians, its utility is limited. Currently, use of the SSP in Malaysia is confined to a

minority of English- speaking parents who would be able to complete the SSP. While

individual therapists may attempt their own translation to administer the SSP to non-English

speaking parents, the process is time consuming and lacks standardization. The availability of

a Malay version of the SSP would allow expansion of its use to benefit the wider Malay-

speaking population in Malaysia.

In order to have a reliable and valid tool, the methodology used in translation is of

utmost importance. To date, the SSP has been translated into Hebrew (Engel-Yeger, 2010)

and Spanish. The process of translation and cross cultural adaptation for the Hebrew version

is well documented. Production of the Hebrew version involved forward and backward

translation, calculation of internal consistency and principle component analysis to test for

further psychometric properties of this version (Engel-Yeger, 2010). However details of the

translation and cross cultural adaptation process for the Spanish version SSP have not been

published. To date, the reliability and validity of this version has not been established

(Román-Oyola and Reynolds, 2010) and is limited to a small US study to examine the

content validity of the Spanish version(Román-Oyola and Reynolds, 2010) through a

cognitive interview with eight Puerto Rican mothers.

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The aims of this study were to translate, culturally adapt and examine the reliability,

content validity and construct validity of the Malay version of the Short Sensory Profile (SSP-

M) for use in Malaysia among Malay- speaking parents of children aged 3 to 10 years. In this

study, we conducted a comprehensive translation, cultural adaption and examination of the

reliability, content validity and construct validity of the Malay version of the Short Sensory

Profile (SSP-M) based on recommended criteria (Beaton et al., 2000; Sousa and Rojjanasrirat,

2011).

Prior to translation, applicability of the SSP to the local context was established

through a test retest study with the original English version on 30 English speaking Malaysian

parents of typically developing children using convenience sampling. The Cronbach’s alpha

for each section ranged from 0.62 to 0.89. The Cronbach’s alpha for the total scale was 0.93.

The test-retest reliability of individual items determined by the intraclass correlation

coefficient (ICC) ranged from 0.70 to 0.93, except for item 30 where the ICC was 0.58. This

preliminary study confirmed that the SSP is applicable for use with English- speaking

Malaysian parents.

METHODS

Permission to use and translate the SSP(McIntosh et al., 1999) into Malay was granted from

Pearson Company (Pearson, 2013). The study was reviewed and received ethics clearance

from the Medical Ethics Committee of the University of Malaya Medical Centre. Permission

to recruit the parents of children attending kindergartens and schools was obtained from the

Ministry of Education of Malaysia. Parents were recruited via the heads and principals of

schools and kindergartens. An initial draft Malay translation was obtained through a process

of two forward and two backward translations. Cultural adaptation and content validation of

this draft version was carried out through consultation with a panel of experts and participants

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(n= 30) of a pilot test to obtain a final version of the SSP-M. This final version of the SSP-M

was tested on 419 parents for construct validity.

Short Sensory Profile

The Short Sensory Profile (SSP) is a questionnaire used to screen children aged 3 to 10 based

on caregiver reports. The 38-item questionnaire is divided into 7 sections: Tactile sensitivity

(7 items), Taste/Smell Sensitivity (4 items), Movement Sensitivity (3 items),

Underresponsive/Seeks Sensation (7 items), Auditory Filtering (6 items), Low Energy/weak

(6 items), and Visual/Auditory Sensitivity (5 items). The frequencies of engagement in the

described behaviours are indicated on a 5-point Likert scale (1=always, 2=frequently,

3=occasionally, 4=seldom and 5=never) (McIntosh et al., 1999). The total score for an

individual ranges from 38 to 190. Scores from 155 to 190 are interpreted as “typical

performance”. A score ranging from 38 to 141 is categorised as “definite difference”

indicating the likelihood that the child is having significant problems with processing sensory

stimuli and consequent difficulties in performing daily life activities. An intermediate score

ranging from 142 and 154 is classified as “probable difference” (Dunn, 1999). According to

the developers, internal consistency and internal validity of the total and section scores range

from 0.70 to 0.90 and 0.25 to 0.76, respectively. The SSP can be used to screen for a variety

of sensory processing difficulties due to the conceptual relationship between sections of SSP

and the long SP(McIntosh et al., 1999).

