Siblings of disabled children

When a child is diagnosed with a disability or chronic illness, the focus is often on the child with special needs and one or both parents. However for optimal family functioning we need to support all members of the family. Siblings of a child with special needs often have a mix of confusing feelings - love and protectiveness on the one hand, but also isolation, resentment, guilt, embarrassment and grief.

Parents can have difficulty recognising the needs of siblings, if their own emotional resources are stretched. Sibling distress can manifest in ‘acting up’, withdrawing or trying too hard to be the ‘good child’, with the risk of longer term emotional difficulties. However, if brothers and sisters are able to express their feelings and if they can learn the skills to deal with difficult situations, they can develop resilience and other positive qualities.

Clinicians can play an important role:
1. You can ask parents whether a sibling:

• is confused by the special needs of their brother or sister
• has any difficulties at school – either with schoolwork or friendships
• expresses anger through aggressive behaviour
• withdraws from communicating or family activities
• shows signs of anxiety, like stomach aches or headaches
• tries hard to be the ‘good child’ much of the time
• experiences embarrassment or teasing

2. You should interact directly with siblings, about the sick or disabled child, but also about their own interests. Encourage parents to have siblings connect with other siblings, either through sibling support groups or through internet discussion groups accessed via the website below (for young, teen and adult siblings).

3. Let parents know that there is a range of resources that can help them support their children, eg Siblings Australia, which hosts an extensive website (www.siblingsaustralia.org.au). The organisation also runs parent workshops on sibling issues and how best to support them, and has produced a brochure for parents on sibling support.

It is clear that siblings of children with special needs (disability, chronic illness) are at risk for developing a range of emotional and mental health issues. Research from the US suggests that siblings are, in fact, at greater risk for negative physical health as well.

"Even if a child is without a disability but has a sibling with a disability, he/she experiences an increased likelihood of lower health status, unmet need for medical care, and bed days sick. Indeed the health impact of living with a sibling with a disability is greater than the impact of being poor, and similar to the impact of belonging to an ethnic minority group."

Hogan, D., Park, J., & Goldscheider, F. (2003). Using Survey Data to Study Disability: Results From the National Health Interview Survey on Disability. Research in Social Science and Disability, 3, 185-205.