Perceived competence and behavioral adjustment of siblings of children with autism

Feelings of Loneliness and Social Dissatisfaction in Siblings of Children with Autism Spectrum Disorders: The Role of Birth Order and Perceived Social Support

Loneliness has been associated with several adverse psychosocial outcomes in childhood and adolescence. The present study aimed to investigate feelings of loneliness and social dissatisfaction in school-aged typically-developing (TD) siblings of children with an autism spectrum disorder (ASD). For this purpose, 118 siblings of children with ASD and 115 siblings of TD children and one of their parents participated in this study. Siblings of ASD-children reported higher levels of loneliness and social dissatisfaction than the controls. The hierarchical multiple regressions performed revealed that those feelings were inversely associated with being the first-born and with specific aspects of social support as perceived by the parent. The younger siblings of ASD-children seem to be in need of certain interventions beyond social support.

Functioning Among Typically Developing Siblings of Individuals with Autism Spectrum Disorder: A Meta-Analysis

The literature on typically developing siblings of individuals with autism spectrum disorder (ASD-Sibs) provides inconsistent results, with some studies reporting ASD-Sibs are more likely to have negative outcomes than comparison groups, and others reporting no significant differences. Therefore, the purpose of this study was to meta-analytically aggregate study effect sizes to more accurately calculate the degree to which ASD-Sibs function similarly or differently compared to siblings of people who do not have ASD. Studies were eligible for inclusion if they had a sample of ASD-Sibs older than 5; reported on emotional, psychological, behavioral, or social functioning; and provided information necessary for calculating relevant effect sizes. Results from 69 independent samples indicated that ASD-Sibs have significantly more negative outcomes than comparison groups overall (g = - 0.26); specific areas of functioning in which ASD-Sibs fared worse include internalizing behavior problems, psychological functioning, beliefs, social functioning, and the sibling relationship, but no significant differences in adjustment, attention/hyperactivity, externalizing behavior problems, coping, or family functioning. Noteworthy sub-areas of functioning in which ASD-Sibs also fared worse included beliefs about disability (g = - 0.56), anxiety symptoms (g = - 0.25), and depression symptoms (g = - 0.36). In terms of comparison group, ASD-Sibs had significantly lower functioning than siblings of individuals with other intellectual and developmental disabilities (g = - 0.31), including Down syndrome (g = - 0.40) and siblings of individuals without any disabilities (g = - 0.31). Clinicians and service providers should work to ensure that ASD-Sibs are included in family interventions and support strategies, and researchers should further explore individual differences that may relate to enhanced or impaired functioning in ASD-Sibs.

Randomized controlled trial of a sibling support group: Mental health outcomes for siblings of children with autism

LAY ABSTRACT

Typically developing siblings of a child with autism spectrum disorder may show mental health difficulties. A support group is one approach to help typically developing siblings. During support groups, typically developing siblings discuss their feelings, learn coping strategies and problem-solving skills, and develop a peer network. We compared a support group to participation in a similar group without a focus on the sibling with autism spectrum disorder. Some areas of mental health improved. Improvements were also impacted by autism spectrum disorder symptom severity in the sibling with autism spectrum disorder. Findings suggest continuing to examine how support groups can help typically developing siblings and for which siblings support groups might be particularly effective.

Academic self-concept and sense of school belonging of adolescent siblings of autistic children

BACKGROUND

Whilst there is a growing body of research on the psychological outcomes for siblings of autistic children (autism siblings), few studies have considered the school context.

AIMS

To explore group differences on two school-related self-reported outcomes for autism siblings and siblings of non-autistic children: sense of school belonging, and academic self-concept. Data on self- and parent/carer-reported behavioural and emotional problems were also collected.

METHODS AND PROCEDURES

65 autism siblings and a comparison group of 57 siblings of non-autistic children aged 11-16 years completed questionnaires measuring sense of school belonging, academic self concept, and behaviour problems. 73 parents in the autism sibling and 67 parents in the comparison sibling group completed the behaviour problems measure.

OUTCOMES AND RESULTS

Autism siblings reported significantly lower school belonging and academic self-concept, and had significantly poorer self- and parent- reported behaviour problems. When controlling for demographic variables and internalising and externalizing behaviour, robust sibling group differences on academic variables remained.

CONCLUSIONS AND IMPLICATIONS

Autism siblings reported poorer school-related outcomes and increased behavioural difficulties relative to siblings of non-autistic children. There was wide variation in autism siblings' outcomes, highlighting the importance of taking an individualised and contextualised approach to understanding the varying needs of autism siblings.

Impact of growing up with a sibling with a neurodevelopmental disorder on the quality of life of an unaffected sibling: a scoping review

PURPOSE

Growing up with a sibling with a neurodevelopmental disorder can have positive and negative effects on personal, social and emotional well-being; however, little is known about the impacts on unaffected siblings' quality of life. The purpose of this review was to synthesize evidence from studies evaluating the quality of life of unaffected siblings of children with neurodevelopmental disorders.

