Depression and social adjustment in siblings of boys with autism

The impact of individuals with profound intellectual and multiple disabilities on peer relationships of typically developing siblings

INTRODUCTION/BACKGROUND

This study aims to determine the impact of a person with profound intellectual and multiple disabilities on peer relationships of their siblings.

METHODS

Information obtained from typically developing siblings of individuals with profound intellectual and multiple disabilities served as research material for this study. There were a total of 18 participants in the study. The analysis and interpretation were based on the procedures of grounded theory.

RESULTS AND CONCLUSION

The results of the study show that young adults with a brother or sister with profound intellectual and multiple disabilities have some difficulties in establishing relationships with their peers, especially those more intimate such as friendships or romantic endeavors. At the same time, research confirms that siblings of individuals with profound intellectual and multiple disabilities have high levels of empathy and understanding for others as well as sincere attachment to family.

Psychopathological symptoms in parents and siblings of people on the autism spectrum: A systematic review and meta-analysis

Parents and siblings of children on the autism spectrum experience significant distress, and for this reason, it is essential to understand the most prevalent psychopathological symptoms among this population. This work aims to establish the prevalence of psychopathological symptoms in parents and siblings of individuals on the autism spectrum, following the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) criteria. Searches were carried out using the PubMed/Medline, Embase, PsycINFO, SciELO, and Biblioteca Virtual em Saúde (BVS) databases. Twenty-three articles were included in this review. Depressive symptoms were the most frequently reported conditions, with a higher prevalence in mothers of children on the autism spectrum. In the meta-analysis, mothers of children on the autism spectrum scored higher by 0.42 standard deviations on the symptom scales (SMD 0.42; CI 0.25-0.59), with low statistical heterogeneity (I² 0%, p = 0.5) when compared with mothers of children with atypical development. The psychopathological symptoms of relatives should be investigated as part of the follow-up procedures for the child on the autism spectrum to facilitate their treatment.

What If You Can’t Ask Them? Psychometric Properties of a Behavioral Assessment of Sibling Relationship Quality

Building on studies of preferences for social interaction in children with autism spectrum disorder (ASD) we sought to provide a way for siblings with ASD to express their perspective about the quality of their sibling relationships. We developed a behavioral assessment of sibling relationship preference (Sibling Relationship Assessment [SRA]) and examined the psychometric properties of test-retest reliability, inter-rater reliability, and convergent validity. The SRA was feasible to administer and revealed expected differences between sibling dyads with one sibling with ASD compared to typically-developing sibling dyads. We found strong positive correlations for inter-rater reliability and test-retest reliability and convergent validity. The SRA provides a way to assess the perspective of the sibling with ASD that taps one characteristic, preference for spending time with one’s sibling, of the quality of sibling relationships.

Growing up alongside a sibling with a disability: A phenomenological examination of growth and deficiency in adulthood

BACKGROUND

A growing literature underscores the role played by sibling throughout life particularly for siblings with disabilities. However, limited research focuses on how growing up with a sibling with a disability impacts adult personality and well-being.

AIMS

The current study is a qualitative examination of the long-term effects of growing up with a sibling who has a developmental disability, using both a deficiency and growth model perspective.

METHODS AND PROCEDURES

Participants included 20 adult siblings of individuals with disabilities interviewed using a semi-structured interview. Interviews were conducted via an online platform.

OUTCOMES AND RESULTS

Themes identified were: impact on personal character traits, social development through sibling and overcoming social challenges, impacts on religiosity, influence on career choice, influence on romantic relationships and finding a partner, and future planning and stress. Distinct patterns of growth were noted in areas of personal development, character traits, social development, and interpersonal skills. On the other hand, hardships and anxieties were noted in general with specific negative features relating to social embarrassment and concerns about how the sibling status will impact potential romantic partnerships and future family life.

CONCLUSIONS AND IMPLICATIONS

The current study highlights the long-term impact of growing up with a sibling with a developmental disability with empirical and clinical implications.

