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Sibling Assessment Tool - Portland State University

Sibling Assessment Form PSU-CWP-Salem/share drive/office Sibling RELATIONSHIP checklist 1 child A_____DOB_____ child B_____DOB_____ Behavior of child A to child B Frequency (select one) A Defends or protects 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ B Recognizes Sib s distress and offers comfort 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ C Accepts comfort from sib

Sibling Assessment Form PSU-CWP-Salem/share drive/office SIBLING RELATIONSHIP CHECKLIST 2 Child A_____DOB_____

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Transcription of Sibling Assessment Tool - Portland State University

1 Sibling Assessment Form PSU-CWP-Salem/share drive/office Sibling RELATIONSHIP checklist 1 child A_____DOB_____ child B_____DOB_____ Behavior of child A to child B Frequency (select one) A Defends or protects 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ B Recognizes Sib s distress and offers comfort 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ C Accepts comfort from sib 1 Often 2 Sometimes 3 Never Examples of this behavior _____

2 _____ D Teaches or helps 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ E Initiates Play 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ F Responds to overtures to play 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ Sibling Assessment Form PSU-CWP-Salem/share drive/office _____ G Openly shows affection 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____

3 H Misses sib when apart 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ I Resolves conflict through age-appropriate reasoning 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ J Annoys, irritates or teases 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ K Shows hostility or aggression 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ L Blames or attempts to get sib into trouble 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ M Behavior sabotages efforts to meet other

4 Sib s needs 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ Sibling Assessment Form PSU-CWP-Salem/share drive/office Sibling RELATIONSHIP checklist 2 child A_____DOB_____ child B_____DOB_____ Behavior of child B to child A Frequency (select one) A Defends or protects 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ B Recognizes sib s distress and offers comfort 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ C Accepts comfort from sib 1 Often 2 Sometimes 3 Never Examples of this behavior _____

5 _____ D Teaches or helps 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ E Initiates play 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ F Responds to overtures to play 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ Sibling Assessment Form PSU-CWP-Salem/share drive/office _____ G Openly shows affection 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____

6 H Misses sib when apart 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ I Resolves conflict through age-appropriate reasoning 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ J Annoys, irritates or teases 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ K Shows hostility or aggression 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ L Blames or attempts to get sib into trouble 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ M Behavior sabotages efforts to meet other

7 Sib s needs 1 Often 2 Sometimes 3 Never Examples of this behavior _____ _____ Sibling Assessment Form PSU-CWP-Salem/share drive/office _____ Sibling checklist 3 Interactions 1 What evidence is there of sharing: Examples Boisterous play _____ _____ Imaginative activities _____ _____ Rituals ( bed or bath time) _____ _____ Jokes and fun _____ _____ Secrets _____ _____ Other _____ _____ 2 Are there marked differences between them in any of the following respects.

8 Examples The roles they adopt _____ _____ Activities and interests _____ _____ Behavior _____ _____ Sibling Assessment Form PSU-CWP-Salem/share drive/office _____ Personality _____ _____ Other _____ _____ 3 What evidence is there of reciprocity Example Pride in each other _____ _____ Praise and criticism _____ _____ Mutual help _____ _____ 4 Do they model on each other Example Think they look alike _____

9 _____ Imitate each other _____ _____ Emulate the qualities they like_____ _____ Unite in face of problems_____


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