METHOD

A systematic search was conducted on four databases to identify studies reporting the quality of life of unaffected siblings of children with neurodevelopmental disorders.

RESULTS

Seven studies met the inclusion criteria. Four studies reported impaired quality of life in unaffected siblings of children with neurodevelopmental disorder while three studies reported not the impaired quality of life. Parents reported the lower quality of life for children with or without neurodevelopmental disorders compared to children's self-reports.

CONCLUSIONS

This review provides the mixed evidence on the quality of life in unaffected siblings of children with neurodevelopmental disorders, and identifies the substantial gap in the research regarding the impacts of children's neurodevelopmental disorders on the quality of life of their unaffected siblings. Assessment of unaffected siblings' quality of life is necessary to identify those who may be at risk and to provide support programs for physical and emotional well-being. Future research examining the quality of life of unaffected siblings across a variety of NDD is needed.Implications for rehabilitationGrowing up with a sibling with a neurodevelopmental disorder influences the personal and social development of the unaffected child.Measuring quality of life can have a meaningful impact on the lives of unaffected siblings of children with neurodevelopmental disorders and their families. Evidence generated from such studies can be used by healthcare providers such as physicians, nurses, psychologists, and social workers to recommend appropriate supports to the family and siblings.

'I don't live with autism; I live with my sister'. Sisters' accounts on growing up with their preverbal autistic siblings

BACKGROUND

The experiences of siblings in early adolescent years who grow up with an autistic brother or sister have received very little research interest, especially in terms of sisters' experiences. Hence our understanding of wellbeing opportunities and challenges in siblings' everyday life is inadequate and not reflected in the current clinical practices.

METHODS

Semi-structured interviews utilising an active, non-judgemental and curious stance to explore how sisters make sense of their everyday experiences (inspired by the notion of mentalizing) were conducted to capture important experiences of nine typically developing female siblings.

RESULTS

Interpretative Phenomenological Analysis (IPA) was employed. The master themes included: (i) sisters' interactions with their siblings- 'I don't live with autism, I live with my sister' (ii) sisters' interactions with their parents- 'Always there for us, but often asking too much', (iii) practical struggles of caring- 'Like a lonely fighter, tired but always on duty', (iv) perceived sisters' needs- 'I care about my brother and I want society to care about us'.

DISCUSSION

As experts of their own lived experience, sisters shed light on their day-to-day experiences. The themes derived from their experiences may help to draw attention to an appreciation of everyday life including planning for the parts that remain a struggle. This latter point is discussed in terms of implications and adoption of an existential view of wellbeing for future research and practice.

Brief Report: Sibling Feelings Toward their Brother or Sister With or Without Autism or Intellectual Disability

The present study examined 97 adolescent siblings of individuals with autism spectrum disorder (ASD), intellectual and developmental disabilities (IDD), or no disabilities. Siblings reported on their feelings toward their brother or sister (anxiety, hostility, and positive affect), and parents reported on general optimism, child behavior problems, and perceptions of how the child impacts the family, including the sibling. There were no differences between siblings of individuals with ASD and siblings of individuals with IDD on any sibling self-reported feelings toward their brother or sister, though parents of individuals with ASD reported significantly less optimism and more negative perception of the child's impact on the family than did parents of children with IDD or no disability.

The Autism Family Experience Questionnaire (AFEQ): An Ecologically-Valid, Parent-Nominated Measure of Family Experience, Quality of Life and Prioritised Outcomes for Early Intervention

There is a lack of measures that reflect the intervention priorities of parents of children with autism spectrum disorder (ASD) and that assess the impact of interventions on family experience and quality of life. The Autism Family Experience Questionnaire (AFEQ) was developed through focus groups and online consultation with parents, and reflected parental priorities. It was then administered to the parents of children enrolled in the Pre-school Autism Communication Trial and its 6-year follow-up study. The AFEQ showed good convergent validity with well-established measures of child adaptive functioning, parental mental health and parental wellbeing. It was sensitive to change in response to a parent-mediated intervention for young children with autism, showing treatment effect at treatment endpoint which increased at six-year follow-up.

Discrepancy in perceived social support among typically developing siblings of youth with autism spectrum disorder

Social support can buffer against stressors often associated with having family members with autism spectrum disorder. This study included 112 parents and typically developing siblings of children with autism spectrum disorder. Relations between self-reported typically developing sibling emotional and behavioral problems and discrepancy between social support frequency and importance were examined via polynomial regression with response surface analysis. Typically developing siblings who described social support as frequent and important reported relatively few problems. Typically developing siblings who reported social support as highly important but infrequent exhibited the highest emotional and behavioral difficulties. Thus, typically developing siblings with little support who view support as highly important may be particularly responsive to social support improvement efforts.