Examination of the Effectiveness and Acceptability of a Play-Based Sibling Intervention for Children with Autism: A Single-Case Research Design

Complementary and reciprocal interactions are a defining feature of sibling relationships for young children. However, the social and communication difficulties of children with autism spectrum disorder (ASD) can make reciprocal play more difficult and play between siblings can be less rewarding. Sibling play can serve an important role in intervention and family cohesiveness, but there is no consistent method for involving siblings in intervention benefitting the sibling dyad. This study evaluated a novel treatment package including training siblings on play strategies to increase positive sibling play in combination with a sibling support group to offer social support for the neurotypical sibling (NT). The effects of the treatment package on NT sibling play and fidelity of implementation of naturalistic play strategies was examined using a concurrent multiple-baseline design across six dyads, five of whom completed the intervention. After behavior skills training, all NT siblings increased the number of strategies they used, and increased the frequency of initiations towards their sibling with ASD. In addition, the percentage of reciprocal play between siblings increased. Generalization probes and follow-up probes demonstrated above-baseline levels of performance across most dyads, indicating that the skills learned generalized across other toys and were maintained over time. Only three of the sibling support group sessions were completed due to the COVID-19 pandemic. Although the effectiveness of the sibling support group cannot be determined, social validity questionnaires suggest siblings and parents valued and liked the support group.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43494-021-00043-5.

Um olhar ético para o sofrimento da família da criança com autismo

No presente artigo, temos como objetivo discutir, do ponto de vista da ética, alguns impactos que o autismo pode ter nas relações familiares e, de maneira específica, no irmão mais novo da criança autista. Para tanto, recorremos a uma revisão bibliográfica acerca de possíveis efeitos do autismo nas relações familiares e também à apresentação de recortes autobiográficos de famílias de crianças autistas. Por décadas, a questão da etiologia do autismo foi tema de persistentes estereótipos e perspectivas reducionistas, que frequentemente culpabilizaram a mãe ou cuidadores pelo autismo da criança. Operamos uma torção no sentido de pensarmos sobre como a criança autista, com suas singularidades, pode vir a impactar as relações familiares, refletindo sobre como a subjetividade da criança afeta a família ao mesmo tempo em que é afetada por ela. Dessa forma, esperamos alargar as pesquisas psicanalíticas que enfocam este tema e escapar de uma perspectiva exteriorizada, especialista e culpabilizante.

'I Felt Like I was Floating in Space': Autistic Adults' Experiences of Low Mood and Depression

It is recognised that a high proportion of adults on the autism spectrum experience depressive symptoms. However, limited research has explored autistic peoples’ experiences of low mood and depression. The aim of this study was to explore the lived experiences of low mood and depression for adults on the autism spectrum. The study employed Interpretive Phenomenological Analysis to investigate the experiences of 8 adults (7 males and 1 female), aged between 19 and 51, who had a diagnosis of autism without co-occurring learning disabilities, and experienced low mood or depression. All participants recorded their thoughts and feelings in a mood diary for 1 week and participated in a semi-structured interview. Three superordinate themes emerged from the data: ‘Autism has made me the person I am’, ‘I can’t function in the world’ and ‘It’s like trying to do accounts on the futures market’: Making sense of emotions. Findings highlight a need for specialist mental health provision for adults who are on the autism spectrum. Limitations of this study and implications for future research are discussed.

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.

In their own words, in their own photos: Adolescent females' siblinghood experiences, needs and perspectives growing up with a preverbal autistic brother or sister

Thus far very little research has focused on siblings in early adolescent years growing up with an autistic sibling. Adopting a community-based participatory research (CBPR) approach, 11 typically developing sisters actively collaborated in the study to collect and analyse data as well as disseminate their experiences, needs and perspectives in their local communities. This is the first study to use a modified Photovoice methodology which provided typically developing sisters an active participatory role. The results highlighted the feelings, needs and thoughts the sisters expressed in their role as siblings, friends, but also as students and citizens with a passion for advocacy, and limited support in the community due to unhelpful attitudes of members of their community towards autism. The findings indicated that the current method used can successfully co-generate research findings with family members by ensuring pathways for engaging local community. This is crucial in shifting the balance between vulnerability and resilience in families raising an autistic child. Furthermore, when knowledge about the lived experience is drawn directly from the perspective of the actual people (siblings) involved in the phenomenon (siblinghood and autism), a more appropriate, responsive and need-fulfilling strategy of supportive and proactive support systems can be initiated.

'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.

