Sibling Support Research Articles

The experiences of children with Williams syndrome and their nondisabled siblings of their relationship

AbstractObjectiveThis study explored sibling relationships from the perspective of children with Williams syndrome (WS) and their nondisabled (ND) siblings.BackgroundWS, a genetic condition with a profile that can include intellectual disabilities, hypersociability and anxiety, might be predicted to impact sibling relationships, but this has not been qualitatively explored from the children's perspective.MethodsThirty‐nine children (6–17 years; 20 male, 19 female) participated: 20 sibling dyads in which one child had WS and the other was ND (one child with WS did not participate). Children were interviewed about experiences of their relationship. Data were analyzed with reflexive thematic analysis.ResultsSiblings described multifaceted relationships, in which love and positivity were overtly evident and embedded in the reciprocity of sibling expertise and support. Children skillfully navigated the spaces and boundaries of their relationship across home, school, and friendship contexts, with parent support. ND siblings' knowledge of WS supported interactions, relationships, and advocacy, but some children with WS felt their sibling lacked knowledge of the challenges of WS.ConclusionsThe WS profile was woven through multidimensional relationships.ImplicationsFindings have implications for how parents are supported to help siblings navigate relationships and learn about WS, and how schools support WS sibling relationships.

Support for Siblings of Children With Complex Care Needs: Public Health Nurses' Perceptions of Their Role in Primary Schools.

To explore the role of public health nurses (PHNs) in Norwegian primary school health services in supporting siblings who have a brother or a sister with complex care needs. A qualitative, exploratory design using focus groups combined with visual methods. Nineteen Norwegian PHNs participated in three focus group discussions between May and September 2022. The nurses were asked to draw themselves as PHNs working in primary schools. Braun and Clarke's reflexive thematic approach was used to analyse the transcribed interviews. The drawings were analysed using critical visual analysis methodology. The findings revealed that PHNs in primary schools focused on establishing good relationships and found it important to be flexible and creative. However, a challenge to successful service provision in supporting siblings and their families was that the nurses lacked support for the implementation of health promotion interventions and often felt alone. The analysis elicited three main themes: 'the importance of relationships and flexibility in meeting siblings' needs', 'feeling alone with responsibility for supporting siblings' and 'the forgotten children: a need for coordinated services'. PHNs in school health services are in a unique position to provide support to improve siblings' mental health and well-being. To fully benefit from PHNs' potential to support siblings, there is a need to clarify guidelines and develop evidence-based interventions. This study provides valuable insights for health authorities, educators and practitioners on what inhibits sibling support in Norway. The study highlights the potential for PHNs to play a significant role in delivering timely health-promoting interventions for these siblings in school settings independent of context. This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ). No patient or public contribution.

THE POWER OF OPEN COMMUNICATION: EXAMINING THE RELATIONSHIP BETWEEN PARENT-ADOLESCENT COMMUNICATION AND PROBLEM EXTENT AND THE MODERATING ROLE OF SIBLING INFLUENCE

Adolescence is the period of extensive physical, emotional, and social transformation. This article focuses on the primary role of effective communication within the family, especially parents and siblings influence, in shaping adolescence development. It considers how open, supportive, and sincere interactions help in identity formation, peer relationships, cognitive development, and affect regulation during this critical stage. The article draws both on Eastern and Western psychological paradigms, showing how academic psychology has evolved over the years and the main theoretical frameworks which inform our understanding of adolescent development. It is in this regard that the current study will explore the importance of effective family communication in developing a positive identity, building self-esteem, and supplying a sense of belonging. Emphasized herein is the role of parents in guiding adolescents through open discussions that will help them think critically, solve problems, and make independent decisions. Attention falls onto sibling influence in that they are in a special position to offer emotional support, companionship, and modeling behaviors. It draws from quantitative studies how family dynamics impact adolescent results. Construction and standardization processes of psychological measures are described to explain why reliable and valid instruments are needed when studying adolescent behavior and family interaction. This article concludes with the practical recommendations to enhance family communication strategies in supporting adolescent development. This integration of theoretical perspectives and empirical findings thus provides critical insights for educators, practitioners, and families seeking to promote healthy developmental trajectories among adolescents through effective communication and supportive sibling relationships.