An exploration of common dopaminergic variants and behavior problems in siblings at high risk for autism spectrum disorder

Younger siblings of children with ASD often exhibit elevated internalizing and externalizing problems. We investigated common dopaminergic variants (DRD4 and DRD2) in relation to behavior problems at 36 months. Genotypes linked to less efficient dopaminergic functioning were associated with higher internalizing problems in high-risk siblings.

Risk Factors for Behavioral and Emotional Difficulties in Siblings of Children With Autism Spectrum Disorder

This study examined risk factors for behavioral and emotional problems in 1973 siblings of children with autism spectrum disorders (ASD). Results revealed six correlates of sibling internalizing and externalizing problems: male gender, smaller family size, older age of the child with ASD, lower family income, child with ASD behavior problems, and sibling Broader Autism Phenotype. Siblings with few risk factors were at low risk for behavioral and emotional problems. However, siblings with many risk factors were at increased risk for both internalizing and externalizing problems. These results highlight the need to assess risk for individual siblings to best identify a sub-population of siblings who may be in need of additional support.

Psychosocial Adjustment and Sibling Relationships in Siblings of Children with Autism Spectrum Disorder: Risk and Protective Factors

This study compared sibling adjustment and relationships in siblings of children with Autism Spectrum Disorder (ASD-Sibs; n = 69) and siblings of children with typical development (TD-Sibs; n = 93). ASD-Sibs and TD-Sibs demonstrated similar emotional/behavioral adjustment. Older male ASD-Sibs were at increased risk for difficulties. Sibling relationships of ASD-Sibs involved less aggression, less involvement, and more avoidance than those of TD-Sibs. Partial support for a diathesis-stress conceptualization of sibling difficulties was found for ASD-Sibs. For TD-Sibs, broader autism phenotype (BAP) was related to psychosocial difficulties regardless of family stressors. For ASD-Sibs, BAP was related to difficulties only when family stressors were present. This suggests that having a sibling with ASD may be a protective factor that attenuates the negative impact of sibling BAP.

A community support program for children with autism and their typically developing siblings: Initial investigation

Siblings are a critical part of lifelong support for individuals with autism spectrum disorder (ASD). But siblings face their own social-emotional adjustment needs. These needs may be addressed through programs that include support groups specifically for the siblings. This study examined the effects of a community program on typical siblings' depression, anxiety, ASD knowledge, and peer network as well as reciprocal interactions between the typical sibling and sibling with ASD. The program provided a sibling support group, a skills intervention for children with ASD, and an inclusive recreation time. Siblings reported significant decreases in depression and physiological anxiety and improvements in their peer network. Autism knowledge increased but only approached significance. Direct observations revealed improvement in reciprocal interactions by most children that did not reach statistical significance. Parents, typical siblings, and interventionists indicated positive reactions to the program and its goals and outcomes. Findings are discussed in terms of the need to continue to explore interventions for siblings of children with ASD.

Trait-level temporal lobe hypoactivation to social exclusion in unaffected siblings of children and adolescents with autism spectrum disorders

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Brain responses to social exclusion were measured in ASD unaffected siblings.

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Unaffected siblings show trait atypical activation in posterior temporal lobe.

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Biological vulnerability moderates relationship between IQ and brain responses.

Social exclusion elicits powerful feelings of negative affect associated with rejection. Additionally, experiencing social exclusion reliably recruits neural circuitry associated with emotion processing. Recent work has demonstrated abnormal neural responses to social exclusion in children and adolescents with autism spectrum disorders (ASD). However, it remains unknown to what extent these abnormalities are due to atypical social experiences versus genetic predispositions to atypical neural processing. To address this question, the current study investigated brain responses to social exclusion compared to a baseline condition of fair play in unaffected siblings of youth with ASD using functional magnetic resonance imaging. We identified common deviations between unaffected siblings and ASD probands that might represent trait-level abnormalities in processing Social Exclusion vs. Fair Play, specifically in the right anterior temporoparietal junction extending into posterior superior temporal sulcus. Thus, hypoactivation to Social Exclusion vs. Fair Play in this region may represent a shared genetic vulnerability to developing autism. In addition, we present evidence supporting the idea that one's status as an unaffected sibling moderates the relationship between IQ and neural activation to Social Exclusion vs. Fair Play in anterior cingulate cortex. These results are discussed in the context of previous literature on neural endophenotypes of autism.

Self-reported behaviour problems and sibling relationship quality by siblings of children with autism spectrum disorder

BACKGROUND

There are few published research studies in which siblings of children with autism spectrum disorder (ASD) provide self-reports about their own behavioural and emotional problems and their sibling relationships. Reliance on parent reports may lead to incomplete conclusions about the experiences of siblings themselves.

