Psychological Adjustment,Social Responsiveness and Parental Distress in an Italian Sample of Siblings of Children with High-Functioning Autism Spectrum Disorder

The psychosocial adjustment of siblings of children with autism spectrum disorder (ASD) is a relatively recent field of study, but results in literature are often inconsistent, and studies specifically focused on samples of siblings of children with high-functioning ASD are very few. This paper analyzes the level of social impairment (index of broader autism phenotype), the risk of internalizing and externalizing problems (index of psychological adjustment) and the parenting distress in an Italian sample of siblings of children with high-functioning ASD (n = 26). The presence of risk factors (birth order, sex and number of siblings in the family) and the role of the siblings’ age are also explored. The data were collected through self-report instruments administered to parents. The results do not show higher average risk levels for psychosocial adjustment problems, even though a minority of the cases is at risk for social impairments (7.7 %), internalizing (23.1 %), externalizing (3.8 %) and total difficulties (11.5 %) and for distress in the parent–child system (15 %). Distress in the parent-sibling system seems to be modulated by the sibling’s features and to be higher when the sibling is older than the child with ASD. Additionally, a link between difficulties in psychological adjustment and broader autism phenotype is suggested.     

Adaptation to juvenile rheumatic disease: a controlled evaluation of functional disability with a one-year follow-up.

Compared the adaptation of 165 patients with juvenile rheumatic disease (JRD) to that of their healthy siblings. Patients were divided into those with mild functional disability and those with moderate/severe disability. Adaptation in several domains was assessed by parents and children on two occasions 1 year apart. The adjustment difficulties of the JRD children were limited primarily to social functioning but appeared also in the psychological and family problems domains. Compared to "mild" patients, "moderate/severe" patients had more adjustment difficulties; in some areas, mild patients functioned as well as their healthy siblings. Some Time 1 differences were replicated at Time 2. The results help to delineate (a) the specific domains in which children with chronic disease have adjustment difficulties and (b) the factors that put children at risk for developing adjustment problems.     

Impact of End-of-Life Circumstances on the Adjustment of Bereaved Siblings of Children Who Died from Cancer

The aim of this study was to examine the impact of end-of-life (EoL) circumstances on grief and internalizing symptoms among bereaved siblings. Bereaved families (N?=?88) were recruited from three sites 3–12 months (M?=?11.57, SD?=?3.48) after their child’s death from cancer. One sibling per family aged 8–17 years (M?=?12.41, SD?=?2.64) was randomly selected to participate. Families completed measures of siblings’ grief and internalizing symptoms, as well as a structured interview about circumstances surrounding the death. Mother and sibling reports of EoL circumstances were generally concordant, except there was a discrepancy between mothers and children about whether or not children expected their sibling’s death (t(75)?=?1.52, p?=?.018). Mother reports of sibling internalizing symptoms were above the normative mean (t(83)?=?4.44, p?≤?.001 (M?=?56.01?±?12.48), with 39% (n?=?33) in the borderline/clinical range. Sibling opportunity to say goodbye was associated with greater grief-related growth (t(79)?=?? 1.95, p?=?.05). Presence at the death and wishing they had done something differently were both associated with greater grief (t(80)?=?? 2.08, p?=?.04 and t(80)?=?? 2.24, p?=?.028, respectively) and grief-related growth (t(80)?=?? 2.01, p?=?.048 and t(80)?=?? 2.31, p?=?.024, respectively). However, findings were primarily unique to sibling report, with few mother-reported effects. The adjustment of bereaved siblings may be affected by certain modifiable circumstances surrounding the death of their brother or sister. A proportion of bereaved siblings had elevated internalizing symptoms irrespective of circumstances at EoL. Further work is needed to understand predictors of adjustment among bereaved siblings to provide better support and optimize their outcomes.

     

Siblings as Selfobjects in Childhood: An Interview Study of Factors and Consequences

This study explores the factors psychotherapists working with adult clients identify as contributing to their clients' use in childhood of relationships with siblings to meet selfobject needs or the use of clients by their siblings for selfobject purposes in childhood, and the consequences of this to the children's intrapsychic development as evidenced in their adult psychotherapy. Using interviews with six psychotherapists practicing within the framework of self psychology, this research determines that the emotional and physical unavailability of parents was a common factor causing children to use their siblings for selfobject purposes. The research also explores the lasting impact of these selfobject ties on the psychological development of both the child using a sibling for selfobject purposes and the child who serves this function for another, as well as the role of psychotherapy in understanding these relationships. These findings give psychotherapists from a variety of disciplines, including social work, an enhanced conceptual framework from which to consider the role of siblings in psychological development.     