Supporting siblings during the critical illness hospitalization of a child: learning from experience.

Childhood critical illness impacts the entire family of the critically ill patient. Disruptions to usual family rhythms and routines, established relationships, physical relocations or shifts in caregivers, and the uncertainty about the patient's well-being can have significant impacts on siblings and other connected children in the family. Promoting and facilitating family interactions and engaging younger family members in the hospital experience have been shown to reduce patient and family anxiety, enhance family adaptation, and improve child and family outcomes. The critical care team can implement evidence-informed approaches to address and mitigate challenges for families and provide developmentally aligned support to impacted siblings. This conceptual paper describes the potential impacts of a critical illness hospitalization on siblings, approaches to supporting siblings, and practical interventions drawn from a synthesis of the current literature and the author's practice experience caring for critically ill children and their families. A traditional review and narrative analysis moderated by the authors and supported by lived experience. There is a range of impacts of a critical illness hospitalization on siblings and young family members of the patient. Providing consistent, transparent, and supportive child, sibling, and whole family-centered care can improve the experience and outcomes for the child and family.

Siblings at home: Moderating influence of sibling presence and composition on the relation between problem behaviors and Theory of Mind in early childhood

Despite the prevalence of internalizing and externalizing difficulties in children, the impact of these problem behaviors on the development of important social cognitive skills, such as Theory of Mind (ToM), is not well-understood. Indeed, many studies that have explored relations between problem behaviors and ToM report inconsistent findings. A possible reason for these disparities may be a lack of accounting for social protective factors within the home, such as the presence and number of siblings. Here, we explored the moderating influence of sibling presence and number on the relation between problem behaviors (i.e., internalizing and externalizing) and ToM. A total of 184 children (88 boys; Mage = 64.6 months, SD = 10.39) completed six well-validated ToM tasks while mothers reported on their children’s externalizing and internalizing behaviors. Children who had siblings living in the same home exhibited higher ToM than children without siblings. In addition, both sibling presence and number of siblings moderated the relation between children’s externalizing behaviors and ToM, such that in children without siblings externalizing behaviors were negatively associated with ToM. In contrast, children with siblings had similar ToM regardless of externalizing behaviors. As well, children with relatively fewer siblings and higher externalizing behaviors displayed lower ToM than children with relatively more siblings and higher externalizing behaviors. We did not detect a moderating effect of sibling presence or number on the relation between internalizing behaviors and ToM. These findings provide support for siblings’ protective utility within the context of children’s social cognition.

Relationships among adult full, half, and stepsiblings: Does coresidence explain the stepgap?

AbstractObjectiveThis article aims to compare adult sibling ties of stepsiblings to the ties of full and half‐siblings in divorced families, widowed families, and single‐parent families.BackgroundSiblings are one of the most stable sources of attachment and companionship over the life course and function as important providers of practical and emotional support when going through important life transitions. Due to a steep rise in divorce over the past decades and accompanied increases in remarriage and multipartner fertility, many adults nowadays not only have full siblings, but also half‐siblings and stepsiblings.MethodUsing a new module on adult sibling relationships and random‐ and fixed‐effects modeling (OKiN, N = 4506 dyads nested in N = 1742 respondents), we examine the quality of full, half, and stepsibling ties in adulthood and test the main mechanisms driving a potential stepgap in sibling ties: (1) the (absence) of a shared genetic relatedness and (2) the amount of time shared in the same parental household.ResultsThe weaker bonds adults, on average, have with their stepsiblings compared to their biological (full and half) siblings are largely explained by the shorter period of time they have lived together during childhood. Nevertheless, a substantial gap remains.ConclusionOur results confirm that a stepgap in sibling closeness, contact, and support is visible, but substantially reduced once shared time is considered.