METHODS

Siblings 7-17 years and their mothers from 94 families of children with ASD were recruited. Mothers reported on family demographics, the behavioural and emotional problems of their child with ASD, and on their own symptoms of depression. Siblings reported on their relationship with their brother or sister with ASD, and siblings 11+ years of age also self-reported on their behavioural and emotional problems.

RESULTS

Compared with normative British data, siblings reported very slightly elevated levels of behavioural and emotional problems. However, none of the mean differences were statistically significant and all group differences were associated with small or very small effect sizes - the largest being for peer problems (effect size = 0.31). Regression analysis was used to explore family systems relationships, with sibling self-reports predicted by the behaviour problems scores for the child with ASD and by maternal depression. Maternal depression did not emerge as a predictor of siblings' self-reported sibling relationships or their behavioural and emotional problems. Higher levels of behaviour problems in the child with ASD predicted decreased warmth/closeness and increased conflict in the sibling relationship.

CONCLUSIONS

These data support the general findings of recent research in that there was little indication of clinically meaningful elevations in behavioural and emotional problems in siblings of children with ASD. Although further research replication is required, there was some indication that sibling relationships may be at risk where the child with ASD has significant behaviour problems.

The well-being of siblings of individuals with autism

Objective. The purpose of this review of the literature was to summarise studies regarding the psychosocial impact of growing up with a sibling with autism and to identify gaps in the related literature. Methods. Electronic databases were reviewed in order to critically appraise the 14 articles relevant to the topic. The search included a combination of the following key words: autism∗, quality of life, well-being, sibling∗, ASD, ASD sibling∗, family, adjust∗, psychological functioning. Results. The majority of studies involved mixed children and adolescent samples, leading to confounding results and an inability to draw accurate conclusions about these distinct life stages. Autism appears to contribute to unique environmental stressors for the typically developing sibling. When experienced in the context of additional demographic risk factors, these stressors can result in difficulties adjusting to the demands of a special-needs child. Despite some vulnerability to behavioural and emotional dysfunction in at-risk children, siblings have the potential to not only adjust but to thrive in the face of disability adversity. Conclusion. Growing up with a sibling with autism appears to manifest in both positive and negative outcomes for siblings, depending upon important demographical, family, and individual variables.

Behavior and sleep problems in children with a family history of autism

The present study explores behavioral and sleep outcomes in preschool-age siblings of children with autism spectrum disorders (ASD). This study focuses on behavior problems that are common in children with ASD, such as emotional reactivity, anxiety, inattention, aggression, and sleep problems. Infant siblings were recruited from families with at least one older child with ASD (high-risk group, n = 104) or families with no history of ASD (low-risk group, n = 76). As part of a longitudinal prospective study, children completed the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule, and parents completed the Child Behavior Checklist (CBCL) and the Social Communication Questionnaire at 36 months of age. This study focuses on developmental concerns outside of ASD; therefore, only siblings who did not develop an ASD were included in analyses. Negative binomial regression analyses revealed that children in the high-risk group were more likely to have elevated behavior problems on the CBCL Anxious/Depressed and Aggression subscales. To explore sleep problems as a correlate of these behavior problems, a second series of models was specified. For both groups of children, sleep problems were associated with elevated behavior problems in each of the areas assessed (reactivity, anxiety, somatic complaints, withdrawal, attention, and aggression). These findings support close monitoring of children with a family history of ASD for both behavioral and sleep issues.

The perceptions and experiences of adolescent siblings who have a brother with autism spectrum disorder

BACKGROUND

There is a dearth of research on the perspectives of adolescent siblings growing up with a brother or sister with an autism spectrum disorder (ASD).

METHOD

Semistructured interviews were used to elicit the perceptions and experiences of 12 typically developing adolescents with a brother with an ASD. Interpretative phenomenological analysis was used.

RESULTS

The data analysis of the siblings' perceptions yielded 6 themes: (a) difficulties and negative impact of their brother's condition on themselves and their family, (b) how others' reactions to their brother negatively affected them as siblings, (c) how their histories with their brothers contextualised their present circumstances, (d) the varying degrees of acceptance and tolerance towards their brothers, (e) positive perceptions and experiences with their brothers, and (f) their thoughts and worries about the future.

CONCLUSIONS

The main implications are for supports to adolescent siblings by helping them to develop skills in managing others' reactions and openly discussing concerns about their brother's future.

Having a brother or sister with Down syndrome: perspectives from siblings

This study asks brothers and sisters about their feelings and perceptions toward their sibling with Down syndrome (DS). We analyzed valid and reliable surveys from 822 brothers and sisters whose families were on the mailing lists of six non-profit DS organizations around the country. More than 96% of brothers/sisters that responded to the survey indicated that they had affection toward their sibling with DS; and 94% of older siblings expressed feelings of pride. Less than 10% felt embarrassed, and less than 5% expressed a desire to trade their sibling in for another brother or sister without DS. Among older siblings, 88% felt that they were better people because of their siblings with DS, and more than 90% plan to remain involved in their sibling's lives as they become adults. The vast majority of brothers and sisters describe their relationship with their sibling with DS as positive and enhancing.