Having a Sibling with ASD: Perspectives of Siblings and Their Parents

The overall purpose of this research was to explore the experiences of families living with a child with autism spectrum disorder (ASD). This paper reports the experiences of siblings of children with ASD, from the perspective of both siblings and parents. Using a phenomenological case study design, participants completed face sheets to provide context for one-on-one, semi-structured interviews, which were transcribed verbatim, and verified via member checks. Van Manen's (1990) selective approach was used for data analysis. Siblings and parents described that the children with ASD made their siblings the targets of their aggression, and siblings spent less time with parents the children with ASD required more attention. It was also acknowledged that the siblings were more mature as a result of having a sibling with ASD. Families acknowledged that the relationship between children with ASD and their siblings would not differ if their children did not have ASD. This work highlights the importance of examining the family as a unit to provide a multifaceted perspective of how having a child with ASD affects their siblings.

Altered Working Memory Processing of Emotion in Adolescents with Dysphoric Symptomatology: An Eye Tracking Study

It has been suggested that altered processing of emotion during cognitive control plays an important role in the etiology of depressive symptoms. The current study investigates the influence of emotional stimuli on working memory (WM) in adolescents with dysphoric symptomatology (DS). Twenty-five adolescents with DS and 40 adolescents with no dysphoric symptomatology (NDS) completed a memory-guided eye movement task. This task assessed the influence of irrelevant affective information on WM processes during high and low cognitive load. Latency analyses showed that, in the high load WM condition, negative distractors disturbed WM performance in adolescents with NDS, but not in adolescents with DS. Accuracy analyses revealed that adolescents with NDS had higher accuracy rates in the presence of positive distractors relative to negative and neutral distractors, and in comparison to adolescents with DS. The findings indicated altered WM performance in the context of emotional distractors in adolescents with DS and may contribute to theoretical knowledge and early prevention of youth depression.

Engaging with and navigating limbo: Lived experiences of siblings of adults with autism spectrum disorders

BACKGROUND

Supporting an adult with autism spectrum disorder (ASD) can be associated with family stress but also with personal growth and resilience. Research providing insight into how typically developing siblings make sense of their unique sibling relationships in adulthood remains limited.

METHOD

Using interpretative phenomenological analysis, this study explored subjective experiences of eight siblings of adults with ASD and co-occurring intellectual disability.

RESULTS

Analysis of interview transcripts revealed a complex lived experience explained by the overarching theme "engaging with and navigating limbo", which was characterized by commitment to the sibling relationship, power tensions in the family, uncertainty about the future and negotiating the tension between relational closeness and distance.

CONCLUSION

Using family systems theory, overregulation and closed communication emerged as processes relevant to families living with ASD. Clinical opportunities to support family communication, change tolerance and belonging are discussed.

Analyzing the Status of the Autism Spectrum Disorder Amid Children with Intellectual Disabilities in Bangladesh

Autism spectrum disorders (ASDs) are a collection of conditions characterized by stereo typed behaviors and narrow interests and pervasive problems with communication and social interactions. Globally, researchers are working on identifying the root cause and management of ASD. Although research on autism is at nascent stage in Bangladesh but in terms of social epidemicity, it is currently an utmost important issue. The aim of the study is to analyze the effect of age, sex, birth weight, mother’s pregnancy duration, pregnancy time complicacy and genetic linkage on autism. The study also related, the socio-economic status of the autistic children and satisfaction of parent on government response in this issue. The study was conducted on 50 patients in 2 Autistic Schools (Bangladesh Protibondhi Foundation and Autistic Children Welfare Foundation, Bangladesh) of the Dhaka City from June 2010 to December 2010. Study related data were collected through a predesigned questionnaire In our study out of 50 children with autism 86% were male and 24% were in the age range between 73to 84 months. About 84% children with autism were lived in urban area and about 52% were belonging at the upper middle class. The main signs and symptoms observed, was prefer to play alone (i.e. 74%). Moreover 60% children with autism talks later than age 2 and 58% had poor eye contact. During our study we have observed that 14% children were linked by heredity and 10% have siblings with same problem. Rett syndrome (i.e. 40%) and autistic disorder (i.e., 32%) were more commonly observed. From the prescription, the study revealed, physicians diagnosed speech delay in 32% patient and 8% were diagnosed with attention deficit hyperactivity disorder. For treatment physicians mainly prescribes vitamins (i.e. 50%), antiepileptic drugs (i.e. 12%), and antipsychotic drugs (i.e. 4%). Besides most of the children were treated with physical and occupational therapy but no objection was found with vaccine. During our study we had observed that, 82% parents were not satisfied by the steps taken by the government yet. This study observed that, apart from alarming increase rate of autism in Dhaka City, modern diagnosis and medication facilities as well as therapies are deficit. Therefore, the new born babies and upcoming parents are at great risk due to insufficiency of awareness. So proper awareness programs and more facilities for autistic children should be introduced by both government and non-government sectors.

