A systematic review of social support for siblings of children with neurodevelopmental disorders

Interventions for siblings of children and young people with mental health conditions: A systematic review

Background

Childhood mental health conditions typically affect the entire family, including siblings, however there is a lack of research investigating interventions supporting siblings.

Methods

The review was prospectively registered with PROSPERO (CRD42022377163). We conducted systematic searches of 7 databases (Medline, EMBASE, PsycINFO, Child and Developmental and Adolescent Studies, Applied Social Science Index and Abstracts, Education Research Information Centre, and British Eduction Index) for studies evaluating interventions for children and young people (CYP) with siblings presenting with mental health conditions from January 1980 to August 2024. We included interventions for young people aged 4 to 24 years who have a sibling with a mental health condition, with symptoms and impact lasting at least 3 months. Quality of reporting was assessed using the Critical Appraisal Skills Programme qualitative checklist for qualitative and the Effective Public Health Project Practice quality assessment Tool for quantitative studies.

Results

We identified 4 eligible studies; 2 of family-based treatment and the other of drop-in group support from 2469 studies that were screened in total. Quantitative results were rated weak for three out of four studies, while qualitative results were rated moderate for two studies, and high for one study. The two studies of sibling support groups reported high acceptability.

Conclusion

The evidence for the effectiveness of interventions for siblings of CYP with mental health conditions is limited in both size and quality, highlighting a significant gap in research and practice. We cannot draw definitive conclusions from the available evidence, but it suggests support groups have potential to improve sibling outcomes. Additional research is required to determine sibling mental health trajectories and to identify risk and resilience factors possibly influencing poorer mental health outcomes. Clinicians should be mindful of potential effects of mental health conditions on other family members and encourage parents to communicate openly with siblings about family dynamics and the challenges they may face.

Siblings in families of children with chronic disorders: a model of risk and protective factors

OBJECTIVE

We empirically tested a family systems model's ability to explain variance in psychosocial adjustment among siblings of children with chronic developmental and physical disorders (CDs). The model included the impact of CD severity, family social support, parental mental health, and parent-sibling communication quality. We hypothesized that family social support would moderate the relationship between CD severity and parent mental health, and that sibling-reported communication quality with their parents would mediate the relationship between parent mental health and sibling psychosocial adjustment.

METHODS

We used baseline data from a sibling intervention trial (SIBS-RCT) comprising 288 families with siblings aged 8-16 years and their parents, recruited from health services and user organizations. Parents reported CD severity, parental mental health, and family social support. Siblings self-reported their psychosocial adjustment, including mental health, CD-related adjustment, quality of life, and prosocial behavior. We employed structural equation modeling to test the hypothesized relationships.

RESULTS

Higher parent-sibling communication quality was significantly associated with better sibling-reported quality of life and more prosocial behavior. Lower levels of paternal depression were significantly associated with better sibling-reported quality of life and mental health, whereas maternal depression was not. We did not find support for the hypothesized mediating and moderating pathways for family social support and parent-sibling communication.

CONCLUSIONS

The findings highlight the importance of addressing paternal mental health and parent-sibling communication in promoting sibling psychosocial adjustment. Future studies should use comprehensive, multi-informant approaches and consider the complex interplay of family factors in the context of childhood CD.

Psychosocial adversities in adulthood among individuals raised with family members with disabilities

Despite millions of individuals worldwide growing up with family members who have disabilities, little is known about how this experience is associated with long-term outcomes. We address this gap by examining how growing up with a parent and/or sibling with a disability is associated with individuals' psychosocial situation in adulthood. Using retrospective information from the 2020 wave of the Survey of Health, Impairment and Living Conditions in Denmark (SHILD, N = 15,699), we explore how growing up in a family with disability is associated with loneliness, socialsupport, general self-efficacy, subjective well-being, and feelings of resentment in adulthood. Our results from linear probability models suggest that growing up with a parent and/or sibling with a disability increases the likelihood of experiencing loneliness, low subjective well-being, and reduced self-efficacy. Additionally, we find that individuals who grow up in a family with disability are more likely to report a lack of social support and heightened feelings of resentment. We conclude that growing up with a parent and/or sibling with a disability is associated with a wide range of psychosocial adversities in adulthood. However, having a disability oneself is even more detrimental for psychosocial outcomes. These findings highlight the need for strengthened support for families with disabilities to improve psychosocial outcomes and break cycles of intergenerational disadvantage.