Psychological and school functioning of Latino siblings of children with intellectual disability

BACKGROUND

Siblings of children with disabilities are at risk for internalizing psychological disorders; however, little is known about how culture influences this effect. This study examined the psychological and school functioning of Latino siblings of children with intellectual disability (ID).

METHODS

Participants were 100 Latino (L) and nonLatino (NL) siblings (8-15 years) of children with ID (50 LID, 50 NLID) and 100 Latino and nonLatino control siblings (50 LC, 50 NLC). Siblings, parents, and teachers completed standard questionnaires regarding sibling emotional and behavioral functioning; sibling school report cards were obtained. Analyses of variance were conducted, controlling for parent age and family income; planned contrasts compared LID siblings to the other sibling groups.

RESULTS

LID siblings reported significantly more internalizing (t(1) = 2.41, p < .05) and emotional t(1) = 3.06, p < .05) symptoms, poorer awareness of (t(1) = 2.26, p < .01) and greater reluctance to express (t(1) = 3.12, p < .01) their emotions, and more problems in personal adjustment and relationships with parents (t(1) = -2.50, p < .05). Significantly higher percentages of LID siblings scored in the at-risk or clinical range for internalizing and emotional symptoms, and were more likely to score above the clinical cut-off for separation anxiety disorder and to endorse global impairment. LID siblings experienced more school absences and lower academic performance. There were no group differences in externalizing behavior problems, somatic symptoms, or teacher-reported internalizing symptoms.

CONCLUSIONS

Latino siblings of children with ID are at greater risk for internalizing psychological disorders and greater impairment in personal and school functioning. Results are discussed in terms of their sociocultural significance and clinical implications.

Emotional and behavioural adjustment in siblings of children with intellectual disability with and without autism

Siblings of children with autism may be at greater risk for psychological problems than siblings of children with another disability or of typically developing (TD) children. However, it is difficult to establish whether autism or the presence of intellectual disability (ID) explains the findings in previous research. Mothers rated the emotional and behavioural adjustment of siblings of children with ID with ( N = 25) or without ( N = 24) autism. Data were also available 18 months later for siblings of children with autism and ID ( N = 15). Siblings of children with autism and ID had more emotional problems compared with siblings of children with ID only and with normative data. Three variables were pertinent: increasing age of the child with autism, having a brother with autism, and being younger than the child with autism. Behavioural and emotional difficulties of siblings of children with autism and ID were relatively stable over 18 months.

The impact of children with high-functioning autism on parental stress, sibling adjustment, and family functioning

The article discusses a study conducted to investigate the impact of children with high-functioning autism (HFA) on parental stress, sibling adjustment, and family functioning; the study involves a sample of parents of 15 children with HFA and parents of 15 matched control children who completed questionnaires measuring the dependent variables. The results indicate parents of children with HFA experience significantly more parenting stress than parents of children with no psychological disorder, which was found to be directly related to characteristics of the children. The study further shows that the higher intellectual functioning in children with HFA does not compensate for the stress associated with parenting children with autism spectrum disorders. Because the intervention efforts directed at children with HFA will not eliminate the child's primary symptoms, treatment programs may need to address parental stress, which in turn will help optimize treatment outcome for the child and the family.

Adolescent siblings of individuals with an autism spectrum disorder: testing a diathesis-stress model of sibling well-being

The purpose of this study was to test a diathesis-stress model of well-being for siblings who have a brother or sister with an autism spectrum disorder (ASD). Data were collected from 57 adolescents and their mothers. Sisters reported higher levels of depressive and anxiety symptoms than brothers. Having a family history of ASDs was associated with depressive, but not anxiety, symptoms. A high level of maternal depression was also associated with more depressive and anxiety symptoms. A diathesis-stress model was partially supported, primarily through the findings that sibling sub-threshold autism characteristics were associated with depressive and anxiety symptoms in siblings, but only in the presence of a high number of stressful life events.

Caring for an individual with autism disorder: a qualitative analysis

BACKGROUND

Caregivers in this qualitative study reported the multidimensional implications of having a child with autism on their family's lives and overall functioning.

METHOD

The Effects of the Situation Questionnaire (Yatchmenoff, Koren, Friesen, Gordon, & Kinney, 1998) was used to gather qualitative data from 80 caregivers. Colaizzi's (1978) phenomenological data analysis method was used to analyse the caregivers' written narratives. Biopsychosocial-spiritual, systemic, and ecological theoretical lenses were used to conceptualise the recorded experiences.

RESULTS

Seven thematic content areas emerged from the caregivers' data. They include: psychological implications, familial implications, social implications, services, spiritual benefits, economic challenges, and focus on the future of having a child diagnosed with autism.

