Latino siblings of children with developmental disabilities at risk, study finds

"When a child has a disability, all members of the family are affected, including siblings," said lead author Debra Lobato, Ph.D., of the Bradley Hasbro Children's Research Center. "However, little attention has been paid to the influence of cultural factors on the functioning of siblings. Our cultural backgrounds influence who we consider to be our siblings, as well as the expectations and relationships we have with our brothers and sisters."

"In order to understand the impact of a child's disability on siblings it is important to understand the social and cultural context in which they are raised," Lobato added.

According to the study in the Journal of Child Psychology and Psychiatry, now available online, Latino children who have a brother or sister with developmental disabilities experienced significantly more symptoms of internalizing psychological disorders, such as anxiety, than comparison children. These siblings also had more problems with their adjustment and coping skills including difficulties with their relationships, particularly with their parents. Latino children showed a greater reluctance to express any negative experiences or feelings that they had about their siblings' disability. In school, they had more absences and lower academic performances compared to their peers.

Latinos represent the largest minority population in the United States, where they share higher rates of sociodemographic stress, such as poverty, which has been associated with higher rates of anxiety symptoms and disorders among samples of Latino children. Latinos also share significant family-centric cultural values that may heighten the significance of sibling relationships and caretaking responsibilities while discouraging open verbal expression of sibling-related distress.

The study included 100 siblings and parents of children with developmental disabilities, and 100 siblings and parents of typically developing children. Each group was divided evenly between Latinos and non-Latinos. Siblings were between the ages of 8 and 15 years old.

Researchers interviewed siblings, parents and teachers to fully examine the psychological and school functioning of Latino and non-Latino siblings of children with developmental disabilities. Parents or teachers provided copies of the most recent report card for all siblings to gather information about siblings' grades and number of school absences.

According to the findings, Latino siblings of children with a disability were at higher risk for negative outcomes. In addition to experiencing impoverished economic conditions and more difficulties in their personal functioning and relationships, they also reported higher internalizing behaviors -- particularly separation anxiety and agoraphobia -- and were less likely to express their emotions.

"We can only speculate about why Latino brothers and sisters of special needs children respond by internalizing their emotions," said Lobato, adding that there may be both direct (e.g. sibling worry about their brother or sister) as well as indirect (disruptions in the parent-sibling relationship) ways that a child's disability affects Latino siblings.

When researchers looked at school functioning, they found Latino siblings of children with developmental disabilities had significantly more school absences, which their parents were more likely to attribute to the child with the disability. Greater family obligations, such as providing translation for parents at their sibling's medical appointments, as well as siblings' anxiety regarding separation from their parents may have influenced school attendance. Siblings were also less likely to have above average or excellent grades in language arts compared to other children in the study, which appeared to be unrelated to language proficiency.

According to researchers, this combination of greater anxiety, worse attendance and lower performance may place Latino siblings of children with developmental disabilities at risk for poor academic outcomes.

Lobato says the study's findings have clinical implications for children with developmental disabilities -- especially among Latino families, where siblings appear to be most vulnerable. "Our findings suggest that family-based, culturally sensitive services acknowledge the importance of siblings every step of the way," she said. "This might include proactively conducting screening assessments of sibling functioning as well as active consideration of siblings' perspectives and needs when treatment plans are developed and renewed."

Lobato is the founder and creator of SibLink -- one of the only support groups in the nation for siblings of children with chronic illnesses or disabilities. The six-week program, offered by the Bradley Hasbro Children's Research Center, focuses on sibling education, peer support and fun.

The study was funded by a grant from the National Institute of Child Health and Human Development. Co-authors included Wendy Plante, Ph.D. and Ronald Seifer, Ph.D., from the Bradley Hasbro Children's Research Center and Alpert Medical School; Barbara Kao, Ph.D., from Hasbro Children's Hospital and Alpert Medical School; Edicta Grullon, M.A., and Lydia Cheas, B.A., of the Bradley Hasbro Children's Research Center; and Glorisa Canino, Ph.D., from the University of Puerto Rico.