Adapting and providing a virtual psychosocial intervention, iSibWorks, for siblings of youth with disabilities, a qualitative acceptability study

PURPOSE

The objectives included: (1) Adapt the SibWorks group intervention for use on a virtual platform with siblings; and (2) Assess the acceptability of the adapted intervention, iSibWorks.

MATERIALS AND METHODS

Participants were youth aged 8 to 12 years who had a sibling with a disability, and their caregivers. iSibWorks was implemented with siblings on a weekly basis for six weeks. Sessions were conducted using Zoom for Healthcare and lasted approximately 60 min each. One week after the final session, siblings and their caregivers were invited to participate in separate semi-structured interviews. Qualitative content analysis of interview transcripts was utilized to assess intervention acceptability.

RESULTS

Adapting SibWorks to iSibWorks was achieved. Three categories were developed based on sibling and caregiver feedback. First, participants shared their satisfaction with the delivery of iSibWorks, reporting enjoyable experiences and valuing its interactive design. Next, participants perceived their involvement in the intervention as beneficial, due to opportunities to connect with others, learn applicable coping strategies, and improve self-esteem and mood. Finally, participants provided suggestions regarding the intervention's future delivery, content, and participation.

CONCLUSIONS

iSibWorks is an acceptable virtual group intervention for siblings of youth with a disability. Families noted positive experiences and perceived benefits with intervention participation.

Health-Related Quality of Life Among Siblings of Children with Special Needs and Typically Developing Children in Japan: A Cross-Sectional Study

With the global rise in children with disabilities, their siblings may experience various impacts on their daily lives. This study investigates health-related quality of life (QOL) and related factors among siblings of students attending special-needs schools in Japan. A cross-sectional study was conducted with two groups: 71 siblings of children with disabilities and a control group of 398 siblings of typically developing children, using the KINDLR QOL scale. Results showed a median QOL score for siblings of children with disabilities of 72.92 versus 71.88 for siblings of typically developing children (p = 0.711). This lack of significant difference may be attributed to existing social support systems and special-needs schools in Japan, which may reduce the burden on siblings of children with disabilities. These findings highlight the importance of maintaining and improving support systems for siblings of children with disabilities while continuously monitoring their well-being at home and in their communities.

Effectiveness of a group intervention to improve mental health in siblings of children with chronic disorders: a cluster randomized controlled trial

OBJECTIVE

We evaluated the effectiveness of SIBS, a preventive intervention for siblings and parents of children with chronic disorders (CDs).

METHODS

This two-arm, unmasked cluster randomized controlled trial registered on ClinicalTrials.gov (NCT04056884), included 288 siblings (M age = 10.4 years, SD = 1.9) and parents of children with CDs (mainly neurodevelopmental disorders) randomly assigned to intervention (k = 34, n = 137) or waitlist control (k = 35, n = 151) groups. Eligible siblings were aged 8-16 years and had a sibling diagnosed with a CD. SIBS is manual-based and was delivered as five sessions over 2 weeks in primary care and hospital settings across Norway. Three sessions are separate for siblings and parents, and two are integrated sibling-parent dialogues. The primary outcome was sibling mental health, rated by siblings, parents, and teachers. The secondary outcome was parent-child communication, rated by siblings and parents. Analyses included intention-to-treat (ITT) and complier average causal effects (CACE).