Procedure

Translation, Cross Cultural Adaptation and Content Validation

The process of translation, cross cultural adaptation and validation was conducted in

accordance with the American Educational Research Association, the American

Psychological Association, and the National Council of Measurement in Education ( AERA et

al., 1985) and recognized guidelines (Beaton et al., 2000; Sousa and Rojjanasrirat, 2011) as

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well as requirements stipulated in the NCS Pearson Inc. Research Translation License

Agreement. The original version of the SSP was forward translated from English to Malay

independently by two bilingual native Malay speakers. Back translation from Malay into

English was carried out by two qualified local bilingual translators from non-medical

backgrounds who were blind to the original English version of the SSP. The two initial

forward translations were merged to form a draft Malay version that was evaluated by a panel

of 10 experts for semantic, idiomatic, and conceptual equivalence. This panel consisted of the

researcher, four bilingual native speakers of Malay, one language expert; three bilingual

occupational therapists and a bilingual pediatrician. Based on recommendations by this expert

panel, minor modifications were made to the draft Malay version to produce an amended

version, the SSP-M. Proof reading of the SSP-M was done by two persons, a native Malay-

speaking occupational therapist and a teacher proficient in Malay (who was also a parent).

Through this process, a grammatically correct, easier to read, and culturally acceptable SSP-

M was developed. A third and final backward translation of the SSP-M into English was

conducted by a professional translator and the translation was found to be similar to the

original SSP. The forward and backward translation were sent to NCS Pearson(Pearson, 2013)

the copyright owner of SSP.

Content Validation by Occupational Therapists

This process was carried out by 10 Malaysian occupational therapists proficient in Malay with

3 to 10 years of working experience in the field of pediatrics to further support the conceptual

equivalence (clarity) and content validity of the SSP-M. They were asked to rate the

instructions, items and the response format of the SSP-M as “clear” or “unclear” and to

provide suggestions to improve the clarity of statements that were rated as “unclear”.

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These 10 occupational therapists were also asked to examine the content validity of the SSP-

M by using a 4 point rating scale (1 = “not relevant” to 4= ”very relevant”) (Davis et al., 1992)

and evaluate the relevance of individual items of the SSP-M. An expert panel of 3 to 10

members is recommended by Lynn (1986).

Content Validation by Parents of children with Typical Development

Following the content validation by the panel of occupational therapists, pilot testing of the

SSP-M was conducted on 30 Malay speaking parents of various ethnicities who had typically

developing children aged 3 to 10 years old without any medical conditions associated with

developmental problems (e.g., attention deficit hyperactivity disorder, Down syndrome,

cerebral palsy). Participating parents signed written consent and completed a questionnaire

containing questions on demographic data of parents and their children together with the SSP-

M. Participants were asked to comment on words and sentences that were unclear. In

addition, the researcher also conducted brief cognitive interviews, where participants were

asked about any items that were unclear to them to further verify the content validity of SSP-

M and to ensure that it would be easily understood. This sample size and interview as a

qualitative measure of content validity was based on the recommendation of Beaton et

al.(2000).

Psychometric Properties of the Malay Version of SSP

The same 30 parents who were in the pilot test were recruited for a retest within an interval of

one to two weeks. Each parent completed a questionnaire with reference to one child.

Construct Validity.

In order to test the construct validity of the SSP-M, the questionnaire was administered to a

larger sample. The sample size was determined by rule of thumb following the

recommendation of at least 10 respondents per item and at least 300 respondents for factor

analysis (Tabachnick and Fidell 2007). The criteria for inclusion in this study were (1)

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Respondents were parents of typically developing children aged 3 to 10 years old. (2) Neither

the child nor siblings had any medical diagnosis (e.g. attention deficit hyperactivity disorder,

Down syndrome, cerebral palsy, autism) or had a health condition associated with delayed

development such as low birth weight or prematurity. (3) Ability to speak read and

understand Malay language.

