Building Sibling Relationships: The Effects of Sibling Support on Siblings and Children with Autism

Background:   Autism spectrum disorder (ASD) affects the entire family system and, in turn, the family affects outcomes for individuals with ASD. Family members, including siblings, may be affected by the presence of a family member with ASD. Siblings may show adjustment and skill needs; the sibling relationship may be strained. Improving sibling adjustment and the sibling relationship may be valuable for lifelong outcomes for individuals with ASD as siblings play a critical support role throughout the life of an individual with ASD. Support groups are one way to address the needs of siblings and improve sibling relationships. Only a few studies (Smith & Perry, 2005) suggested the effectiveness of support groups specifically for siblings of children with ASD. In an initial study, we found improvements in sibling adjustment and relationship following participation in a support group. After this pre-post comparison we are following up with a randomized control trial, comparing a support group to an attention only control condition.

Objectives: The purpose of this investigation was to evaluate the effects of a support group targeting siblings of children with ASD on sibling’s knowledge about ASD, coping skills, peer network and, adjustment as well as the sibling relationship using self and parent-reports and observational measures in a randomized-control trial. 

Methods: To date, 28 siblings of children with ASD aged between 3 and 16 years have completed participation with their 24 siblings with ASD aged between 3 and 18. An additional 11 siblings and 4 children with ASD will complete participation this fall. We randomly assigned siblings to a 1-hour group social group (control group) or support group, for 10 weeks. The support group lessons and activities focused on issues related to having a sibling with ASD for a period of 10 weeks. The social group involved similar activities with a focus on general social interaction and friendship. Pre- and post-measures evaluated sibling’s knowledge and adjustment, family functioning, and sibling relationship measured through sibling and parent report as well as direct observation of sibling interactions.

Results: Initial analyses indicate that children who participated in the support group showed greater improvement on three of the four coping domains from pre to post. We are continuing to analyze other scales and data collection continues with new sibling dyads.

Conclusions: Support groups show promise in addressing the individual needs of siblings of children with ASD as well as fostering the sibling relationship. Findings of the current RCT indicate improvements in coping skills for siblings who attended the support group compared to those who attended the social control group. This builds on our preliminary studies which indicated improvements in depression and anxiety as well as sibling interactions. Continued data collection and analyses will allow us to examine additional measures of sibling adjustment, family functioning, and the sibling relationship.