as a screening tool for parental mental health." The only reason they want our families to fill out this assessment every six months is so our children's ABA providers can identify if we need any additional support. After taking these assessments, it is clear that the focus has shifted away from identifying what our children with autism need and it has moved towards what we are not doing as parents.
Health Net Federal Services (HNFS) states that the SIPA will prompt the "clinical reviewer to evaluate parent training recommendations, parent engagement, and unique circumstances." Without taking the SIPA, one may think that Tricare makes sense in this requirement. The more information about the family, the better to support them. My question is, why is Tricare the only funding source that requires this assessment? This question still remains unanswered.
Why fight filling out the SIPA every six months? It's just one more assessment to fill out in order for our children to receive services. The reason is plain and simple. The SIPA is an intrusive and insulting assessment that is being used as a tool to bully parents out of seeking services for their children for services. It is Tricare's sleaziest attempt to shame our military families from access to the appropriate care they need. Tricare's acts are discriminatory against our families and it is criminal that we need to answer questions about the most private parts of our lives in order for our children to receive care.
When the assessment is researched and taken, there is even a question if the assessment was created for the purpose in which it is being used. In the Journal of Autism and Developmental Disorders, a paper entitled "Parent and Family Outcomes of PEERS: A Social Skills Intervention for Adolescents with Autism Spectrum Disorder by Karst et al, the SIPA was used as an assessment tool to study the level of stress a family is under while raising a child with autism, but the study was done with "64 families of adolescents with high-functioning ASD." This is a very important variable in the level of
efficacy in forcing our families to complete the SIPA every six months, because a large percentage of the assessment cannot truly be completed for adolescents with moderate to severe autism. Many children with moderate to severe levels of autism have difficulty with expressive language. If the parent is to take the time to fill out this assessment honestly, they are unable to successfully complete the
task. In turn, this confuses and frustrates the parents even more as to why they are filling the SIPA out every six months in the first place.
"After being subjected to filling out the SIPA, I've experienced a sense of emotional rape that I have never experienced before because frankly, my sex life is none of Tricare's business. "
For this assessment, we are given statements and tasked to either "strongly disagree, agree, state we are not sure, agree, or strongly agree." Statements in this assessment are "My child never seems to do anything", "My child gets upset over little things", "My child does things for me that make me feel good", "My child thinks I do not love him or her", and "I find myself giving up more of my life to meet my child's needs than I ever expected." I am forced to respond to statements that seem outlandish and trivial concerning an adolescent who has severe autism, such as, "I believe that my child drinks more alcohol than I would like." This, again, leads me to question the validity of the assessment concerning my son qualifying for ABA services. My son only drinks a high caloric nutrition supplement. The idea of my son drinking alcohol is asinine.
The SIPA assessment encompasses statements that lead the parent to question themselves as a person and their own worth, such as, "I often have the feeling that other people my own age
don't particularly like my company" and "I can't make decisions without help." After the experience of having to respond to these statements, my thoughts are, "What is Tricare trying to accomplish with this assessment?" The only response I could find was good old-fashioned shame and guilt.
The SIPA then veers our military families to a darker side. Statements such as, "I feel every time my child does something wrong it is really my fault" and "I expected to have closer and warmer feelings for my child at this age than I do." Just when you feel the statements you are being told to respond to couldn't get any more insulting, you receive a statement about your sex life. "Since my child became a teenager, my sexual relationships 'have' been less satisfying."
In the late 1940's to early 1950's, there was a theory entitled, "The Bettelheim's Theory of Autism" or in more layman's terms, "The Refrigerator Mom Theory". This unproven theory states that the reason a child has autism is because the mother lacks warmth to their child. After filling out the SIPA, I can't help but feel as if I'm being put on trial for not loving Broden enough and, even further, being asked if I think my sex life is related to Broden's autism.
I've seen Tricare reach to treacherous depths to cut costs, but after being subjected to filling out the SIPA, I've experienced a sense of emotional rape that I have never experienced before because frankly, my sex life is none of Tricare's business. •
PUZZLES & CAMO
Shelly Huhtanen is an Army wife stationed at Fort Benning, GA who has a child with autism. She enjoys sharing her experiences of day-to-day life caring for her son with autism while serving as an Army spouse. She authored "Giving a Voice to the Silent Many" that encompasses many stories of raising a child with autism in the military. Shelly is passionate about autism advocacy for our military and works to bring awareness to our local legislators and command about providing better support for our military autism community, such as better health care and education.