The participants were recruited from parents of children attending 6 kindergartens and 6

primary schools in Selangor and Kuala Lumpur. A written information sheet was provided to

ensure that the participants had sufficient information on the conduct of the research. Parents

who agreed to participate signed the consent form and then completed a questionnaire

containing questions on the demographic profile of the parent and child as well as the SSP-M.

Instructions for completion of the questionnaire were provided.

The questionnaires were distributed through an appointed teacher by the school

management and the researchers during activities in the school or kindergarten that were

attended by parents.

Data Analysis

The minimum inter-rater agreement among the experts for clarity was set at 80% (Topf, 1986).

Content validity examines the degree to which samples of items, taken together, constitute an

adequate operational definition of a construct being measured (Polit and Beck, 2006). The

assessment of content validity by the panel of experts was analysed by calculation of the

content validity index (CVI). The CVI, is easy to understand, and can be used as a guide for

modification or deletion of instrument items (Polit and Beck, 2006). The CVI was calculated

at both item level (I-CVI) and scale level (S-CVI). The I-CVI is computed as the number of

experts giving a rating 3 or 4 to the relevance of each item, divided by the total number of

experts. The I-CVI which expresses the proportion of agreement on the relevance of each item

should be at least 0.78 (Lynn, 1986). The S-CVI is defined as “the proportion of items on an

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instrument that achieved a rating of 3 or 4 by the content experts” (Beck and Gable, 2001;

Lynn, 1986) The S-CVI which was calculated using the average calculation method, S-

CVI/Ave should be ≥ 0.90 (Waltz et al., 2005).

Descriptive statistics were obtained using the statistical software SPSS version 21.

Means and standard deviations were used to describe continuous variables, and frequencies

and percentages were used to describe categorical variables. Internal consistency of the

translated SSP-M was examined using Cronbach’s Alpha for each section scale and test-

retest reliability was examined using the intraclass correlation coefficient (ICC).

Confirmatory factor analysis (CFA) was used to determine if the items in the 7

constructs as in the original English SSP were appropriate as well as to improve the

instrument, if necessary. CFA was performed using AMOS version 21 software. In this study

we examined factor loadings, factor intercorrelations, as well as goodness of fit indices.

Four indices for goodness of fit were used in this study, satisfying the

recommendation for at least 3 to 4 goodness of fit(GOF) scores (Hair et al., 2010): the ratio

between Chi-square and degree of freedom (X2/df) value, with a ratio of 3 indicating good or

acceptable fit(Chin and Todd, 1995), the Comparative Fit Index (CFI; Bentler, 1990) and

Tucker-Lewis Index (TLI; Tucker and Lewis, 1973) for which values above .90 indicate good

fit (Hair et al., 2010) and Root Mean Square Error of approximation (RMSEA; Steiger, 1990),

where a value less than .08 is considered acceptable(Marsh et al., 2004). Composite reliability

(ω) and average variance extracted values were calculated from factor loadings.

RESULTS

Translation, Cross Cultural Adaptation and Content Validity

The forward translation process was carried out without much difficulty. However the

backward translations of items 14, 21, 32 and 33 were not consistent with the original English

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SSP. These difficulties arose either because there was no word of equivalent meaning in

Malay or because of lack of familiarity with words that are rarely used in ordinary

communication. As there is no single Malay word that conveys the meaning of “prop” in the

phrase “props to support self’ in item 32, words used by both forward translator were

combined to construct the phrase “menupang dan menyandar untuk menyokong diri” (use

hands and lean to support self”). As the Malay phrase “balik kuang” to translate “somersaults”

in item 14 is not commonly used in daily communication, the English word “somersaults”

was added to the phrase for better clarity. As the word “bergulung” used to translate “twisted”

in item 21 conveyed the idea of “rolling”, the word” untidily” was added in brackets to

communicate the equivalent meaning. The translation of the phrase “poor endurance” for

item 33 as “kurang daya tahan” lacked conceptual equivalence as it conveyed “lack of

immmunity”rather than inadequate stamina. Members of the expert panel agreed to change

this to “Kurang ketahanan diri” which means “poor self edurance”.