Examining emotional and behavioural trajectories in siblings of children with life-limiting conditions

BackgroundHealthy siblings of children with life-limiting conditions often experience emotional and behavioural struggles over the course of the ill child’s condition(s). Resources to support these siblings are limited due to a lack of understanding about their needs. Therefore, this study was designed to characterize the emotional and behavioural trajectories among siblings of children with progressive, life-limiting genetic, metabolic, or neurological conditions over a 12-month observation period.MethodsSeventy siblings were recruited from a large-survey based study (Charting the Territory) that examined the bio-psychosocial health outcomes of parents and siblings. Linear mixed effect models were used to assess the association between siblings’ emotions and behaviour trajectories and selected demographic variables. Siblings’ emotions and behaviour were measured with Child Behaviour Checklist (CBCL).ResultsSiblings’ mean age was 11.2 years at baseline and Internalizing, Externalizing, and Total Behaviour Problems mean scores were within normal ranges across time. However, 7–25% of siblings had scores within the clinical range. Brothers had higher levels of Internalizing Problems than sisters, whereas sisters had higher levels of Externalizing Problems than brothers. When treatment was first sought for the ill child less than a year prior to study participation, siblings had higher levels of Internalizing and Externalizing Problems compared with siblings who participated more than one year after treatment was sought.ConclusionHealthy siblings experience emotional and behavioural problems early in the child’s disease trajectory. Although these problems improve with time, our findings show that brothers and sisters experience different types of challenges. Therefore, timely support for siblings is important as they navigate through the uncertainties and challenges.

Supporting Autistic Students and Their Siblings through Inclusive Music Groups

This article provides a brief review of research along with a recommended music program with the purpose of facilitating constructive and loving relationships between autistic individuals and their allistic siblings. We highlight research regarding the need for family-based interventions, as well as the benefits of music participation for both the individuals with autism and their allistic siblings. Finally, we recommend a world percussion program for the siblings to participate in together that coincides with an allistic sibling support group. Music educators can facilitate growth within these relationships because they have a unique perspective on the individuals involved.

A Family Stress Approach to Understanding Sibling Relationships Following Parental Divorce

ABSTRACT This study utilized family stress theory to examine whether sibling closeness differed between young adults with married (n = 193) and divorced (n = 113) parents; if sibling closeness differed before and after divorce; and whether levels of sibling support and experiential discrepancy was related to sibling closeness following parental divorce. Research questions and hypotheses were tested using t-tests and three-step hierarchical regression analysis. No differences were found between pre-divorce and post-divorce closeness or between the two samples. Support seeking and support seeking success were significantly related to post-divorce closeness. The implications of the results and future directions will be discussed.

Enhancing sibling support in oncology: Collaborative care for families facing cancer in young people.

This study investigates the support systems and needs of siblings of young people with cancer, shedding light on the emotional and informational challenges siblings face. This topic area has had relatively little attention. Qualitative interviews were conducted, and thematic analysis was employed to gain in-depth insights into the experiences and perspectives of siblings. While the study's relatively small sample size and participant homogeneity are acknowledged limitations, the approach offers several strengths, including relevance and participant diversity across age cohorts. The findings underscore the essential role of healthcare professionals, particularly nurses, in providing emotional and informational support to siblings. Family-centred care, psychosocial support, tailored interventions, and ongoing research and education are recommended to address the unique needs of siblings effectively. Overall, this study highlights the importance of recognizing and addressing the support needs of siblings in pediatric oncology care, emphasizing their role as a vital component of the family system and advocating for holistic support throughout the cancer journey and beyond.

Enhancing Sibling Support in Oncology: Collaborative Care for Families Facing Cancer in Young People