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.

Multi-informant assessment of siblings of youth with autism spectrum disorder: Parent-child discrepancies in at-risk classification

BACKGROUND

The behavioral and emotional functioning of typically-developing (TD) siblings of youth with autism spectrum disorder (ASD) has been frequently assessed in the literature; however, these assessments typically include only one informant, rarely considering differences between parent and self-reports of sibling adjustment.

AIMS

This study examined parent-youth reported informant discrepancies in behavioral and emotional functioning, including whether parent and youth reports yielded the same conclusions regarding TD sibling risk status.

METHODS, PROCEDURES, AND RESULTS

Among 113 parents and TD siblings of youth with ASD, TD siblings self-reported more overall, conduct, hyperactivity, and peer problems (compared to parent reports). Although few siblings were considered at-risk, those who were identified were not usually identified as at-risk on both informants' reports. Moreover, ASD symptoms, broader autism phenotype symptoms, parent mental health concerns, and social support from parents were all related to differences in at-risk classification between parent- and sibling self-report.

CONCLUSIONS AND IMPLICATIONS

This paper highlights the necessity of multi-informant reporting when considering TD sibling psychological functioning.

WHAT THIS PAPER ADDS

This study helps to address gaps in the literature on assessment of emotional and behavioral functioning of TD siblings of youth with ASD. The results highlight the importance of utilizing both parent- and self-report when identifying TD siblings at-risk for maladjustment. Although few siblings were considered at-risk, those who were identified were not usually identified as such on both informants' reports, and a variety of sibling- and parent-factors were associated with differences in at-risk classification. Thus, inclusion and examination of both parent- and self-report of TD sibling psychological functioning is vital for accurately identifying numbers of TD siblings at-risk of maladjustment.

Sibling relationship quality and psychosocial outcomes among adult siblings of individuals with autism spectrum disorder and individuals with intellectual disability without autism

Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability.

Participation in extracurricular activities for children with and without siblings with autism spectrum disorder

OBJECTIVE

To compare the number, frequency, enjoyment and performance in extracurricular activities of siblings of children with autism spectrum disorders (ASD) to their typically developing (TD) peers, and to identify differences between actual and desired participation.

METHODS

A case-control study with 30 siblings of children with ASD and 30 siblings of TD children was conducted using the Paediatric Interest Profiles and a questionnaire.

RESULTS

Siblings of children with ASD participated in fewer extracurricular activities than those with TD siblings. ASD symptoms were significantly associated with the sibling participating in fewer extracurricular activities. Children with TD siblings had higher enjoyment scores in relaxation activities than children with siblings with ASD.

CONCLUSION

While results were mainly positive, some differences indicated that having a sibling with ASD may impact participation in extracurricular activities. Assessments of participation barriers, as well as support to minimise participation restrictions among siblings of children with ASD are required.

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.

Anxiety and depression symptomatology in adult siblings of individuals with different developmental disability diagnoses

Factors predicting the emotional well-being of adult siblings of those with developmental disability (DD) remain under-researched. In this study adult siblings of individuals with Down's syndrome (DS), autism (ASD), Prader-Willi syndrome (PWS) and those with DD but with unknown aetiology (DUA) were compared with each other and a closely-matched control group to ascertain if sibling disability type made a difference to anxiety and/or depression levels. Also considered was the interactive effect of gender, age, parental and sibling educational attainment levels, socio-economic status and birth order on anxiety and depression outcomes. With the exception of siblings of those with DS, adult siblings of those with ASD, PWS and DUA reported significantly higher levels of anxiety and depression than the control group. There were some predictive effects of the demographic variables upon anxiety and depression but none common to all disability types and no moderating effects of demographic factors were found. Consequently other solutions must be found as to why this important group of people have elevated rates of anxiety and depression in comparison to the general population.