CONCLUSIONS

The results of this study offer valuable insight into how helping professionals may attend to the biological, psychological, social, and spiritual dimensions of those caring for an individual with autism.

Neuropsychological functioning of siblings of children with autism, siblings of children with developmental language delay, and siblings of children with mental retardation of unknown genetic etiology

Neuropsychological functioning of 30 siblings of children with autism (AU-S), 28 siblings of children with mental retardation of (MR-S), and 30 siblings of children with developmental language delay (DLD-S) was compared. Two siblings, both AU-S, received diagnoses of pervasive developmental disorder (PDD). More siblings with cognitive disabilities were found in DLD-S than in AU-S. However, these differences disappeared after excluding diagnosed siblings or after accounting for family membership. In sum, despite the elevated incidence of PDD among AU-S, the neuropsychological functioning of the remaining siblings did not convey specific characteristics related to the genetic risk associated with autism, in contrast to the cognitive functioning of the DLD-S, which did reflect a genetic risk.

Siblings' experiences of having a brother or sister with autism and mental retardation: a case study of 14 siblings from five families

The aim of this study was to describe the present and past experiences of 14 siblings from five families in terms of having a brother or sister with autism and mental retardation. Personal interviews were conducted with the siblings before their brothers or sisters were moved to a newly opened group home. Qualitative content analysis was used for the analysis of the transcribed texts. The analysis resulted in seven content categories: precocious responsibility, feeling sorry, exposed to frightening behavior, empathetic feelings, hoping that a group home will be a relief, physical violence made siblings feel unsafe and anxious, and relations with friends were affected negatively. The conclusion is that these siblings' experiences revealed stressful life conditions. Counseling for the family and for siblings is recommended to help them deal with their feelings and problems. For the siblings in these five families, a group home was a relevant alternative as a temporary or permanent placement for the child with autism and mental retardation.

Siblings of individuals with autism or Down syndrome: effects on adult lives

BACKGROUND

In this study, we examine instrumental and affective involvement in the sibling relationship for adults who have a brother or sister with an autism spectrum disorder (ASD) or Down syndrome (DS). We ask three research questions: (1) How do adult siblings of individuals with ASD differ from siblings of individuals with DS in their assessment of the quality of the sibling relationship and their experience of growing up with a brother or sister with a disability? (2) Are there gender effects on the sibling relationship and sibling experience in these two groups? (3) Which factors are predictive of variation in the sibling relationship for siblings of adults with ASD or DS?

METHODS

Data from 154 siblings who participated in two linked longitudinal studies were used. Seventy-seven siblings with a brother or sister with ASD were matched by age and gender to 77 siblings with a brother or sister with DS. The siblings in each group were between 21 and 56 years of age and over half were sisters. Siblings completed questionnaires on instrumental and affective involvement with their brother or sister with ASD or DS, the impact of growing up with a brother or sister with a disability on their lives, and their coping skills and feelings of pessimism.

RESULTS

Compared with the siblings of adults with DS, siblings of adults with ASD had less contact with their brother or sister, reported lower levels of positive affect in the relationship, felt more pessimistic about their brother or sister's future, and were more likely to report that their relationships with their parents had been affected. For siblings of adults with ASD, a closer sibling relationship was observed when the sibling had lower educational levels, lived closer to the brother or sister with ASD, used more problem-focused coping strategies, and when his or her brother or sister with ASD had higher levels of functional independence. In contrast, for siblings of adults with DS, a closer sibling relationship was observed when the sibling did not have children, had lower levels of education, lived closer to the brother or sister with DS, when he or she used more problem-focused coping, was less pessimistic about the brother or sister's future, and when his or her life had been impacted to a greater extent by growing up with a brother or sister with DS.

CONCLUSIONS

We discuss the implications of these findings for future caregiving roles for siblings. Siblings of individuals with ASD may face difficulty when their parents are no longer able to be the primary caregivers for their brother or sister with ASD, as they tend to have less emotional closeness and are more pessimistic about their brother or sister's future than siblings of individuals with DS. Moreover, in both groups, a closer sibling relationship was observed when the sibling used more problem-focused coping strategies, which may have implications for intervention.

Cognitive and verbal abilities of 24- to 36-month-old siblings of children with autism

The cognitive and language skills of 30 siblings of children with autism (SIBS-A) and 30 siblings of typically developing children (SIBS-TD) were compared. Non-significant group differences emerged for cognition at both ages. At 24 months, significantly more SIBS-A demonstrated language scores one or two standard deviations below the mean compared to SIBS-TD. At 36 months, the groups differed significantly in receptive language, and more SIBS-A displayed receptive and expressive difficulties compared to SIBS-TD. Six SIBS-A (including one diagnosed with autism) revealed language scores more than two standard deviations below the mean at both ages, a pattern not seen in the SIBS-TD. Results are discussed in reference to language difficulties in autism spectrum disorders and the genetic liability for autism.

