Family dynamics can change frequently for a variety of reasons.  There are many influences on family dynamics, some of these influences may be: 

• Number of children in the family 
• Events that affected family members 
• Family values 
• Culture and ethnicity 
• Economic influences

There are different approaches you may take to prepare your child for changes in family dynamics.  Here are some of the approaches you can take: 

Open yourself up to questions from your child: 

Your child may feel curious and confused about different life changes.  If you open the door to discussion with your child, they may feel more at ease as these changes affect your family dynamics.

Utilize social stories:

Prior to these changes taking place within your family dynamics, utilize social stories with your children.  Creating and reading stories to your child about how things may be different in your home life is useful in preparing your child for these changes.  In these stories you create, paint the picture for your child.  You can explain what the change is going to be and what it is going to look like for the child and your family.  Reading this book may also assist with a guided discussion with your child about these changes in your family dynamics. 

The news of a child’s new diagnosis (medical or psychological) is devastating to the child, the parents, and others that are closely involved within the family unit. Adults will often go through various stages of grief including denial, anger, depression, guilt bargaining, and acceptance. Parents and caregivers are often focused on resolving the stressors of getting the effected child “better,” adjusting to changes in daily routines and navigating increased financial responsibilities. But while many focus on supporting the necessities of the diagnosed child and parents, the unique fears and needs of the sibling(s) of the diagnosed child are often neglected. This blog talks about the effect a diagnosis can have on a sibling and give tips of how to prepare a sibling for this diagnosis.

Siblings are often the most overlooked population during the onset of a new diagnosis (Bingen, et. al, 2018). Parents will often “shield” siblings from the trials that are occurring involved with caregivers and diagnosed child; or completely disregard the needs of other children–often unintentionally—because of the additional stressors/demands associated with a child’s medical diagnosis. A recent study discovered that siblings of children suffering from a major illness actually experienced more emotional and social impairments than the sick child—even two years after diagnosis (Bingen, et. al, 2018). But if caregivers are already overwhelmed with newly onset responsibilities; how can they also meet the needs of the other children as well?

Fortunately, at present time there is more information/resources available and support groups that can navigate this arduous and complicated process. The most important factor is making sure that siblings are provided with information and included in major decision-making processes that will affect the entire family. Often caregivers justify isolating siblings and omitting information in order to protect the children. However, the opposite actually occurs—children’s emotions increase exponentially due to ignorance and misinformation.

But won’t siblings become traumatized from witnessing their siblings receiving treatment/rehabilitation or knowing that their brother or sister is “different?” The opposite actually occurs; siblings actually increase bonding with siblings, comprehend diagnosis education information, and often become advocates for their siblings (educators on their medical diagnosis) for others outside of the family unit (Bingen, et. al, 2018). The important factors to remember are to keep the child’s age, understanding, and temperament into account before providing information and exposure to their sibling’s diagnosis. Qualified professionals such as occupational therapists, child life specialists, or pediatric psychologists can assist in this process via age-appropriate language, processing a variety of emotions through therapy, and sharing resources (i.e. books, medical role play, or incorporating them into the treatment). There are also diagnosis-specific sibling support groups where children can have a safe space to explore their feelings with peers that have similar experiences.

Each child, family, and diagnosis are unique experiences and no one method fits perfectly. The most important thing to remember is to know that all family members should be included in this process and that there is help available. Listed below are various local and national resources that will further assist children and their families as they navigate the overwhelming process of a pediatric new diagnosis.

Bingen, K., Craig, E., Flynn, K., Panepinto, J., Yan, K. & Zhang, L (May 2018). Impact of pediatric cancer on family relationships, Cancer Medicine, 7(5), pp1680-1688.

Resources:

Sibling Support Groups (national organization) – https://www.siblingsupport.org/about-sibshops

Books for Children/Siblings of Chronic Illness – http://saidsupport.org/books-to-help-kids-living-with-chronic-illness/

Art Therapy Services in Chicago – https://www.dandelionartstudio.com/Medical Education for Siblingshttps://www.uchicagomedicine.org/patients-visitors/classes-events/sibling-preparation

Siblings tend to be our first friends and companions during childhood. This relationship assists in building a foundation for future relationships and social interactions. But what happens when a sibling receives a diagnosis of ASD? This bond may not be as strong or even exist yet. The sibling of the child with ASD, whether they be younger or older, may not fully understand why their brother or sister is different. Children with ASD may have deficits in play skills, communication, and social interactions. This makes it difficult for typical sibling interaction or play to occur. Parents are often consumed in the needs of their child with ASD and their sibling may perceive this as favoritism or special treatment. As a result, the neurotypical sibling may begin to experience stress, confusion, or loneliness. So, how do we support this child? With these three strategies:

1. Have open communication 

• Educate the child on the disability to prevent anxiety or fear of the unknown related to their brother or sister. This will be an ongoing process throughout their childhood and teenage years as they grow in their own development. 
• Explain their differences, but promote inclusion.
• Children are great observers – this is how they learn. It is best to answer their questions about their sibling honestly. For instance, if a child asks why their sibling jumps up and down or rocks back and forth, respond with the truth: they are trying to make their body feel better. “The key is to remember to adjust your information to your child’s age and understanding” (Autism Society, 2020). 

2. Set specific alone time with each child 

• 1:1 attention from parents allows the child to feel like they are part of the family. 
• Alone time with the neurotypical sibling is extremely important. Parents should set aside time for this child to feel that he/she is special and important, too.  

3. Teach coping skills 

• Teach the child how to appropriately respond to the stress or strong emotions they’re feeling towards their sibling with ASD. 
•  Your child wants to relate or express themselves to someone who will understand their feelings. Reaching out to other families you know with a child diagnosed with ASD or seeking support from pediatric counselors may be helpful. 

 

Links to helpful information for parents or caregivers:

Autism and Your Family

Living with Autism: Sibling Perspectives

Siblings Guide to Autism

Link to children’s books that are written about children with autism and their siblings:

Autism Books for Siblings