Objectif : Cette étude examine les systèmes de soutien et les besoins des frères et sœurs des jeunes touchés par un cancer, mettant en lumière les défis émotionnels et informationnels auxquels les frères et sœurs sont confrontés. Ce domaine a reçu relativement peu d'attention. Devis et méthodologie : Des entretiens qualitatifs ont été menés et une analyse thématique a été utilisée pour obtenir des perspectives approfondies sur les expériences et les points de vue des frères et sœurs. Bien que la taille relativement petite de l'échantillon de l'étude et l'homogénéité des participants soient reconnues comme des limites, l'approche présente plusieurs forces, notamment la pertinence et la diversité des participants dans les cohortes d'âge. Résultats : Les résultats soulignent le rôle essentiel des professionnels de la santé, en particulier des infirmières pour fournir du soutien émotionnel et informationnel aux frères et sœurs. Une approche centré sur la famille, un soutien psycho- social, et des interventions personnalisées sont recommandés pour répondre de manière efficace aux besoins spécifiques de la fratrie. Conclusion : Dans l'ensemble, cette étude met en lumière l'importance de reconnaître et de répondre aux besoins de soutien des frères et sœurs dans les soins en oncologie pédiatrique, en mettant en avant leur rôle en tant que composante essentielle du système familial. Cette étude souligne l'importance de fournir un soutien à la fratrie pendant et après l'expérience du cancer. Mots-clés : cancer pédiatrique, cancer chez les jeunes, frères et sœurs, éducation en santé, soutien, soins infirmiers, professionnels de la santé, soutien psychologique, soutien informationnel

Development of a blueprint for sibling psychosocial services: A nationwide study.

Siblings of youth with cancer have heightened risk for poor long-term psychosocial outcomes. Although sibling psychosocial care is a standard in pediatric oncology, this standard is among those least likely to be met. To address barriers to providing sibling services, a blueprint for systematic psychosocial screening and support of siblings was developed based on feedback from a national sample of psychosocial providers. Semi-structured interviews were conducted with a purposive sample of psychosocial care providers (N=27) of various disciplines working in US pediatric cancer centers, varied in size, type, and extent of sibling support. Interviews queried providers' suggestions for the future of sibling psychosocial care and impressions of a blueprint for sibling service delivery, which was iteratively refined based on respondents' feedback. Interviews were analyzed using applied thematic analysis. Based on existing literature and refined according to providers' recommendations, the Sibling Services Blueprint was developed to provide a comprehensive guide for systematizing sibling psychosocial care. The blueprint content includes: (i) a timeline for repeated sibling screening and assessment; (ii) a stepped model of psychosocial support; (iii) strategies for circumventing barriers to sibling care; and (iv) recommendations for how centers with varying resources might accomplish sibling-focused care. The blueprint is available online, allowing providers to easily access and individualize the content. Providers indicated enthusiasm and high potential utility and usability of the blueprint. The Sibling Services Blueprint may be a useful tool for systematizing sibling psychosocial care, promoting wider availability of sibling-focused services, and addressing siblings' unmet needs.

The Impact of Sibling Relationships on Behavioral and Sexual Health among Latino Sexual Minority Men

Pre-exposure prophylaxis (PrEP) is a highly effective method for preventing HIV acquisition and plays a crucial role in the Ending the HIV Epidemic in the US initiative. However, there are various barriers that hinder the access and uptake of PrEP among Latino sexual minority men (SMM) at individual, interpersonal, and cultural levels. While the significance of cultural factors in designing and implementing HIV prevention programs for Latino populations has been consistently emphasized in the literature and prioritized by the Centers for Disease Control and Prevention, few studies have directly integrated these cultural factors into their programs. Our study aimed to investigate the potential influence of siblings in promoting the utilization of PrEP for HIV prevention, an area that has received limited attention. We conducted interviews with 31 pairs of siblings between December 2020 and January 2021, which were held in either English or Spanish and lasted approximately 45–60 min. The data were analyzed using a deductive thematic content analysis approach. The interviews revealed several key themes and categories, including: (1) Sibling support for coming out; (2) Types of support that siblings provide to each other for behavior change; (3) Sibling support for PrEP; and (4) The impact of the study interview on the quality of the sibling relationships. Our findings indicated that siblings were willing to provide support for PrEP in various ways, ranging from emotional support for brothers who may be concerned about potential rejection to practical support such as transportation or financial assistance. These results have significant implications for the design of HIV prevention interventions for Latinos. Incorporating siblings or other extended family members into these interventions can facilitate communication between siblings and their brothers, ultimately encouraging the use of PrEP or similar prevention methods. By considering the unique dynamics and support systems within Latino communities, researchers can develop more effective strategies to promote HIV prevention and support the well-being of Latino SMM.