RESULTS

Although not statistically significant, at 3-month follow-up, the intervention group showed fewer mental health problems (ITT: sibling-rated d = -0.16, 95% CI [-0.49, 0.17]; parent-rated d = -0.10, 95% CI [-0.48, 0.12]; teacher-rated d = -0.18, 95% CI [-0.50, 0.29]) and higher-quality parent-child communication (ITT: sibling-rated d = 0.21, 95% CI [-0.10, 0.52]; parent-rated d = 0.24, 95% CI [-0.07, 0.55]) compared to waitlist.

CONCLUSIONS

The SIBS intervention demonstrated small, consistent positive effects on sibling mental health and parent-child communication. This suggests SIBS is a promising preventive program for siblings of children with CDs.

Daily life situations and participation of siblings of children with childhood-onset disabilities: a scoping review

BACKGROUND

Siblings of children with disabilities or childhood-onset chronic conditions (eg, autism, cerebral palsy or congenital heart disease) often face challenges in mental health, quality of life and psychosocial adjustment. However, comprehensive knowledge of their participation in daily activities remains limited. Understanding their participation patterns and potential restrictions can help clarify their needs.

AIMS AND METHODS

This scoping review aims to summarise current research on the participation of siblings of children with childhood-onset chronic conditions. Following the Joanna Briggs Institute methodology, we systematically searched MEDLINE, CINAHL, AMED, PsycINFO and ERIC for peer-reviewed studies published in English between 2001 and 2024. Eligible studies focused on siblings of children with disabilities or early-onset chronic conditions (population) and their participation, including attendance and involvement in daily activities (concept) across children's homes, communities and schools (context). The review adheres to the Preferred Reporting Items for Scoping Reviews guidelines.

RESULTS

A total of 62 articles met the inclusion criteria: 45 qualitative (73%) and 7 quantitative (11%) studies, 7 reviews (11%) and 3 meta-studies (5%). The studies covered various chronic conditions (eg, cancer, chronic kidney disease and Down syndrome), with autism being the most common (22 studies). Key participation themes identified include family life, home participation, school involvement, leisure activities, social interactions with peers, information-seeking and continuous meaning-making. Factors such as normalcy, advocacy, identity, gender, age, culture and socioeconomic status were found to intersect with participation.

CONCLUSIONS

This review provides a comprehensive overview of current research and contributes to our understanding of how participation in daily activities has been studied so far in the population of siblings of children with disabilities. It reveals a gap in research specifically measuring participation among siblings. The identified themes enhance our understanding of potential participation restrictions in this population.

Resilience in Families of Autistic Children and Children With Intellectual Disability During the COVID-19 Pandemic

Resilience in families of autistic children and children with intellectual disability is associated with factors such as family functioning, social support, and financial strain. Little is known about family resilience during the COVID-19 pandemic when many resources were limited. This study examined the association of family resilience with child characteristics, family resources, and socioecological factors during the pandemic. Data collected during the COVID-19 pandemic from 734 United Kingdom parents/caregivers of children who are autistic and/or have intellectual disability were analyzed using path analysis. Greater family resilience was significantly associated with fewer child behavior problems, absence of intellectual disability, higher financial status, and greater family functioning, though not school support. These factors might guide future research and practices to support vulnerable families at risk of low resilience.

Mental health dynamics between mothers and siblings of children with disabilities

Introduction

When a child has a disability, their families face significant challenges that also impact parents' and siblings' mental health and adjustment. We examined the potential bidirectional relationships between parental mental health and sibling mental health and adjustment in families of children with a disability.

Methods

We utilized baseline and 12-month follow-up data from a randomized controlled trial of a brief intervention designed to enhance parent-sibling communication in families of children with a disability. The sample comprised 214 siblings aged 8-16 years and their parents (N = 203 mothers, N = 124 fathers). We estimated bivariate latent change score models to examine the longitudinal cross-domain associations between changes in parental mental health and changes in sibling mental health, and changes in parental mental health and sibling adjustment.

Results

The results showed that changes in maternal mental health and sibling adjustment over the 12-month period were correlated (r = 0.22). The cross-domain associations between changes in maternal mental health and sibling mental health and adjustment were not statistically significant in any of the two models. However, baseline sibling mental health had nearly doubled impact on changes in maternal mental health (Β = 0.232, p = 0.061) compared to maternal health's impact on sibling mental health (Β = -0.134, p = 0.289). Models with paternal mental health data unfortunately did not run due to low paternal response rate at 12-months.

