The purpose of this study was to construct and conduct preliminary reliability and validity studies on a questionnaire designed to measure a mother’s ability to provide an adequate sensory environment for her newborn child. The questionnaire was conceptualized as an extension and application of sensory integrative theory into the domain of maternal role preparation. The instrument assessed (a) a mother’s knowledge of the sensory capacity of the newborn and (b) a mother’s perception of her ability to influence the development of her child. The subjects were 55 primaparas of newborn infants who responded to the questionnaire within 3 days postpartum. The findings demonstrated that the questionnaire measured the two traits reliably. Additionally they indicated that knowledge of the sensory capacity of the newborn correlated positively with perceived influence on development. Maternal age did not correlate with the mothers’ knowledge of the sensory capacity of the child, but did correlate with perceived influence of mothers on development. Educational level of the respondent correlated with scores on both subscales. With further research, it is foreseen that this questionnaire may be used by occupational therapists as a part of a screening interview for identifying mothers who may be at risk for failure to provide adequate sensory experiences for their children.