As many know, one of the problems with the SIB-R is how much it lends itself to malingering. Sometimes this malingering comes from coaching by the provider and other times it is just a parent's rationalization due to a feeling of desperation. This desperation comes from a number of sources, sometimes it is out of a hope that something will be better for their child and sometimes it comes from the need to have someone watch their child and their fear that there is no one except someone from an agency who will watch their child. Often times they have given up on the possibility that their young child with a disability might be accepted by a typical day care or that their older child with a disability might be able to be included in typical programs. While there are always going to be some children who will need specialized supports in order to participate in some type of child care or other activities including family based, for the majority of children we work with there is real hope for significant improvement. Unfortunately there are two primary obstacles, with numerous ancillary obstacles.
#1 Meaningful Functional Outcomes.
If we do not start with the end in mind, we will not know where we want to go. If the end is not meaningful to the parent, the parent will not feel vested and involved and will be less willing to participate. If the path or route taken towards the end does not involve the parent, let alone make sense to the parent, then the parent will disengage further. On the other hand, if the outcome is meaningful to the parent and it's practical functionality is obvious to the parent (because it originated from the parent), the parent will be more likely to be invested in the intervention especially when the parent has been taught both the essentiality of their involvement and been assured that they will be given the requisite skills and supports.
#2 Parent involvement. It is no wonder that SIB-R Maladaptive scores often get worse while the child is making progress in the center or even community with the therapist or tech when there is little or no parental involvement in the actual intervention for the child. There are three primary reason for parental involvement in the actual intervention with the child. 1. It provides more and more consistent intervention for the child. 2. It provides better outcomes for the child. and 3. The parents perception of their ability to help the child, handle the child during difficult times, interact and communicate with the child are heightened. This last issue has become so important in the research that for early intervention there has even been developed The Early Intervention Parenting Self-Efficacy Scale (EIPSES) which you can find on my page at: http://www.collaboration.me.uk/q.php
When used correctly, the SIB-R Maladaptive score is actually reflective of two things, one is the actual behavior of the child and the other is the parent's perception of that behavior, which includes their perception of their personal self-efficacy in relation to those behaviors.
Of course and as is well known, any research about the efficacy of intervention or even any kind of extended additional hours clearly demonstrates that parental involvement is essential.
