Siblings and Autism

For any child, the arrival of a sibling with autism can be a big adjustment.

A 2007 Harvard Review of Psychiatry article mentions studies that document “distressing emotional reactions such as feelings of anxiety, guilt and anger” and “more adjustment problems” as well as research noting that “some siblings benefit from their experience, others seem not to be affected.” The studies used different methodology, but even so, the difference perhaps should not be surprising.  Just as no two people with autism are alike, no two siblings are alike in how they adjust to their family situation.

Understandably, most of the scientific focus goes to the child who has the condition.  Some studies report that people who grew up with autism in the house tend to be more empathetic. This is a point Macks wants to emphasize: Most siblings of children with autism or any other type of disability wind up doing just fine.  Autism can have large effects, good and bad, on a disabled child’s siblings.

There also can be better outcomes in families of more financial means.  A fair amount of research has been done on how autism impacts the family. These are the main issues the kids are dealing with and what we really want to look out for, Moskowitz says. The data offers only a few hints at what might determine a siblings response to autism in the family. “They’ve learned how to handle embarrassing situations in public; they’ve learned how to handle negotiations better,” Macks says. The majority will handle the situation quite well.

How parents handle the situation,whether it is a temper tantrum in public, other  behaviors or daily behavioral interventions, is extremely important, according to Macks and Moskowitz.  One of the things we know, Macks says, is that the mental health of the parent, their coping skills, tends to be the primary predictor in terms of how the sibling is going to handle the situation.

According to Macks, the majority of the research found that when you are a sibling  younger than the child with autism it is easier, because that is all you have ever known.
A 2006 review of the research in the Journal of Intellectual and Developmental Disability found that while some researchers were uncovering deleterious outcomes,others were finding siblings who were well adjusted or whose challenges were of low magnitude and non-significant. One reason for this, Macks says, is that most kids on the spectrum look like typical kids, with no abnormal physical or facial features to signal that the child is different. He believes that there is a misconception that having an autistic sibling sentences a child to a whole range of intense struggles throughout your life. With autism, a lot of the time they look at the parents or the siblings, and they say, “Why are you not doing something to control this child?”

Mishori is a family physician and faculty member in the Department of Family Medicine at Georgetown University School of Medicine. One in 88 children in the United States has some form of autism, according to the Centers for Disease Control and Prevention. In fact, in stable families with no demographic risk factors such as a one-parent household or economic issues, Macks says, by and large, having a sibling with autism is extensively viewed as a very positive experience, with limited long-term negative impact.

Charley Moskowitz, a social worker in New York who works in a program designed to help children adjust to disabled siblings in the home, says that after years of working with such families, it’s clear there is no such thing as a typical sibling. Boys tend to have an easier time of it than girls, Mack says, possibly because boys are not usually given as many caretaking responsibilities for handicapped siblings as girls are.

Researchers  and some siblings themselves  are discovering that the sibling experience can produce long-term benefits.