“…Despite four decades of research into understanding SIB and improving outcomes for the people affected by it, the persistence of SIB is well-documented and moving the needle toward sustainable progress under naturalistic conditions remains elusive (Dimian & Symons, 2022). People often seek care in emergency departments (Iannuzzi et al, 2015), out of home placement is common (Friedman et al, 2014; Jackson & Roper, 2014; Jacobson et al,1998), children are less able to engage successfully in the classroom (O’Reilly et al, 2005; Robinson et al, 2019), and participate less effectively or fully in peer, family, and community-based relationships (Sigafoos et al, 2014; Symons et al, 1999). Parents and family members experience exorbitant stress levels (Hastings, 2002; Lecavalier et al, 2006), a higher risk of anxiety and depressive disorders (Dumas et al, 1991; Olsson & Hwang, 2001), as well as financial burdens and employment disruptions (Breslau et al, 1982; Cidav et al, 2012).…”