Discussion

The findings suggest that whereas maternal mental health and sibling adjustment changes are correlated over time, the relationship between maternal and sibling measures does not necessarily operate bidirectionally. Future studies on family mental health dynamics should include data from fathers that may contribute to a broader understanding of these complex relationships.

Evaluating iSibWorks: A virtual cognitive-behavioural intervention for siblings of children with disabilities

Objectives

1) Examine if participation in iSibWorks, a group-based virtual intervention for siblings of children with disabilities, impacted siblings' perception of quality of life (QoL) and social support; and 2) Explore siblings' feedback on iSibWorks.

Methods

Thirty-eight children participated in iSibWorks and completed questionnaires (Pediatric Quality of Life [PedsQL™], Social Support Scale for Children [SSSC]) one week pre- and post-intervention. Conventional content analysis was used to explore siblings' open-ended responses on a post-participation feedback form.

Results

No significant differences in PedsQL™ and SSSC scores were observed after participating in iSibWorks. Despite this, siblings had positive feedback about iSibWorks and discussed: 1) Engaging in group learning and activities, 2) Meeting other siblings, and 3) Applying iSibWorks content to their daily life.

Conclusion

Factors related to the COVID-19 pandemic such as family stress, school closures, virtual learning, and social distancing likely impacted study results. Although there were no significant changes in QoL and social support, siblings found iSibWorks to be fun, meaningful, and engaging.

Innovation

Siblings of children with disabilities can experience psychosocial challenges and there are few virtual interventions designed for this population. iSibWorks was adapted to address this gap and increase access and support for siblings of children with disabilities.

Experiences of siblings of children with profound intellectual and multiple disabilities: a qualitative systematic review protocol

OBJECTIVE

The objective of this systematic review is to explore the experiences of siblings of children with profound intellectual and multiple disabilities.

INTRODUCTION

With improved life expectancy of children with profound intellectual and multiple disabilities, the research focus is on care at home and in the community. Although parents are the primary caregivers, siblings often assume the role of young caregivers, bearing the weight of caregiving responsibilities. Thus, a synthesis of qualitative findings is required regarding their experiences to facilitate the development of effective support strategies.

INCLUSION CRITERIA

Siblings of children with profound intellectual and multiple disabilities will be included, defined as children with an IQ of ≤40 or mental development below a 2-year-old's level, coupled with an inability to walk independently. Disabled children aged <20 years will be included. There will be no restrictions on the siblings' age or type of relationship. Qualitative studies on experiences, caregiving burdens, challenges, difficulties, and frustration in daily life will be considered, covering home, community, school, and hospital settings for children with disabilities.

METHODS

We will follow the JBI methodology for systematic reviews of qualitative evidence. The search strategy will be conducted in 3 phases: initial limited search, comprehensive database search, and reference list search of the included articles. The MEDLINE, CINAHL Plus, PsycINFO, Scopus, Ichushi-Web, and CiNii databases will be searched, with no restrictions on language or publication date. Study selection, critical appraisal, data extraction, and data synthesis will be conducted by 2 independent reviewers. We will evaluate the final synthesized findings using the ConQual approach.

REVIEW REGISTRATION

PROSPERO CRD42024499042.