Supervision in marriage counseling

Abstract

The objective of this research was to explore the impact of having a schizophrenic sibling. Fourteen siblings, aged 24 to 46, were interviewed. As a group, the subjects were functioning at high levels of adjustment. All had had a period in late adolescence in which they were separated from their families in surroundings that facilitated personal growth. Among older subjects, there followed a period of reinvolvement, including assuming responsibility for the ill sibling. Guilt was a predominant emotion in their lives. Variations in the intensity of guilt were most often related to ordinal position. Younger siblings, particularly if same-sexed, expressed guilt over being well, whereas older siblings expressed guilt over earlier sibling rivalry.     

Understanding of ASD by Siblings is Associated with Warmth and Hostility in the Sibling Relationship

Autism Spectrum Disorder (ASD) impacts not only the child with ASD, but also the entire family system, including siblings. The present study examined perceptions of the sibling relationship in brothers and sisters of children with ASD, as well as how understanding of autism (symptoms, long-term implications of the disorder) in siblings of children with ASD is related to the sibling’s perceptions of quality of the sibling relationship. Siblings (N?=?44, Mean Age?=?10.4 years, SD?=?2.6) of children with ASD were administered an interview assessing their understanding of ASD and self-report questionnaires measuring their perception of the sibling relationship quality. The more siblings understood about ASD, the more hostility they reported by their sibling with ASD. Age of the sibling, conversely, was negatively associated with both hostile and warm behavior by the brother or sister with ASD towards the sibling. More understanding of autism may be associated with more contention within the sibling relationship, whereas older siblings may spend less time with their brother or sister with autism. Results have implications for improving sibling relationship quality, as well as elucidating the complexity of sibling relationships. These findings have further implications for the development of support systems with use of coping skills for improving the quality of the sibling relationship.

     

Relationship Quality as a Moderator of Anxiety in Siblings of Children Diagnosed with Autism Spectrum Disorders or Down Syndrome

The purpose of this study was to examine typically-developing adolescents’ perceived relationship quality with their developmentally-disabled sibling, specifically siblings diagnosed with an autism spectrum disorder (ASD) or Down syndrome (DS). The 119 eleven through seventeen-year-old adolescent participants (M = 13.32, SD = 1.90) completed an online survey that assessed demographics, sibling relationship quality, and anxiety. Results showed that siblings of children with DS have a greater overall sibling relationship quality than do siblings of children with an ASD. Results further indicated that reporting more negative interchanges within the sibling relationship was related to higher levels of anxiety regardless of sibling disability type. Lastly, sibling relationship quality moderated the relation between sibling disability type and anxiety. These findings promote greater understanding of the sibling dynamic in families with children with developmental disabilities and suggest the need for establishing more research and greater clinical evaluation in this area. Furthermore, the current study suggests that therapeutic intervention to address the sibling relationship quality within children diagnosed with ASDs and their typically-developing siblings would be beneficial in order to increase social support within the relationship as well as decrease the amount of negative interchanges within the sibling relationship. Results also suggested that decreasing the amount of negative interchanges within the sibling relationship may decrease the level of anxiety the typically-developing sibling reports.     

Siblings of individuals with autism spectrum disorders across the life course

In this article, we review the literature on siblings of individuals with autism spectrum disorders (ASD) from a lifespan developmental perspective, from infancy through adulthood, focusing on the sibling relationship and sibling well-being. We situate this review within the larger body of research on siblings of individuals with developmental disabilities (DD) across the lifespan. We then consider the genetic aspects of ASDs and their implications for siblings. We conclude that there is an evidence of atypical social and communication development in some siblings of children with an ASD during infancy. During childhood and adolescence, siblings describe both positive and negative aspects of their sibling relationship and there is some evidence that siblings of children with an ASD may be at heightened risk for social and behavioral adjustment problems. The limited research on adulthood suggests that lack of closeness in the sibling relationship and social and emotional difficulties may continue. We encourage more attention focused on developmental issues, specifically with respect to samples in narrower age groups and in longitudinal research. Finally, we note the variability in sibling outcomes, and suggest further examination of potential moderating and mediating factors, including genetic predispositions.     