Improving family grief outcomes: A scoping review of family-based interventions before and after the death of a child

Background: Experiencing the illness and death of a child is a traumatic experience for the parents and the child’s siblings. However, knowledge regarding effective grief interventions targeting the whole family is limited, including how to integrate age-appropriate support for siblings. Aim: We aimed to synthesize the empirical literature regarding grief interventions that target the whole family before and/or after the death of a child. Design: A scoping review following the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Data sources: We searched PubMed, PsycINFO, Embase, CINAHL, and Scopus covering January 1998–May 2022. We included studies describing any type of structured intervention targeting the whole family (i.e. parents and siblings) before or/and after the death of a child (below 18 years), with pre-post assessments of grief-related symptoms in the family as an outcome. Results: After removal of duplicates, we screened the titles and abstracts of 4078 publications and identified 30 publications for full-text screening. None of the studies met the inclusion criteria. Most of the studies were excluded because they either did not target the whole family or did not target families who had lost a child below 18 years. Bereavement camps were a popular form of family intervention, but none were evaluated in a pre-post design. No grief interventions offering support pre-death were found. Conclusions: There is great need for research to improve bereavement outcomes for the entire family and to potentially integrate this in pediatric palliative care.

The Experience of Work–Family Conflict: Does Being the Only Child Matter?

A lack of resistance resources in the family, such as a lack of sibling support, might cause the family to be more prone to family crises; however, little if anything is known about whether being the only child will influence the experience of work–family conflict (a family crisis). Using an online questionnaire sample of 622 Chinese employees, we investigated the influence of only child status on work–family conflict and further explored the moderating effect of only child status on the relationship between work–family conflict and its performance outcomes. Analyses revealed that being the only child would spend less time on family responsibilities, thereby decreasing the level of family-to-work conflict; in addition, being the only child would ease the negative impact of work-to-family conflict on family performance. The recommendations for future studies, implications of this study, and the need for further research on only child’s work–family conflict experience are discussed.

‘Glad to the heart to see any of my brothers’: exploring Irish family life through sibling relationships

ABSTRACT This article proposes using the sibling relationship as an historical lens into nineteenth-century Ireland. Often taken for granted in historiography, brothers and sisters influenced family financial decisions and provided emotional support to each other in childhood, adulthood, and into old age. They were members of each other’s social networks and could be a cause of worry, conflict, and tension within the home. As the longest-lasting relationship an individual experiences, siblings provide a unique vantage point for the historian to explore the role of family in society across the life cycle. Their presence, or lack thereof, is vital to a sibling’s identity. Whilst individuals shape their own identity in relation to their family and peers, people have their own ambitions, successes, and failures. Tracing these interactions allow the historian to similarly trace wider social and cultural change. This article uses two sets of siblings to explore how brothers and sisters consciously kept family connection, utilised it in times of crisis, and benefited from sibling support networks. Separated through migration, the migrant letters exchanged between the Sinclair family in County Tyrone and Philadelphia shed light on the emotional toll of migration and provide insight into everyday life in rural Ireland. Making use of genealogical methodologies and digitised collections, this article reveals how family stories can be pieced together using fragmentary sources across a diverse range of archives. A horizontal approach elucidates wider societal changes over generations of the family. This article uses the sibling relationship to unravel complex family networks and explore nineteenth-century Irish society through the family lens.

Barriers and facilitators of sibling relationships of youth in foster care from an ecological perspective

For children in foster care sibling support is associated with better mental health and resiliency. Despite the findings on the importance of sibling relationships, siblings are frequently separated from each other. Previous research has explored sibling separation and barriers to placing siblings together. This qualitative study aims to identify barriers and facilitators to sibling relationships from the perspective of those formerly in foster care. A thematic analysis was completed to explore the experiences of 11 adults with foster care experience and identify perceived barriers and facilitators to sibling relationships. Results are interpreted through an ecological framework. Barriers and facilitators are identified at the individual, microsystem, exosystem, and macrosystem levels. Specifically, barriers and facilitators relating to visitation, placement, foster parents, child welfare workers, the foster care system, and the legal system are discussed. Participants also provided recommendations for overcoming barriers and finding ways to facilitate relationships between siblings in the different levels of the ecological system.