Attitudes and Experiences of Community Palliative Care Nurses Regarding Pediatric Home-Based End-of-Life Care: A Statewide Survey

Objectives: Pediatric end-of-life (EOL) care at home is often provided by community palliative care (CPC) nurses who do not specialize in pediatrics. This study aimed to better understand the challenges CPC nurses face when providing EOL care to children at home. Methods: A total of 52 CPC nurses across New South Wales (NSW), Australia, participated in an online survey about their training, attitudes, and experiences regarding the provision of home-based pediatric EOL care. Participants were asked to reflect back over a "negative" experience of caring for a child at EOL, where things did not go as well as hoped, and a "positive" EOL care experience, where nurses perceived that care of the child and family went well, and respond to questions about these experiences. Results: Confidence of CPC nurses when providing EOL care to pediatric patients was significantly lower than when caring for adults (p's < .05). Most respondents expressed the desire for more training in pediatric EOL care. Cases identified as negative by CPC nurses did not significantly differ from positive cases in terms of the timing of the referral to CPC, clinical symptoms at EOL, or how well informed the nurses felt. Siblings were present at EOL in 74% of the negative experiences and 86% of the positive experiences, reportedly receiving significantly poorer support in the negative experiences (p = .002). Conclusion: This research contributes to an improved understanding of the challenges associated with home-based pediatric EOL care and highlights potential areas for improvement in CPC service delivery and training.

Emerging adults' emotions toward their siblings with down syndrome

BACKGROUND

Typically-developing siblings of individuals with Down Syndrome often experience complex emotions towards their sibling. This study explored how social support, personal resources (optimism, sense of coherence [SOC]), and individual variables (sex, religious affiliation, siblings' functionality) may impact emerging adult siblings' emotions toward their sibling with Down Syndrome.

METHODS

Participants were 292 siblings of individuals with DS ranging in age from 18-27 (M=21.54, SD=2.50). Participants completed self-report questionnaires exploring optimism, SOC, support, and acceptance.

RESULTS

Higher levels of support and optimism were positively associated with positive emotions, and higher SOC with lower levels of negative emotions. Siblings' functionality and religious affiliation interacted with variables to predict emotions.

CONCLUSIONS

This study contributes to a greater understanding of how emotions may play a role in sibling relations during the emerging adulthood stage. It also provides unique insight into how religious affiliation may be associated with more positive outcomes for siblings.

The experiences and perceptions of healthy siblings of children with a long-term condition: Umbrella review

PROBLEM

The lives of healthy siblings living with a sibling with a long- term condition are often shaped by the family, type of illness, length of illness, age of the child, caregiver demands, and support provided to the family, ill sibling, and healthy sibling. While the experiences of healthy siblings are documented in the literature by parent proxy, literature on healthy siblings self-reported experiences of living with a sibling who has a long-term condition remains scarce.

PURPOSE

This umbrella review aims to synthesize reviews on the self-reported experiences of healthy siblings of children living with a sibling who has a long-term condition.

ELIGIBILITY CRITERIA

Published peer-reviewed reviews in English language exploring the self-reported experiences of healthy siblings under 24 years old, whose siblings are diagnosed with a long-term condition.

SAMPLE

Using a developed search strategy, seven electronic databases (CINAHLPlus, Scopus, PubMed, PsycINFO, Cochrane Database of Systematic Reviews, Clinical Key, and Google Scholar) were searched from 2018 till December 2023. Eleven reviews met the inclusion criteria and were subjected to narrative synthesis.

RESULTS

Four themes (adjusting to changes, wanting to help, living the ups and downs, living the changes), and eight subthemes were generated from the syntheses.

CONCLUSION

This is the first umbrella review undertaken on healthy siblings self-reported experiences of living with a sibling who has a long-term condition. The impact of a long-term condition on healthy siblings of children with a long-term condition suggests a need for healthcare providers and organisations to provide better emotional, psychological, and informational support to healthy siblings and their families.

IMPLICATIONS

Findings from this review will inform healthcare providers, organisations, researchers, and policymakers on the development of future clinical practices and research for healthy siblings.

Balancing on life's ladder: A meta-ethnography of the existential experiences of siblings of children with complex care needs

AIM

To synthesize and interpret existing qualitative research on the existential experiences of siblings of children with complex care needs.

DESIGN

Noblit and Hare's interpretive meta-ethnography.

METHODS

The study has been registered in the international prospective register for systematic reviews (PROSPERO). Noblit and Hare's 7-step procedure was followed and reciprocal translation was performed to analyse the data and develop a line of argument synthesis.