A Child With Autism Spectrum Disorder Teaches Siblings to Skateboard: Effects on Sibling Skills and Family Social Behavior

Abstract

Children with autism spectrum disorder (ASD) may have few common activities with their siblings who do not have ASD, and this can limit their opportunities for social play. In this study, we used a multiple-baseline across skills design to assess the effects of a boy with ASD following an activity schedule to teach his favorite activity of skateboarding to his two siblings who do not have ASD. Family social behavior was also measured before and after sibling training. After training by the boy with ASD, both of the siblings’ skateboarding skills improved, and measures of family social behavior also increased. Results suggest that sibling relationships may benefit when a child with ASD teaches siblings to play.     

The role of parents’ autonomy support and psychological control in sibling relationship functioning through children’s need-based experiences

This study aimed to examine whether parents’ autonomy support and psychological control during sibling conflict would relate to children’s need-based experiences and relationship functioning within the sibling relationship. Two siblings (M_age = 8.61 years, SD = 0.91 and M_age = 10.50 years, SD = 0.94) of 205 families filled out questionnaires. Results showed that parental autonomy support related positively to siblings’ relationship satisfaction via children’s need satisfaction. Additionally, fathers’ psychological control related negatively to provided autonomy support and positively to provided psychological control from one sibling to the other (as reported by the other sibling) and negatively to satisfaction with this relationship via need frustration. These findings highlight the importance of the quality of parents’ involvement during sibling conflict.     

Siblings of Children with disabilities: Psychological and behavioural characteristics

The purpose of the current study was to assess the behavioural and psychological characteristics of siblings of children with disabilities and the perceptions of parents and children regarding sibling relationships. Participants included 32 children between 6 and 13 years of age, one-half with a younger sibling with a disability and one-half with a younger sibling without a disability. Analyses revealed a difference in children's perceptions of maternal partiality, with siblings of children with disabilities perceiving their mothers to be more partial to their siblings than did siblings of children without disabilities. Further, parents of children with disabilities indicated a greater difference in status/power between their child and his/her younger sibling than did parents of children without disabilities. No significant differences were found between groups on measures of behaviour problems, social competence, or self-esteem, supporting other research that has failed to find negative outcomes for siblings of children with disabilities. The implications of these results for parents and professionals are discussed.     

The experiences of living with a sibling who stutters: a preliminary study

Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling. This study investigated the experiences of fluent siblings of children who stutter to examine the impact that stuttering may have on their lives. A mixed methods research design incorporated qualitative semi-structured interviews and quantitative questionnaires. The results of the qualitative investigation revealed four aspects of children's lives that were affected by having a sibling who stuttered: the relationship between siblings, the impact on the fluent sibling, the impact on the parent relationship with both children, and the impact on the sibling's relationship with others. Findings revealed that siblings of children who stutter exhibited strongly negative emotions, and differing levels of responsibility associated with their involvement in the actual stuttering management programme. Furthermore, for the fluent sibling, secondary to having a brother or sister who stuttered, communication with and attention from their parents was variable. The results of the quantitative component of the study revealed children who stutter and their siblings demonstrated significantly greater closeness, and concurrently, increased conflict and status disparity than did the control fluent sibling dyads. The parents of the experimental sibling dyads also demonstrated significantly greater partiality towards a child, namely the child who stuttered, than did the parents of the control sibling dyads. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) identify the themes associated with having a sibling who stutters; (2) identify how the quality of the sibling relationship differs between sibling dyads that do and do not consist of a sibling who stutters; and (3) discuss the clinical implications of the results with regards to working with children who stutter and their families.     

Schizophrenic and sibling: A comparison of parental relationships

Abstract

Differences and similarities between schizophrenics and their siblings in terms of their parental relationships were examined by use of projective tests and questionnaires. The results indicated that schizophrenics were differentiated from their siblings in their tendencies to see themselves as symbiotically attached to their mothers and failing to be accommodated to by their fathers. In addition, it was discovered that schizophrenics tend to be aligned with the same sex parent. It was suggested that these findings may help explain the psychosexual identification difficulties of schizophrenics.     