Family wellbeing of individuals with autism spectrum disorder: A scoping review

Families play an important role in supporting individuals with autism spectrum disorder across the lifespan. Indicators of family wellbeing can help to establish benchmarks for service provision and evaluation; however, a critical first step is a clear understanding of the construct in question. The purpose of the current scoping review was to (a) summarize current conceptualizations and measurements of family wellbeing, (b) synthesize key findings, and (c) highlight gaps and limitations in the extant literature. A final review of 86 articles highlighted the difficulty of synthesizing findings of family wellbeing in the autism spectrum disorder literature due to varied measurement techniques and the limited use of a common theoretical direction. Considerations for future research are presented with an eye toward policy relevance.

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.

Patterns and predictors of anxiety among siblings of children with autism spectrum disorders

The purpose of this study was to examine patterns of anxiety among siblings of children with autism spectrum disorders (ASD), and determine the characteristics of the child with ASD and their parents that predicted anxiety. Data was collected from 1,755 siblings of children with ASD whose families participated in the Simons Simplex Collection; siblings ranged in age from 3 to 18 years (M = 9 years). Male siblings were at increased risk for sub-clinical anxiety problems during middle childhood. Parental history of anxiety disorders, higher maternal pragmatic language, and more proband behavior problems predicted higher anxiety. While siblings overall did not show elevated anxiety symptoms, higher rates of sub-clinical anxiety problems among males and siblings in middle childhood are cause for concern.

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.

Working with families living with autism: potential contributions of marriage and family therapists

This article introduces marriage and family therapists (MFT) to some of the common issues faced by families that have a child with autism spectrum disorder (ASD). First, autism is defined and common myths surrounding it are discussed. Next, relational challenges are presented that families report experiencing during early childhood through the elementary school years, adolescence and the transition into adulthood, and the later years of the family life cycle. Real-life stories are included to illustrate the potential contributions that MFTs can make to families that have a child with ASD.

Coping of siblings of children with developmental disabilities in the Bedouin community

This is the first study that examines the coping of siblings of children with developmental disabilities in comparison with siblings of children without disabilities in the Bedouin community in Israel. For this purpose, the study examines the components of self-esteem, stress, and growth. Data were collected from 200 adolescents. The findings of this study show that siblings to children with developmental disabilities have a similar degree of self-esteem to those siblings to children without disabilities, whereas siblings to children with developmental disabilities have higher levels of stress perception and growth compared to siblings f children without developmental disabilities. In addition, a negative correlation was found between perception of stress and growth and a positive correlation between self-esteem and growth.

Sibling Behaviours and Relationships Following Mild to Moderate Childhood Traumatic Brain Injury: Preliminary Findings

Recent attention has begun to focus on the impact of childhood traumatic brain injury (TBI) on the family. This study examined the impact of mild to moderate childhood TBI on parental ratings of well and injured siblings' behaviours in relation to well siblings' ratings of the impact of injury and the sibling relationship. Parents of 10 children with TBI and 10 children with orthopaedic injury rated both injured and well siblings' behaviours using the Child Behaviour Checklist (CBCL). Well siblings completed the Sibling Impact Questionnaire (SIQ) and Sibling Relationship Questionnaire (SRQ). Results indicated that children with TBI exhibited significantly more externalising and total behaviours than children with orthopaedic injury, while well siblings of children with TBI exhibited more internalising behaviours than siblings of children with orthopaedic injury. Well siblings' ratings of the impact of the injury and sibling relationship did not differ significantly across groups. The behaviours of well siblings and their ratings of injury impact and sibling relationship are examined in relation to the behaviours of the injured siblings for the two groups. The implications of the findings are examined in terms of the need to involve siblings in the rehabilitation process.

Cross-cultural differences in comorbid symptoms of children with autism spectrum disorders: an international examination between Israel, South Korea, the United Kingdom and the United States of America

OBJECTIVE

To examine the relationship between culture and symptoms of comorbid psychopathology in those with autism spectrum disorders (ASD).

DESIGN

Multivariate analyses of variance (MANOVAs) for each country and each sub-scale of the Autism Spectrum Disorders-Comorbid for Children (ASD-CC). Follow-up independent univariate analyses and post-hoc tests as needed.