DATA SOURCES

A comprehensive systematic literature search of five databases, along with extensive manual searches, was completed in November 2022. The final sample comprised 18 studies published between 2010 and 2022.

RESULTS

A line of argument, expressed through an overarching metaphor, "balancing on life's ladder", illustrates the core findings of siblings' fluctuating experiences of existential well-being, and encapsulates four third-order themes: the emotional turmoil of siblings, interrupted family life, siblings strive to be themselves and siblings struggle to cope.

CONCLUSION

Growing up with a sibling with complex care needs made children feel invisible, lonely and struggling to find the courage to cope. By adopting a lifeworld approach, nurses can become aware of healthy siblings' unmet needs. Future research is needed on how nurses can contribute to siblings' existential well-being, in primary - and secondary health care settings.

IMPLICATIONS

The study provides insight into siblings' existential experiences and factors improving their well-being, enabling nurses to provide a more optimized lifeworld-led clinical practice.

IMPACT

Healthcare, nursing education and practice should be informed by the knowledge of existential issues. Nurses are well-positioned to work alongside families to provide family-centered care. Our findings have implications for health policies tailored to the needs of children with chronically ill siblings.

REPORTING METHOD

This review adheres to the Equator and improving reporting of meta-ethnography (eMERGe) guidelines.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution, because the data comprised previously published studies.

Individual-Level Risk and Resilience Factors Associated with Mental Health in Siblings of Individuals with Neurodevelopmental Conditions: A Network Analysis

Siblings of individuals with neurodevelopmental conditions (NDCs) are exposed to unique family environments and experience a range of psychosocial risk and resilience factors. Networks of self-reported risk, resilience, and neuropsychiatric variables were estimated for siblings of individuals with (n = 235) and without (n = 480) NDCs (N = 715, mean age 22.40 years, 76% female, 74% White Caucasian). The NDC group reported more depressive (g = 0.39) and anxious (g = 0.43) symptoms than controls, and 71.5% of the NDC group reported at least one neuropsychiatric diagnosis compared to 36.9% of controls. Self-reported sleep and post-traumatic stress disorders were high amongst NDC siblings. Everyday executive functioning difficulties (cognitive inflexibility, hyperactivity/impulsivity) and emotion dysregulation were the most influential transdiagnostic risk factors for poorer functioning within the NDC group network.

Psychosocial Interventions and Support Groups for Siblings of Individuals with Neurodevelopmental Conditions: A Mixed Methods Systematic Review of Sibling Self-reported Mental Health and Wellbeing Outcomes

Siblings of persons with neurodevelopmental conditions (NDCs) have increased risk of poorer psychosocial functioning. This systematic review evaluated quantitative and qualitative evidence on sibling mental health and wellbeing outcomes following psychosocial interventions and the risk and protective factors associated with post-intervention outcomes. From 2025 identified studies published from 1991 to 2022 across ten databases, 24 studies were included. The largest immediate post-intervention improvements were in self-esteem, social wellbeing and knowledge of NDCs. The most sustained improvements in intervention groups at follow-up periods were in emotional and behavioural adjustment and NDC knowledge. There were positive, but small, differences in favour of the intervention groups on knowledge of NDCs, self-esteem, coping and the sibling relationship as compared to waitlist control groups. Psychosocial interventions for siblings are heterogeneous, and more data, including consideration of unique family circumstances, are needed to improve reporting and replicability, to measure effectiveness and tailor necessary supports.

Risk and resilience factors impacting the mental health and wellbeing of siblings of individuals with neurodevelopmental conditions: A mixed methods systematic review

OBJECTIVE

This pre-registered systematic review synthesised and evaluated the existing literature on self-reported mental health and wellbeing of siblings of individuals with neurodevelopmental conditions (NDCs).

METHODS

From 2437 identified studies published 2000-2022, 81 studies were included: 14 population- or cohort-based, 39 quantitative, 7 mixed method, and 21 qualitative outcome studies.