Psychosocial risk and resistance factors among children with chronic illness,healthy siblings,and healthy controls

Psychosocial risk and resistance factors within the domains of parental functioning, family Stressors, and family resources were examined as predictors of psychological adjustment and physical problems in juvenile rheumatic disease patients (N=93), their healthy siblings (N=72), and demographically matched healthy controls (N=93). Family socioeconomic status and background variables showed few consistent relationships with child functioning. However, a constellation of risk and resistance factors tended to show comparable associations with functioning for patients, siblings, and controls. Higher parental depression and medical symptoms and more family Stressors, sibling problems, and burden of illness on the family predicted more problems among the patients. These relationships held when disease duration and severity were controlled. For the siblings, increased parental and patient dysfunction, more family Stressors, and less family cohesion and expressiveness were associated with more problems. Although the associations were not as strong, mothers' depression and lack of family cohesion and expressiveness also were related to more adjustment problems among the control children. These findings imply that there may be a general association between certain risk and resistance factors and childhood adaptation.This research was supported in part by NIH Multipurpose Arthritis Center Grant AM20610, NIMH Grant MH16744, and Veterans Administration Medical and Health Services Research and Development Service Research funds. Jan Gottlieb provided valuable help in all phases of the research. We appreciate the help of the staff of the Pediatric Rheumatology Clinic at Children's Hospital at Stanford and the families who participated in this study.     

A Review of “Mind to Mind: Infant Research,Neuroscience, and Psychoanalysis”

Abstract

This article examines current research pertaining to the relationship between a mother and her children, and how this relationship may affect sibling interactions. Issues such as temperament, gender, and the age gap between children are also explored to ascertain their impact on the sibling relationship.

The displacement of the first-born child and the ensuing sense of loss and anger he may experience as a result of this is explored. The mother's second pregnancy is also discussed in regard to the impact of unresolved issues relating to her own sibling relations. The mother's interactions with each child, her role as a model for identification, and marital relations are discussed in light of their impact on sibling relations.

The evolution of a positive attachment between siblings is explored. Rivalrous behavior between siblings is also discussed, particularly in association to the mother's treatment of her own children and the manner in which the mother deals with her own aggression.     

Social comparisons with siblings made by adolescents with a learning difficulty

Social comparisons and the family environment are important antecedents of self-esteem. In this study the self-esteem and perceptions of stigma of 50 adolescents with a mild-moderate learning difficulty were measured. The self-esteem and stigma scores were factor-analysed to produce five factors: Positive self; Social competence; Being different; Anxiety; and Work competence. Social comparisons made by the adolescents between themselves and their siblings were also measured. Most adolescents 'preferred' (chose more often and gave high scores to) older same-sex siblings while younger opposite-sex siblings were the least preferred (were chosen less often and derogated). An explanation for these findings is suggested in terms of defensive social comparisons due to the loss of self-esteem in having a younger sibling ‘overtake’ the adolescent on developmental milestones, and in the tendency for non-handicapped pre-pubescent children to derogate the opposite sex during gender identity formation. This explanation is supported by the finding that the adolescents with younger siblings scored higher on the Anxiety factor than those who compared themselves with older siblings. Those with younger same-sex siblings were the most anxious. There was also a tendency for adolescents with siblings to score lower on one of the factors than adolescents with no sibling. The discussion raises the questions of how to deal with social comparisons within the family and how to talk to the child with mild learning difficulties about his or her handicap.     

Sibling relationships and best friendships in young adulthood: Warmth,conflict, and well‐being

Although much work addresses the importance of siblings and friendships in separate investigations, few studies simultaneously examine both relationships. Young adults (N= 102, M age = 18.7) were surveyed about their friendships, their sibling relationships, and their psychological well‐being (assessed by self‐esteem and loneliness). Participants with harmonious (high warmth, low conflict) sibling relations and same‐gender friends had the highest well‐being. Participants with affect‐intense (high warmth, high conflict) sibling relationships had low well‐being. However, participants who had low‐involved (low warmth, low conflict) and affect‐intense same‐gender friendships did not differ in well‐being. When examining joint effects, having a harmonious same‐gender friendship compensated for having a low‐involved sibling relationship, but having harmonious sibling relations did not compensate for having low‐involved friendships. Overall, the results underscore the importance of positive and negative relationship properties and the joint effects of multiple relationships.     