The sibling experience: growing up with a child who has pervasive developmental disorder or mental retardation

Parents raising a child with significant developmental challenges are profoundly aware of the often sustained impact of that child's special needs upon their other children. Supported by recent research on siblings of developmentally challenged children, clinicians are advocating family-based interventions that take into account the needs of siblings. This article reviews the experience of siblings who live with brothers or sisters diagnosed with pervasive developmental disorder or mental retardation. Contributions from research on typical siblings are drawn upon when appropriate. Six domains of the sibling experience are identified. These domains explore relational shifts within sibling relationships and through the expectable differential parental treatment of each child. Shifts considered in this review include the interrelationships with the extended family, peers, and friendships, all of which contribute to shaping the meaning that siblings give to living with developmentally challenged brothers or sisters across time.

What the other children are thinking: brothers and sisters of persons with Down syndrome

Brothers and sisters are obligatorily welcomed to the disability community when a person with Down syndrome (DS) is part of the family unit. How they react to such an invitation is the focus of this investigation. Here, we review the most current research on brothers and sisters of persons with DS, and comment on our own experience in facilitating sibling workshops at the local, state, and national levels. The evidence, to date, seems clear: brothers and sisters experience a wide range of emotions, but typically the positive feelings outweigh the negative ones. Further, siblings find rich value in having a family member with DS, and most will assume positions of advocacy at some level in their lives. Recommendations for physicians on how parents can nurture healthy relationships among their children are offered.

The Adjustment of Non-Disabled Siblings of Children with Autism

This study compared the psychosocial and emotional adjustment of siblings of children with autism and siblings of non-disabled children. In addition, differences between self and parent reports, as well as various demographic characteristics were examined. Fifty-one siblings of children with autism and 35 siblings of non-disabled children, between the ages of 7 and 17, along with one parent of each sibling, participated. Results indicated that the presence of a child with autism appears to enhance the psychosocial and emotional development of non-disabled siblings when demographic risk factors are limited. However, the presence of a child with autism appears to have an increasingly unfavorable impact on the non-disabled sibling as demographic risk factors increase.

Longitudinal Relationships Between Sibling Behavioral Adjustment and Behavior Problems of Children with Developmental Disabilities

Siblings of children with developmental disabilities were assessed twice, 2 years apart (N = 75 at Time 1, N = 56 at Time 2). Behavioral adjustment of the siblings and their brother or sister with developmental disability was assessed. Comparisons of adjustment for siblings of children with autism, Down syndrome, and mixed etiology mental retardation failed to identify group differences. Regression analysis showed that the behavior problems of the child with developmental disability at Time 1, but not the change in their behavior over time, predicted sibling adjustment over 2 years. There was no evidence that this putative temporal relationship operated bidirectionally: sibling adjustment did not appear to be related to the behavior problems of the children with developmental disabilities over time.

Adjustment, sibling problems and coping strategies of brothers and sisters of children with autistic spectrum disorder

BACKGROUND

Siblings of children with autistic spectrum disorder (ASD) express more problem behaviours and experience more difficulties in their relationships than do children in families where all children are developing typically. We know little about what contributes to these difficulties.

METHOD

Mothers of a child with ASD completed the Child Behavior Checklist (Achenbach, 1991) with respect to a non-disabled sibling. Siblings responded to a questionnaire tapping their knowledge about their brother or sister's disorder. They reported on problems they had experienced with their brother or sister with ASD and on the coping strategies they had used in response to these events. Problems were classified into 1 of 5 problem types.

RESULTS

Aggressive behaviour was the most commonly reported interaction problem and anger was the usual response. Siblings did not generally choose blaming (either self or other) as a coping strategy when facing difficulties with their brother or sister with ASD. Neither coping strategies nor knowledge of ASD were associated with adjustment. Forty percent of non-disabled siblings had scores on the Child Behavior Checklist that placed them in the borderline or clinical range.

CONCLUSIONS

The current study indicated that siblings of children with ASD are at increased risk of developing internalising behaviour problems. The contributing factors to this outcome are unknown at this point. It is important for research to focus on dynamic variables in the search for these contributors, as they are open to change.

Systems analysis of stress and positive perceptions in mothers and fathers of pre-school children with autism

Systemic analyses of psychological functioning in families of children with autism have typically shown that parents report different experiences (e.g., stress) and that siblings may also be affected. The purpose of the present research was more explicitly to address relationships between child, partner, and parent variables. Parents of 48 children with autism (41 mother-father pairs) reported on child characteristics, and their own stress and mental health. Mothers were found to report both more depression and more positive perceptions than fathers. Regression analyses revealed that paternal stress and positive perceptions were predicted by maternal depression; maternal stress was predicted by their children's behavior problems (not adaptive behavior or autism symptoms) and by their partner's depression. The future testing of the mechanisms underlying these results is discussed. In addition, the need is emphasized for more systemic analyses to understand the psychological functioning of children with autism and their siblings and parents.

