Associations Between Understanding of ASD and Perceptions of the Sibling Relationship

Background:

Autism Spectrum Disorder (ASD) is a condition that impacts not only the affected child, but also parents and unaffected siblings (UAS). Families in which a child has ASD report higher levels of stress (Eisenhower et al., 2005; Quintero & McIntyer, 2010), less frequent use of adaptive coping strategies (Hastings et al., 2005) and are at greater risk for psychological difficulties (Glasberg, 2000; Dunn et al., 2001). In particular, UAS face unique stressors. In an estimated 73% of ASD cases, the UAS becomes the caregiver after the death of the parents (Gidden, 2007). These sibling relationships have been described as less close, less reciprocal, and more stressful than other sibling relationships (Orsmond & Seltzer, 2007; Stoneman, 2007). In addition, siblings within affected families spend less time together compared to typical sibling pairs (Knott et al, 1995).

Objectives:

The present study aims to examine what UAS understand about autism and how their understanding affects the sibling relationship. We predicted that increased understanding of ASD would lead to improved ratings of the sibling relationship.

Methods:

The sample included 46 UAS (Mean age = 9.93). UAS completed an interview on their understanding of ASD (Glasberg, 2000) and self-report measures regarding the sibling relationship. Parents completed questionnaires on the their observations of the sibling relationship. To test our hypotheses that understanding of ASD would affect the sibling relationship, we conducted linear regressions with understanding of ASD predicting the sibling relationship.

Results:

For child-report, we found that understanding of ASD significantly predicted decreased overall satisfaction with the sibling relationship (p = 0.027, R² = 0.12; Fig 1) and decreased satisfaction with time spent with one’s sibling (p = 0.047, R² = 0.087). Additionally, as understanding of ASD increased, perceptions of positive sibling behaviors decreased (p = 0.034, R² = 0.088) and perceptions of supportive behavior towards their sibling with ASD decreased (p = 0.033, R² = 0.112). Parent-report did not reveal a significant association between understanding of autism and sibling relationship.

Conclusions:

In contrast to our hypothesis, we found, across multiple measures of the sibling relationship, that as understanding of ASD increased, satisfaction with the quality of the sibling relationship decreased. There are many potential reasons for this unexpected finding. For example, knowledgeable parents may spend more time advocating for their child with ASD, which could result in less time with the UAS, or more pressure on the UAS. This interaction may cause UAS to feel frustrated with their sibling with ASD. This hypothesis is somewhat consistent with literature indicating that UAS often feel negative feelings (e.g., guilt, jealousy) about their sibling with ASD (Gray, 1998). Alternatively, UAS who have more knowledge of ASD may feel dissatisfied with the amount of time they get to spend with their sibling (e.g., they may wish to spend more time with their sibling with ASD). It is also possible that UAS with more knowledge are overly critical of their behavior towards their sibling with ASD. Our findings have wide-reaching implications for improving the sibling relationship and family dynamic.