Adjustment of Siblings of Children with Mental Health Problems: Behaviour, Self-Concept, Quality of Life and Family Functioning

This study examined the adjustment of siblings of children with mental health problems. The participants had brothers or sisters receiving treatment at a Child and Adolescent Mental Health Service within the Hunter New England Health Service, New South Wales, Australia. Seventy-five siblings completed questionnaires on their self-concept, quality of life and family functioning. Their carers completed questionnaires on the sibling’s behaviours, family demographics and family functioning. The diagnosis and severity of disability of index children were attained from the treating clinician. The study revealed the siblings had significantly higher rates of psychopathology, poorer quality of life and lived in more dysfunctional families than normally developing children. Regression modelling predicted variables related to the three main behaviour scales of the Child Behaviour Checklist (CBCL). Family functioning, family communication and the extreme ends of family cohesion and balance, were the most significant contributors to regression model. The sibling self-concept domains of global self-worth, athletic competence and behavioural conduct, contributed to the model. Additionally, a smaller family size was associated with more internalising behaviour disorders in the siblings. The diagnosis and severity of mental health problem of the index child and other family demographic factors did not impact on the sibling’s behavioural functioning. This study highlights that siblings of children with mental health difficulties are a group vulnerable to adjustment difficulties regardless of the index child’s diagnosis or the severity of impairment. Overall, family functioning had a greater impact on the siblings than other factors.     

An Initial Look at Sibling Reports on Children's Behavior: Comparisons with Children's Self-Reports and Relations with Siblings' Self-Reports and Sibling Relationships

The authors examined siblings' reports of children's depression, anxiety, and aggression, and their reports of the sibling relationship, and compared them with children's self-reports. In two samples, including 169 sibling pairs (age M = 9.98 years, SD = 1.51), no significant differences emerged in the levels of depression and anxiety found in siblings' reports of children's behavior and children's self-reports, although siblings reported children to have significantly higher levels of aggression than the children self-reported. Age, the difference in ages between siblings, sex, and sibling sex were not related to siblings' reports of children's behavior. The relations between children's and siblings' reports of children's behavior were significant, yet moderate (average r = .22). Both siblings' self-reports of internalizing behavior and their perceptions of aspects of the sibling relationship (affection, rivalry, hostility, and satisfaction with the sibling relationship) explained significant, and unique, variance in siblings' reports of children's internalizing behavior. The findings for aggressive behavior were similar, although siblings' perceptions of affection in the sibling relationship were not significantly related to their reports of children's aggression. The potential uses and benefits of sibling reports of children's behavior, and sibling and family relationships, are discussed.     

Behavioural,emotional and social development of children who stutter

PurposeDevelopmental stuttering may be associated with diminished psychological well-being which has been documented from late childhood onwards. It is important to establish the point at which behavioural, emotional and social problems emerge in children who stutter.MethodsThe study used data from the Millennium Cohort Study, whose initial cohort comprised 18,818 children. Analysis involved data collected when the cohort members were 3, 5 and 11 years old. The association between parent-reported stuttering and performance on the Strengths and Difficulties Questionnaire was determined in regression analyses which controlled for cohort members’ sex, verbal and non-verbal abilities, maternal education, and family economic status.ResultsCompared with typically-developing children, those who stuttered had significantly higher Total Difficulties scores at all three ages; in addition, scores on all of the sub-scales for 5-year-olds who stuttered indicated poorer development than their peers, and 11-year-olds who stuttered had poorer development than peers in all areas except prosocial skills. At ages 5 and 11, those who stuttered were more likely than peers to have scores indicating cause for clinical concern in almost all areas.ConclusionChildren who stutter may begin to show impaired behavioural, emotional and social development as early as age 3, and these difficulties are well established in older children who stutter. Parents and practitioners need to be aware of the possibility of these difficulties and intervention needs to be provided in a timely fashion to address such difficulties in childhood and to prevent the potential development of serious mental health difficulties later in life.