Item 3 posed difficulties with regard to cultural norms. The cited example of children

walking barefoot “especially in sand or grass” was regarded to be inappropriate as Malaysian

children in urban areas do not usually walk barefoot on sand unless they are at the beach. In

addition, most playgrounds in Malaysia do not have sand. To make it culturally appropriate,

this phrase was amended as “terutamanya di atas pasir pantai atau rumput” specifying that

reference was made to “sand on the beach”.

Content Validity

Inter-rater agreement among experts for all the items ranged from 90% to 100%, except for

item 32(70%). Item 32 was then evaluated and revised. The phrase “menupang dan

menyandar untuk menyokong diri”’ “use hand and lean to support self” ” was substituted with

“menongkat /menyandar untuk menyokong diri” or “used body part/lean to support self” by

consensus among all the experts. The CVI for 38 items ranged from 0.90 to 1.00 and S-

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CVI/Ave of 0.99. In the content related validation by participants for clarity of the SSP-M, no

major changes were proposed by the participants with regard to clarity.

Psychometric Properties

Pilot Test

In the pilot study for SSP-M, the Cronbach’s alpha for each section ranged from 0.73 to 0.93

and the total scale was 0.94(refer to Table 1). The item by item test-retest reliability

determined by intraclass correlation coefficient (ICC) ranged from 0.62 to 0.93. ICC for the

seven sections ranged between 0.84 to 0.96. All items were retained and no modification was

needed.

Insert Table 1

Participants

The purposive sample consisted of 419 typically developing children. The socio-demographic

characteristics of the children and their parents are presented in Table 2. The children in the

sample were aged between 3 and 10 years old (mean= 7.7, SD 1.7).

Insert Table 2

Results from confirmatory factor analyses

The Final version of SSP-M was tested for construct validity and goodness of fit

indices. Internal consistency was measured by composite reliability which is one component

of convergent validity. The tested seven-factor model is shown in Figure 1. After adjusting for

correlated error terms, the 7 factor model of SSP-M showed a good fit [The Chi-square/df =

1.94, TLI = 0.91, CFI = 0.92, RMSEA = 0.05]. The model fit indices are provided in Table 3.

Insert Figure 1

Insert Table 3

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According to Hair et al. (2010), the correlation between the constructs should not be

too high. A correlation value of more than 0.85 indicates a problem of multicollinearity

between the constructs. The correlation values between the constructs are provided in Table 4.

In this table, the maximum correlation value was 0.73.

Insert Table 4

The factor loading, composite reliability (CR) and average variance extracted (AVE)

values for each construct are provided in Table 5. All items were statistically significant (p

<0.001) and the factor loadings were more than 0.5, except for two that were close to 0.5. All

the AVE values for the constructs are sizeable, except for tactile sensitivity. All CR values

were more than 0.7.

Insert Table 5

In testing discriminant validity, the rule proposed by Fornell & Lacker (1981) was used,

where, for every paired constructs, AVE and R-squared values were compared. In the

comparison, if the AVEs are more than the R-squared value, then there is sufficient

discriminant validity. The AVE and paired R-squared values are provided in Table 6, where

the diagonals are AVE values and off diagonals are R-squared values. For all pairwise

comparisons, except for underresponsive / Seek Sensation-Tactile Sensitivity and

underresponsive/ Seek Sensation-Auditory Filtering, the AVE values were more than the

respective R-squared value.

