Quality of the sibling relationship when one sibling has autism spectrum disorder: A randomized controlled trial of a sibling support group

Abstract

When one sibling has autism spectrum disorder, the sibling relationship is often characterized by poorer quality with fewer interactions. Because sibling relationships provide a vital social framework for development, they have the capacity to be a risk or protective factor, depending on the quality of the relationship. One way to improve the quality of the sibling relationship is through typically developing sibling participation in a support group. In this study, researchers randomly assigned typically developing siblings to a 10-week support group or attention-only control group. Typically developing siblings in the support group showed significant improvements in the quality of their sibling relationship and interactions with their sibling with autism spectrum disorder compared to the control group. Autism spectrum disorder severity and externalizing behavior moderated the effects of the support group on positive affect. Findings suggest the positive impact of a support group on sibling relationships, a relationship that has the potential to be protective. Lay abstract The sibling relationship can be negatively impacted when one child has autism spectrum disorder. One way to improve the quality of that relationship is through typically developing sibling participation in a support group in which they learn about autism spectrum disorder and coping skills, develop a peer network, and discuss their feelings. Compared to participating in a similar group without a focus on autism spectrum disorder, siblings in the support group showed improvements in the quality of the sibling relationship. Findings suggest that sibling support groups can be a valuable resource to improve sibling relationship quality when one sibling has autism spectrum disorder.

Psychosocial Interventions and Support Groups for Siblings of Individuals with Neurodevelopmental Conditions: A Mixed Methods Systematic Review of Sibling Self-reported Mental Health and Wellbeing Outcomes

“…Seven studies used a parallel parent education component to improve parent-reported understanding of siblings' needs and parent-child communication. In two intervention groups, learning about autism and building coping strategies led to significant improvements in siblingreported sibling relationship quality (Zucker et al, 2021) and psychological functioning (Jones et al, 2020), not evidenced in the active comparison groups without an autism-focussed psychoeducational component. Coping skills were also targeted using psychoeducation; these were measured in five quantitative, two mixed methods and all qualitative studies.…”

“…These studies found larger positive effects on self-esteem, family wellbeing and knowledge of disability post-intervention and consistently indicated that siblings in the intervention groups appeared to benefit more than those in the comparison group (Giallo & Gavidia-Payne, 2008;Phillips, 1999;Williams et al, 2003). Siblings in interventions with combined psychosocial and educational components appeared to have better outcomes post-intervention than those with only social activities (Brouzos et al, 2017;Haukeland et al, 2020;Williams et al, 2003;Zucker et al, 2021), as were siblings in programs with parallel parenting education (compared to studies without parental involvement; Lobato & Kao, 2002;Roberts et al, 2015).…”

“…Five out of the nine studies with comparison groups reported the intervention group made larger improvements compared to the comparison or waitlist groups which showed minimal changes. The other four studies using a non-waitlist comparison had mixed results: the intervention group improved non-significantly (Jones et al, 2020) and significantly (Kang et al, 2021;Zucker et al, 2021) compared to the control group post-intervention; McLinden et al (1991) found the intervention group improved more than the comparison group on social support and positive affect, while the comparison group improved on self-esteem. Overall, therefore, all nine studies reported small to large benefits in favour of the intervention group in at least one outcome measure.…”

“…Only two lower-income populations were included (Fjermestad et al, 2020 in Cambodia;Phillips, 1999 in the United States for low-income African-American families). Only three studies reported a priori power analyses (Jones et al, 2020;Kang et al, 2021;Zucker et al, 2021) and they were all underpowered to detect moderate effect size differences.…”

“…In these nine studies, sibling participants were 4-19 years old (mean 10.5 years; 64% female). Five of the nine studies employed a waitlist-control design; two studies from the same RCT (Jones et al, 2020;Zucker et al, 2021) used an 'attention-only' (educational intervention focussing on general adaptive coping skills but not NDCs) participant-blinded controlled intervention; and the remaining two control groups were allocated activities not specific to being a sibling (a free-play outdoor socialisation condition; Kang et al, 2021;other psycho-educational activities;McLinden et al, 1991).…”