Estresse e relações familiares na perspectiva de irmãos de indivíduos com transtornos globais do desenvolvimento

Os Transtornos Globais do Desenvolvimento (TGD) caracterizam-se pelo comprometimento da interação social, pelo uso estereotipado e repetitivo da linguagem e pela presença de comportamentos repetitivos com interesses restritos. A maioria dos estudos nessa área focaliza o impacto dos TGD nos pais, ao passo que pouca atenção tem sido dada ao impacto nos irmãos. O presente estudo objetivou investigar a presença de indicadores de estresse e a qualidade das relações familiares em irmãos de indivíduos com e sem TGD. Participaram 62 crianças e adolescentes com idades entre 8 e 18 anos. Os resultados revelaram a ausência de indicadores de estresse nos grupos investigados. Os dados corroboram as premissas do metamodelo de Adaptação da Família à Doença Crônica, ao demonstrar que a presença de um membro com TGD na família não representa, obrigatoriamente, um evento adverso para os irmãos, desde que haja qualidade nas relações familiares e uma rede de apoio.

Social and emotional adjustment of siblings of children with autism

BACKGROUND

Social and emotional adjustment of siblings of children with autism was examined, to explore their risk or resilience to effects of genetic liability and environmental factors involved in having a sibling with autism.

METHOD

Social-emotional adjustment, behavior problems, socialization skills, and siblings' relationships were compared among 30 siblings of children with autism, 28 siblings of children with mental retardation of unknown genetic etiology (MR), and 30 siblings of children with developmental language disorders (DLD). Groups were matched by probands' gender, siblings' chronological age, gender, IQ, and birth order, and by family size, ethnicity, and parental income, employment, and stress level.

RESULTS

Four siblings of children with autism, three siblings of children with MR, and seven siblings of children with DLD received DSM-IV diagnoses. Nevertheless, most of the siblings were well adjusted.

CONCLUSIONS

The adjustment of siblings of children with autism is in sharp contrast to the severe social and emotional disabilities characteristic of autism, and is noteworthy considering the stress involved in having a sibling with autism.

Sibling relationships when a child has autism: marital stress and support coping

Family systems theory was employed to study sibling relationships in 50 families with a child with autism. Typically developing siblings expressed satisfaction with their sibling relationships. Parents were somewhat less positive about the sibling relationship than were the siblings themselves. As hypothesized, stress in the marital relationship was associated with compromised sibling relationships. Informal social support buffered the deleterious effects of marital stress on positive, but not negative, aspects of the sibling relationship. Contrary to predictions, families experiencing high marital stress who sought greater support from formal resources external to the family had typically developing siblings who reported a higher level of negative sibling behaviors than families who sought low levels of formal support. Findings reinforce the importance of considering family context as a contributor to the quality of the sibling relationship.

Behavioural problems, social competence and self-concept in siblings of children with autism

INTRODUCTION

This study investigated the psychological adjustment of siblings of children with high-functioning autism (HFA) in comparison with siblings of normally developing children in the domain of behavioural problems, social competence and self-concept.

METHOD

Twenty-nine siblings of children with HFA and 29 siblings of children without a disorder participated in the study. Standardized, written questionnaires were used.

RESULTS

Siblings of children with HFA, especially brothers and sisters between 6 and 11 years old, had more behavioural problems than siblings of the control group. Sisters of children with HFA ascribed higher social competence to themselves. Sisters of children with HFA between 12 and 16 years old had a more positive self-concept. In both groups siblings with a more negative self-concept had less social skills and siblings with a more positive self-concept scored better in the social domain. Finally, in accordance with the control group, the perception of the siblings' social competence of parents of children with HFA broadly matched the perception siblings had of themselves.

DISCUSSION

Overall, siblings of children with HFA are not more susceptible to adaptation problems than siblings of children without a disorder. Implications for practice and further research are discussed.

Behavioral adjustment of siblings of children with autism engaged in applied behavior analysis early intervention programs: the moderating role of social support

There have been few studies of the impact of intensive home-based early applied behavior analysis (ABA) intervention for children with autism on family functioning. In the present study, behavioral adjustment was explored in 78 siblings of children with autism on ABA programs. First, mothers' ratings of sibling adjustment were compared to a normative sample. There were no reported increases in behavioral adjustment problems in the present sample. Second, regression analyses revealed that social support functioned as a moderator of the impact of autism severity on sibling adjustment rather than a mediator or compensatory variable. In particular, siblings in families with a less severely autistic child had fewer adjustment problems when more formal social support was also available to the family. The implications of these data for future research and for practice are discussed.