Insert Table 6

DISCUSSION

The SSP is the first screening tool measuring sensory processing difficulties for children aged

3 to 10 years that has been translated into Malay. The SSP-M was examined for reliability,

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content validity and construct validity. With input from the panel of experts, the initial

translation was refined to make it easier to read and understand and to ensure semantic,

idiomatic, conceptual equivalence and cultural applicability to the Malaysian context.

Grammar and syntax also make major contribution to the translation difficulties. when words,

grammatical structures, or idiomatic expressions are untranslatable directly into the target

language from the original instrument. In such situations, equivalence is best achieved by

translation according to the meaning instead of direct translation of component words

(Sechrest et al., 1972; Su and Parham, 2002).

Pilot study of the SSP-M showed that internal consistency for each section scale was good to

excellent. This means that items in each section are intercorrelated and internal consistency

for the total scale is excellent, indicating that a majority of items are attributable to the whole

SSP-M (Cortina, 1993). Item by item test retest reliabilities showed good reliability. These

findings provide evidence of the stability of the SSP-M as a valid tool to measure sensory

processing abilities at different points in time.

The cronbach’s alpha section scale for all the section scores was similar to the original

English SSP (McIntosh et al., 1999) and the Hebrew version of the SSP(Engel-Yeger, 2010),

but slightly lower for the section on movement sensitivity. These findings provide further

support for the reliability of the SSP-M.

The goodness of fit indices of the SSP-M model with the 7 factors met the criteria for

good fit. The seven original constructs and original 38 items were retained. All 7 factors had

good composite reliability with evidence of convergent validity and disciminant validity.

Strength and Limitations

This study adhered to a rigorous process of cross cultural adaptation and validation to produce

the SSP-M. This enables Malay speaking parents to answer the questionnaires in their

preferred language. This provides researchers and clinicians with a tool that can be employed

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to screen more children for early identification of those who require more detailed evaluation

for sensory processing difficulty. This is the first validation study on a large sample in

Malaysia. However recruitment of subjects from a single urban centre may limit

generalizability of the findings to the rest of the Malaysia population especially those from

rural areas. Further studies are recommended among a larger cohort of Malaysian children

with various disabilities.

CONCLUSION

The SSP-M is a valid and reliable screening tool for use in Malay speaking parents of various

ethnicities and appropriate for the Malaysian culture. Our results confirmed the original factor

structure and suggest that the SSP-M is a well-constructed, useful tool for screening

Malaysian children aged 3 to 10 years to detect sensory processing difficulties. The

development of the SSP-M fulfils the need for a screening tool for sensory processing

difficulties that could be applied in clinical practice in Malaysia to facilitate early detection of

sensory processing difficulties and thus, paving the way for early intervention. Our study also

serves as a guideline for the methodological procedures required for validation of non-native

language tools to be used by occupational therapists and other healthcare professionals from

resource-limited countries.

ACKNOWLEDGEMENTS

We gratefully acknowledge the parents who participated in this study. We especially thank

the Ministry of Education in Malaysia headmasters and teachers from schools and principals

of kindergartens for granting permission to recruit of participants. We sincerely thank the

expert committee members and occupational therapists for their contribution to the process of

translation, cross cultural adaptation and content validation.

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Declaration of Interest Section

The authors report no declarations of interest. This study was funded by a postgraduate

research grant University of Malaya (Grant number: PG090-2013A)

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TABLE 1. Internal Consistency and Test Retest Reliability of The SSP- M

SSP Section Malay Version Short Sensory Profile(M-SSP)

Cronbach’s Alpha (α) Inteclass Correlation coefficient(ICC)

Tactile sensitivity

.81 .90

Taste/Smell sensitivity

.77 .84

Movement sensitivity

.73 .94

Underresponsive/Seeks Sensation

.91 .89

Auditory Filtering

.82 .85

Low Energy/Weak

.93 .92

Visual/auditory Sensitivity

.82 .96

Total M- SSP

.94 .96

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TABLE 2. Social Demographic of Typically Developing Children and Their Parents