METHODS

Separate samples from South Korea, the UK and Israel were compared to a sample from the US in order to examine cultural contributions, using the ASD-CC.

RESULTS

Overall, few differences were found. Significantly, the US had significantly higher scores than South Korea on the avoidant sub-scale. Additionally, the US had significantly higher scores than Israel on the over-eating and tantrum sub-scales. No significant differences were found between the US and the UK.

CONCLUSION

Cultural factors, such as views of typical behaviour, should be taken into account when examining symptoms of comorbidity in children with ASD.

Autistic traits below the clinical threshold: re-examining the broader autism phenotype in the 21st century

Diagnosis, intervention and support for people with autism can be assisted by research into the aetiology of the condition. Twin and family studies indicate that autism spectrum conditions are highly heritable; genetic relatives of people with autism often show milder expression of traits characteristic for autism, referred to as the Broader Autism Phenotype (BAP). In the past decade, advances in the biological and behavioural sciences have facilitated a more thorough examination of the BAP from multiple levels of analysis. Here, the candidate phenotypic traits delineating the BAP are summarised, including key findings from neuroimaging studies examining the neural substrates of the BAP. We conclude by reviewing the value of further research into the BAP, with an emphasis on deriving heritable endophenotypes which will reliably index autism susceptibility and offer neurodevelopmental mechanisms that bridge the gap between genes and a clinical autism diagnosis.

Family report of ASD concomitant with depression or anxiety among US children

The objective is to estimate prevalence of parent-reported depression or anxiety among children with ASD, and describe parental concerns for their children. The design is Analysis of National Survey of Children's Health, 2003-2004. The participants are a national sample of 102,353 parents. 311,870 (544/100,000) parents of children ages 4-17 in the US reported that their child was diagnosed with autism. 125,809 also reported that their child had depression or anxiety (219/100,000). These parents report substantially higher concerns about their child's self-esteem, academic success, and potential to be bullied. Clinicians should take into account that children with ASD may face increased risk of depression or anxiety in adolescence. Coordinated care addressing social and emotional health in addition to clinical attention is important in this population.

Pragmatic language and school related linguistic abilities in siblings of children with autism

Siblings of probands with autism spectrum disorders are at higher risk for developing the broad autism phenotype (BAP). We compared the linguistic abilities (i.e., pragmatic language, school achievements, and underling reading processes) of 35 school-age siblings of children with autism (SIBS-A) to those of 42 siblings of children with typical development. Results indicated lower pragmatic abilities in a subgroup of SIBS-A identified with BAP related difficulties (SIBS-A-BAP) whereas school achievements and reading processes were intact. Furthermore, among SIBS-A-BAP, significant negative correlations emerged between the severity scores on the Autism Diagnostic Observation Schedule and full and verbal IQ scores. These results are discussed in the context of the developmental trajectories of SIBS-A and in relation to the BAP.

Sibling socialization: the effects of stressful life events and experiences

Stressful life events and experiences may disrupt the typical day-to-day interactions between sisters and brothers that provide the foundation of sibling socialization. This chapter examines four experiences that may affect patterns of sibling interaction: parental marital conflict, parental divorce and remarriage, foster care placement, and a sibling's developmental disability. We propose a model to guide future research on sibling socialization in distressed families and special populations in which qualities of the sibling relationship moderate the effects of stressful life experiences on child and family adjustment.

Behavioral problems and parenting style among Taiwanese children with autism and their siblings

AIMS

The purpose of the present study was to investigate the behavioral problems and parenting style among children with autism and their siblings in an ethnic Chinese population.

METHODS

A total of 151 children with DSM-IV autistic disorder, aged 3-12, 134 siblings without autism, and 113 normally developing controls were recruited. Both parents reported their parenting styles and psychological status and mothers also reported children's behavioral problems.

RESULTS

Children with autism had significantly more severe behavioral problems and obtained less affection and more overprotection and authoritarian controlling from their parents than the other two groups. Compared to the controls, unaffected siblings showed some behavioral problems, and obtained less maternal care. Withdrawal and attention, social, and thought problems were the most associated behavioral syndromes to distinguish children with autism from those without.

CONCLUSIONS

In addition to children with autism, who have a wide range of behavioral problems and impaired parent-child interactions, their siblings may be at risk for such problems.

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.