TUESDAY, July 30 (HealthDay News) -- Children who are raised in
the shadow of a sibling with significant health problems or
disabilities may experience more behavioral and emotional problems,
a new study suggests.
It's not that parents aren't concerned about their other
children, the researchers noted. But exhaustive, time-consuming and
sometimes expensive treatments and tasks associated with caring for
a child with such challenges can draw attention, energy and
resources away from siblings.
The study found that healthy siblings of children with a
disability experienced more problems with interpersonal
relationships, psychological issues, functioning at school, and
getting involved with sports and hobbies than did kids without such
The problems, the researchers speculate, lie partly in the
"What goes on in these households? There is financial, psychological and emotional stress," explained study author Anthony Goudie, an assistant professor in the department of pediatrics at the University of Arkansas. "Parents have to cut back hours at work, spend time coordinating care, bring their child to hospital appointments and don't typically have the time or energy with the well sibling to bond effectively."
Because parents tend to spend so much time focused on dealing
with the child with disabilities, they may overlook issues that are
building up for their other children, noted Goudie, because they
may pale in comparison to what the disabled child is facing.
When problems aren't identified, they're less likely to be
treated. "I think counseling and intervention are more
predominantly accessible in children of households where parents
aren't fixated on one specific child with disability," Goudie
Siblings in larger families where a healthy child has another
healthy brother or sister seem to fare better: "If a sibling has
another sibling to interact with, they seem to adapt better,"
That suggests that having other people in the household to talk
to and play with may help siblings develop the social skills and
confidence necessary to succeed outside the home -- in the
classroom and on the playground, he explained.
The study, published in the August issue of
Pediatrics, drew on data from the Medical Expenditure Panel
Survey, used by the U.S. Agency for Healthcare Research and Quality
to randomly survey households around the country. In addition to
collecting general information about each family -- including
health conditions, access to care, income and employment -- the
survey included the parents' assessments of their children's level
Parents were asked about the level of problems experienced by
their children between the ages of 5 and 17 years in the 12 months
before the interview. In total, there were more than 6,500 siblings
identified living in homes with only typically developing children
and 245 siblings who lived in homes in which at least one other
child had a disability.
The researchers found that compared with siblings of typically
developing children, parents said that siblings of children with a
disability were less likely to have a very good or excellent mental
health status; felt the sibling gets sick more easily; had
interpersonal problems with their mother, siblings or adults in
general; were more likely to seem unhappy, sad, nervous or afraid;
and had more problems with schoolwork or in leisure or sports
To counter those problems, Goudie suggested that parents look
for signs of problems related to school behavior, mood, interests,
activities and relationships. "Ask yourself if the problems [the
sibling is having] could be a result of the time you're having to
spend with their brother or sister who has a disability, and then
seek proper counseling," he said.
Parents may also need to seek respite care that would allow them
regular time away for a day or longer with the sibling, find
support groups and get other forms of practical help, said
Pediatricians and other health care providers should ask parents
if they've seen signs of misbehavior in the siblings and suggest
mental health screening if the responses warrant it, Goudie said.
"If you can get at the mental health issues sooner, it may be a lot
easier to intervene. Nip it in the bud," he advised.
One expert said the findings rang true, but noted limitations to
the study. "The way the data was collected, it's like a snapshot in
time, and it would be great to be able to track or show that when
the parents were under more stress, there were exacerbated problems
with the brothers and sisters," said Adam Carle, an assistant
professor of pediatrics at the University of Cincinnati School of
In some ways, the study may have underestimated the impact of
having a disabled sibling, Carle added. Children who don't
misbehave may be shouldering their troubles in ways that are less
obvious to parents. "Kids who are throwing a fit in school or not
listening are brought in [to get counseling], but the ones who go
off to their rooms and are quiet, they may not get noticed," he
Learn more about children with disabilities from the
National Dissemination Center for Children with
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