RESULTS

Seven sibling mental health (any psychiatric disorder, anxiety, depression, bipolar disorder, schizophrenia, internalising and externalising difficulties) and five wellbeing indicators were identified (quality of life, emotional adjustment, social wellbeing, somatic/physical wellbeing, and resilience/growth). Overall, siblings had increased risk of any psychiatric disorder, but they also reported experiences of growth and resilience, primarily in qualitative studies. 41 risk factors and 24 resilience factors associated with these outcomes were identified; the most frequently cited risk factor was symptom severity of the NDC sibling, while the most common resilience factor was adaptive/active coping at the individual sibling level. Studies showed high methodological heterogeneity and 90 different self-report measures were used.

CONCLUSIONS

Sibling mental health indictors are heterogeneous and cumulative risk factors may result in poorer wellbeing. There is a need for consistent reporting of family and sibling characteristics, a strengths-based approach to assessment, and identification of protective and resilience-promoting factors.

Examining the mental health of siblings of children with a mental disorder: A scoping review protocol

INTRODUCTION

Mental disorders affect 1 in 5 children having consequences for both the child and their family. Indeed, the siblings of these children are not insulated from these consequences and may experience elevated levels of psychological distress, placing them at increased risk for developing mental disorders. This protocol describes the methodology for a scoping review that will examine how mental disorders in children impact the mental health of their sibling(s). Further, we aim to examine the role of sex, gender, birth order, age of each child, and familial factors (e.g., parent mental illness, family structure), in sibling mental health. The proposed review will also identify resources that aim to support the needs of siblings of children with mental disorders. Taken together, this proposed review aims to take a fundamental step towards determining intervention targets to reduce the transmission of risk between siblings.

AIM

The proposed scoping review aims to address the following questions: i) how do mental disorders (in children <18 years of age) impact the mental health of their sibling(s) (also <18 years of age)? ii) Can we identify resources designed to address the needs of siblings of children with mental disorders?

METHODS

We will conduct the proposed scoping review in keeping with the six-stage Arksey and O'Malley Framework and the scoping review methodology provided by the Joanna Briggs Institute. In section i) we outline our research questions. In section ii) we describe our process for identifying studies that examine the mental health of siblings of a child with a mental disorder and studies that provide evidence on resources directed specifically at these siblings. We will search peer-review and grey literature published between 2011 and 2022 from OVID MEDLINE, OVID EMBASE, CINAHL Complete, Proquest Nursing and Allied Health, PsycINFO (via APA platform), Proquest Sociology Collection and Web of Science Core Collection and Proquest Theses and Dissertations. Section iii) describes our process for selecting relevant studies. In sections iv and v, we describe our methods for charting and summarizing relevant data. Finally, in section vi) we describe our integrative knowledge translation plan that aims to include knowledge users in interpretating and translating evidence gathered from the proposed review.

Sibling Influences on Trajectories of Maladaptive Behaviors in Autism

Siblings play an important role in the behavioral trajectories of individuals with autism spectrum disorder (ASD). While having siblings has been associated with positive outcomes in ASD, including stronger adaptive functioning, social and non-verbal communication, and theory of mind, little is known about the impact of siblings on more negative outcomes, such as maladaptive behaviors. To address this gap, the present longitudinal study tested sibling predictors of trajectories of maladaptive behaviors (e.g., teacher- and parent-reported hyperactivity, irritability, and social withdrawal) from childhood through early adulthood among individuals with ASD and non-spectrum delays. Multilevel models revealed that, while the mere presence of a sibling did not impact maladaptive behavior trajectories apart from teacher-reported hyperactivity, the diagnostic profile of the sibling (e.g., emotional/behavioral disorder, ASD, medical condition) emerged as an important predictor. Specifically, although findings varied across teacher and parent reports, more hyperactivity and irritability across time was identified when the sibling had diagnoses of an emotional/behavioral disorder, ASD, and/or a medical condition. Overall, this study provides novel insight into the broader family-level factors that influence the presentation of maladaptive behaviors across time and across contexts.