CFA (N=419)

Characteristics n %

Child Age

3 years old 7 1.7

4 years old 12 2.9

5 years old 27 6.4

6 years old 50 11.9

7 years old 94 22.4

8 years old 74 17.7

9 years old 74 17.7

10 years old 81 19.3

Child’s Gender

Boy 170 40.6

24

Girl 249 59.4

Child’s Ethnicity

Malay 338 80.7

Chinese 44 10.5

Indian 37 8.8

Parent’s Age

21-30 years old 23 5.5

31-40 years old 264 63.0

41-50 years old 118 28.2

Above 50 years old 14 3.3

Respondent

Father 139 33.2

Mother 280 66.8

Parent’s Highest level of Education

Primary School 10 2.4

Lower Certificate of Education 20 4.8

Certificate of Education/Diploma 248 59.2

Degree/Master/Doctor of Philosophy 141 33.7

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TABLE 3. Comparison of Model Fit Before and After Modification

Index X2/df RMSE TLI CFI

Best Value <3 <0.08 ≥0.90 ≥0.90

Before Modification 2.45 0.06 0.86 0.87

After Modification 1.94 0.05 0.91 0.92

X2/df Chi-square degree of freedom; RMSE Root Mean Square Error; TLA Tucker-Lewis

Index; CFI Comparative Fit Index

26

TABLE 4. Correlation Value 7 Factors of SSP-M

Factor/Construct 1 2 3 4 5 6 7

1.Tactile Sensitivity

2.Taste/ Smell Sensitivity 0.56

3.Movement Sensitivity 0.49 0.42

4.Underresponsive/Seek Sensation 0.63 0.53 0.37

5.Auditory Filtering 0.52 0.50 0.42 0.73

6.Low Energy/weak 0.42 0.34 0.38 0.42 0.54

7.Visual/ Auditory Sensitivity 0.55 0.43 0.52 0.58 0.59 0.53

27

TABLE 5. Results from Confirmatory Factor Analysis

Construct Item

Factor

Loading AVE CR

Tactile Sensitivity Q1 0.47 0.33 0.76

Q2 0.55

Q3 0.51

Q4 0.69

Q5 0.46

Q6 0.63

Q7 0.61

Taste Smell Sensitivity Q8 0.64 0.56 0.88

Q9 0.86

Q10 0.84

Q11 0.85

Movement Sensitivity Q12 0.50 0.49 0.71

Q13 0.80

Q14 0.70

Under responsive Seek Sensation Q15 0.61 0.45 0.86

Q16 0.70

Q17 0.75

Q18 0.69

Q19 0.65

Q20 0.75

Q21 0.62

Auditory Filtering Q22 0.65 0.47 0.84

28

Q23 0.73

Q24 0.64

Q25 0.67

Q26 0.64

Q27 0.78

Low Energy Weak Q28 0.71 0.57 0.89

Q29 0.69

Q30 0.85

Q31 0.81

Q32 0.70

Q33 0.75

Visual Auditor sensitivity Q34 0.63 0.46 0.82

Q35 0.69

Q36 0.74

Q37 0.68

Q38 0.70

AVE Averange Variance Extraction ;CR Composite Reliability

29

TABLE 6. Test for Discriminant Validity

Diagonal are AVE values and off diagonals are R-squared values.

Factor/Construct 1 2 3 4 5 6 7

1. Tactile Sensitivity 0.34

2. Taste/ Smell Sensitivity 0.31 0.56

3. Movement Sensitivity 0.24 0.18 0.49

4. Under responsive/Seek Sensation 0.40 0.28 0.14 0.45

5. Auditory Filtering 0.27 0.25 0.18 0.53 0.47

6. Low Energy/weak 0.17 0.11 0.14 0.17 0.29 0.57

7. Visual/ Auditory Sensitivity 0.31 0.18 0.27 0.34 0.35 0.28 0.46