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Siblings to the Side: The Impact of Having a Sibling with High Needs

by

Sabrina Rogers-Anderson

Illustration of a small boy standing on the shadow of a larger boy to illustrate the struggles that impact siblings with a brother or sister with a disability

When a child has a disability, mental health issue or chronic illness, their family’s focus is likely to be centred on them. As a result, the child’s siblings may not receive the same amount of attention.

While it has long been assumed that siblings suffer only negative consequences from this family dynamic, recent analyses of existing research show that many of the outcomes are positive (Kovshoff, et al., 2017). A study published in the Journal of Autism and Developmental Disorders (2007) found that siblings of children with autism spectrum disorder (ASD) had more developed psychosocial and emotional skills than siblings of typically developing children. These children showed higher empathy, tolerance and adaptability than children with non-disabled siblings.

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Sibling Rivalry

Similarly, a review of interventions for children with ASD that involved their siblings found not only positive outcomes for the child with ASD, but also an increased sense of efficacy and independence in siblings (Shivers & Plavnick, 2014). This was only true when the siblings didn’t have too much responsibility at home and the interventions took their desires and skills into account.

Of course, there are also numerous studies demonstrating less favorable outcomes for siblings of children with high needs. A study published in Pediatrics (2013) compared 245 siblings of children with a disability and 6564 siblings of typically developing children. The children who had a sibling with a disability were more likely to have problems with interpersonal relationships, psychopathological functioning and functioning at school than siblings of non-disabled children. The percentage of children who were significantly functionally impaired went from 16 percent to 24.2 percent within 12 months when their sibling had a disability. In contrast, the proportion of siblings of typically developing children with significant functional impairment went from 9.5 percent to 10.3 percent in the same time period.

Educational and Developmental Psychologist Dr Kimberley O’Brien says parents can help their typically developing children thrive and even gain strengths from growing up with a high-needs sibling. Here are six ways Kimberley believes parents can support them.

Keep siblings informed

Explain your child’s condition to their siblings in age-appropriate terms and keep them informed of any changes. If you don’t, they may fill in the blanks in their minds with more frightening and inaccurate explanations. As they get older, you can share more complex or detailed information with them.

“Try bringing your child along to the different appointments their disabled sibling needs to go to so they don’t feel excluded,” says Kimberley. “It’s important for them to know what’s happening when you go to these appointments and it’s a good way to help them be informed from a young age.”

Involve siblings in interventions

If your typically developing child is keen to be involved in your high-needs child’s interventions, talk to your medical professional about ways to include them. Sibling involvement can be as simple as encouraging the high-needs child to complete a task or teaching them basic play skills.

“You could also try some combined play dates,” suggests Kimberley. “It can be a struggle for the child with a disability to develop friendships on their own, so having play dates with their siblings could help them develop prosocial skills. It can also help the sibling and other children develop greater understanding, empathy and appreciation. But the typically developing sibling should also have separate play dates with their own friends so they have a chance to develop their own identity and independence.”

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Flower in a Pot

Spend one-on-one time with siblings

Caring for your high-needs child might take up a lot of your time and make your other children feel less important or left out. Try to plan regular one-on-one time with your other children to ensure they also feel special and valued.

“It’s good to have a visual timetable the child can look at and see that Tuesday afternoon between 3:00 and 4:00 is their one-on-one time with Dad,” says Kimberley. “They can plan what they want to do during that time, like go swimming or play basketball. They know it won’t be moved because it’s on the visual schedule and it makes them feel like they’re a priority.”

Give siblings opportunities to express feelings

Siblings of children with high needs should be given space to express their feelings about their sibling’s condition, including negative emotions such as embarrassment and frustration. An emotion wheel can help children express how they’re feeling and reduce anxiety.

“It can also be good to have an external support person like a psychologist, school counselor or agency that offers support for siblings of kids with a disability. Parents often feel conflicted if a child is complaining about having a sibling with high needs, so sometimes kids need space to say, ‘It’s really hard and I hate it.’ That can happen in a psychology session where they’re encouraged to express themselves and don’t feel any guilt.”

Help siblings connect with others

A strong social network can help typically developing children cope with the pressures of having a high-needs sibling. Sibling support groups, such as those run by Siblings Australia, can also help them connect with other siblings who understand what they’re going through.

“It’s good for them to meet older kids who have been experiencing the same situation for a longer time,” says Kimberley. “It’s like having a role model or mentor to see what happens as you grow up. But it’s also important to give the sibling some time away from the world of special needs, maybe at an old friend’s house or on a farm. They should have fun being young and carefree.”

Consider seeking help for siblings

If your typically developing child exhibits changes in their behaviour, you may want to consult with a professional.

“Things to look out for are increased negativity, a peak in sibling rivalry, withdrawal, mood swings or reluctance to participate in family activities,” says Kimberley. “This is common around year 12 because the child can have some feelings of resentment that need to be unpacked. It’s like a sense of grief or loss for what could have been if you didn’t have a child with special needs. If you notice these changes in behaviour, a psychologist can help.”

Want to speak to a professional? We’re here for you.

The Quirky Kid Clinic is a unique place for children and adolescents aged 2 to 18 years. We work from the child’s perspective to help them find their own solutions. If you have a child with high needs and you think their sibling could use some professional support, book a session with one of our experienced child psychologists.

View article references

  • Goudie, A., Havercamp, S., Jamieson, B. & Sahr, T. (2013). Assessing functional impairment in siblings living with children with disability. Pediatrics, 132(2), 476-483.
    https://doi.org/10.1542/peds.2013-0644
  • Kovshoff, H., Cebula, K., Tsai, HW.J., & Hastings, R.P. (2017). Siblings of Children with Autism: the Siblings Embedded Systems Framework. Current Developmental Disorders Reports, 4(2), 37-45. https://doi.org/10.1007/s40474-017-0110-5
  • Macks, R.J., & Reeve, R.E. (2007). The Adjustment of Non-Disabled Siblings of Children with Autism. Journal of Autism and Developmental Disorders, 37(6), 1060–1067. https://doi.org/10.1007/s10803-006-0249-0
  • Shivers, C., & Plavnick, J. (2014). Sibling Involvement in Interventions for Individuals with Autism Spectrum Disorders: A Systematic Review. Journal of Autism and Developmental Disorders, 45(3), 685-696. https://doi.org/10.1007/s10803-014-2222-7

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