Assessment of Quality of Life, Grief, and Psychosocial Need Among Bereaved Caregivers of Children with Cancer.

Cancer is the leading disease-related cause of death for children in the United States; however, limited data exists on caregivers' needs and evidence-based bereavement interventions are lacking. This is a cross-sectional study of primary caregivers of children who died from cancer. Participants completed five surveys assessing well-being and an optional semi-structured, in-depth qualitative interview. Caregiver's greatest unmet needs were finding meaning in the death, personal wellness, and social activities. Bereaved caregivers with greater unmet needs reported poorer quality of life in the energy/fatigue (p = .01), role limitations due to emotional problems (p = .01), pain (p = .01), and emotional well-being (p = .02) domains. Interview themes elicited include inadequate bereavement services, support for siblings, desired contact with the medical team, and connections to other bereaved caregivers. Findings support the need for intensive, evidence-based bereavement programs for families of children who died from cancer, to attempt to mitigate poor bereavement-related outcomes.

Associations between parental depression, communication, and self-worth of siblings bereaved by cancer.

A child's death from cancer may increase the risk for poor self-worth in bereaved siblings. Furthermore, bereaved parents may experience depressive symptoms and communicate differently with their surviving children. However, limited research has examined family factors associated with self-worth in bereaved siblings. Thus, we examined: (a) differences in parental depressive symptoms, parent-child communication, and sibling self-worth between bereaved and nonbereaved families and (b) indirect effects of parental depressive symptoms and communication quality on the association between bereavement and sibling self-worth. Bereaved parents and siblings were recruited 3-12 months after a child's death from cancer. Bereaved (n = 72) and nonbereaved families of classmates (n = 58) completed home-based questionnaires upon enrollment (T1), and 48 bereaved and 45 nonbereaved families completed 1-year follow-up (T2). Relative to controls at T1 and T2, bereaved mothers, but not fathers, reported more depressive symptoms. Bereaved siblings reported poorer maternal and similar paternal communication, and similar levels of self-worth compared to controls. Both cross-sectional and longitudinal serial mediation models for mothers were significant. Bereaved mothers were at greater risk for depressive symptoms, which adversely affected sibling self-worth over time through disrupted mother-child communication. The father sample was limited, but the cross-sectional model was nonsignificant. Mothers and fathers may grieve differently and may require different therapeutic approaches. Family-centered interventions should target bereaved mothers' emotional adjustment and communication to enhance sibling self-worth. Additionally, clinicians should bolster other sources of support for bereaved siblings to promote adaptive outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Community-Based Pediatric Palliative Care: How Services Support Children's and Families' Quality of Life.

Background: The Massachusetts Department of Public Health's Pediatric Palliative Care Network (PPCN) provides Community-Based Pediatric Palliative Care (CBPPC) to children with life-limiting conditions and their families. CBPPC services aim to improve children and families' quality of life (QOL). Objectives: To identify perceived domains of QOL important for children and families and to understand whether and how CBPPC supports QOL. Design: A community-based participatory research framework was used to develop recruitment and data collection materials for eight focus groups and seven interviews. Collected data were transcribed and analyzed with an inductive approach. Setting/Subjects: A convenience sample of 33 PPCN caregivers, 20 providers, and seven key informants, including policymakers, community organizations, and hospital-based clinicians, were interviewed virtually in the United States. Measurements: Perceived QOL domains for children and families, respectively, and perceived impact of CBPPC services on QOL. Results: Reported QOL domains described as important for children were socialization/community integration and accessibility; expression/play; and physical wellness. Control or autonomy, psycho-emotional wellness, and self-care were identified as important for families. Clinical services were described as "integral to mental health" through offered spiritual support; advocacy in the community; and education. PPCN's integrative services were noted as distractions from pain and helped improve communication and bonding. Sibling support and bereavement care were also mentioned as impactful on QOL. Conclusions: Family-centered CBPPC was described as supportive of children's and families' QOL. Future studies should consider using population-based QOL measures, leveraging the QOL domains identified through this analysis and other outcome measures in a cost-effectiveness analysis.