Impact on Siblings

I am sure we have read a good bit of research on how a diagnosis of autism can impact the whole family- from parents to the siblings involved.  Undoubtedly, the family members (more so in regards to immediate family) who don't have the diagnosis than say relatives (grandparents, aunts, uncles, cousins, in-law's, etc.).  What sparked me this post comes from a parent saying this last night-

"... i ve had it with my eldest as my youngest has austism its been a rocky road and has turned my eldest against my partner due to how much attention we very had to give him . My eldest moved out when he was 13 and lives with my mum which i found very difficult . No one prepares a mum with a autistic child and we struggled with this. it can be HHeart renching but how do u as a parent show them both the same attention . I tried everything days out just with my eldest and we would still have the anger if any longer attention was with my youngest. Its sad to say but my two boys dont get on now and its got to the point where they have nothing to do with each other it makes me sad !"

Obviously, this is a pretty extreme example, as my sister never really had an issue with this issue during our lives together due to the fact that we are pretty much complete opposites and we never are in each other's way- unless I am tutoring her in Math.  But, the "snap shot" above is really alarming for those of us who are in the OT community.  That makes me wonder- how can we the OT community help?

1. Getting the sibling involved in the intervention.  This has great value when the sibling(s) is/are young.  However, as the sibling(s) grow older, he/she/they are going to have his/her/their own set of friends.  In time, this could get tricky.

2. Social & play skills- Aspies' inappropriate play and social skills could have an impact on their siblings, especially socially and psychologically.  I think Aspies to certain extent care about their standing socially.  However, they might only care about themselves, not other people around them (e.g. friends, siblings, or other people that might be close to them).  Theo's narratives on Jacob during his younger days on House Rules are legit examples.  Simply put, Aspies might not realized that their presence can actually have a "domino effect" on the quality of life of people who are around them, and they don't know that their inadequate social and/or play skills simply make things worse.

3. Respite care- We have to proactively look at affordable respite care for these families.  That will allow the parents to have quality time for themselves, or with other siblings.  Of course, this is also a delicate balance, as we also don't want the Aspies feel left out as well.

4. Occupations- As much as it should be Aspie friendly, it should also be family centered.  On certain family centered occupations, we should think about proactively how to prepare Aspies in behaving appropriately so that everyone can have a good time.  I think this will help the overall well being of the family.

5. Family Education- This should be tailored to everyone in the immediate family, at the very minimum.  Of course, this includes siblings, too.  I think it's important for siblings because their quality of life could be affected the most in the school setting.  That way, they won't take the diagnosis the wrong way.  Also, they can defend the Aspie if appropriate.

Of course there are more ideas, but I think next time when we get a child with autism, maybe we should get a complete family picture, not just the child's occupational history.  Also, constant communication with the family is imperative, especially on things that are caused by the child with autism in any way.  That way, chances of family tragedies like this will be reduced.