'It Feels Very Weird and Normal at the Same Time': Sibling Perceptions of Their Relationships With an Autistic Brother or Sister With Complex Care Needs.
Louise Rixon, Richard P Hastings, Hanna Kovshoff
PMID 39815778WHAT IT FOUND
Siblings of autistic children with complex needs described joy in shared play, even without reciprocal interaction.
Conflict was rare among siblings of non-verbal children but higher when the autistic sibling had spoken language. Siblings kept friendships separate from home life.
Key findings
01Siblings of non-verbal autistic children often perceived an absence of conflict, attributing this to the lack of verbal exchange rather than true harmony.
02The two siblings of autistic teenagers with spoken language reported the highest levels of conflict, using their bedrooms and online gaming as sanctuaries to escape.
03Siblings reinterpreted behaviours like pinching or hitting as positive or neutral aspects of their relationship, rather than harmful actions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study interviewed only one sibling per family and did not capture the perspective of the autistic child. Complex care needs were defined by parental report rather than standardised clinical measures, which may vary between families. The interviewer's identity as a parent of an autistic child may have influenced how open siblings were about negative feelings. The small sample size (11 siblings) limits the generalisability of the themes. Parents were present in adjoining rooms during interviews, which may have restricted the siblings' willingness to share sensitive information.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume that a lack of reported conflict between a non-verbal autistic child and their sibling indicates a high-quality, harmonious relationship. The study suggests this perception may stem from the absence of verbal interaction, not necessarily positive engagement.