Impact of a Support Group for Siblings of Children with ASD On the Quality of Sibling Relationships

Background: Research suggests that the quality of the sibling relationship is impacted, both positively and negatively, when one sibling has an ASD.  Some positive characteristics include increased admiration for the affected sibling (Kaminsky and Dewey, 2001), and a greater amount of nurturing behaviors from the unaffected sibling (Abramovitch et al, 1987).  At the same time, the sibling relationship may be characterized by less closeness, intimacy, reciprocity, interactive play, and in some cases increased physical aggression (Kaminsky and Dewey, 2001; Orsmond & Seltzer, 2007; Rivers & Stoneman, 2003).  These aspects of the sibling relationship are consistent with the behaviors and social impairments characteristic of ASD, and may create a source of stress for unaffected siblings.  The sibling relationship is typically the human relationship with the greatest longevity, and unaffected siblings often become caregivers for their sibling with ASD when parents are no longer able to provide care.  Thus, it is in the interest of children with ASD as well as their unaffected siblings to ensure that unaffected siblings’ needs are met, and to promote positive sibling relationship quality.

Objectives: To evaluate the effectiveness of a sibling support group in improving the quality of sibling relationships.

Methods: Five 10-week support groups for unaffected siblings of children with ASD were conducted across three age groups (two for ages 6-9, two for ages 10-12, one for ages 13-17; total n=28).  An additional group (ages 10-12; n=4) was conducted as a waitlist control group.  Group sessions were based on the Sibshop model (Meyer & Vadasy, 1994), with additional activities aimed at educating participants about the nature of ASD and teaching strategies for coping with stress.  Several questionnaires assessing the quality of the sibling relationship were administered pre- and post-group (or waitlist period): the Sibling Relationship Questionnaire, Parent- and Self-Report forms (Slomkowski et al., 2001); the Sibling Relationship Scale (modified from Riggio, 2000); and the Satisfaction with the Sibling Relationship Questionnaire (McHale & Gamble, 1989). 

Results: Unaffected siblings reported a significant increase in overall satisfaction in their sibling relationship following participation in the support group (p=.01).  Several additional findings trended toward significance.  Parents noted decreased negative behaviors in their unaffected children directed toward their affected siblings. Interestingly, across two measures, unaffected siblings reported a decrease in positive behaviors directed toward their affected siblings (such as time spent helping, playing, or talking together).  No changes were found in the waitlist control group.

Conclusions: The sibling support group was effective in improving participants’ overall satisfaction in their relationship with their sibling with ASD.  The contrast between parent ratings and unaffected siblings’ self-report ratings may suggest a general “diffusing” of intensity of the sibling relationship, which unaffected siblings perceive as less positive engagement and parents perceive as reduced negative behaviors.  Alternatively, unaffected siblings may develop new insight or greater sensitivity through participation in the group that causes them to evaluate their own actions toward their siblings less positively.