Supporting Siblings of Children With Disabilities or Serious Illness

To support the brothers and sisters of a child with a disability or serious illness, give them honest information, protect their own time and activities, let them say hard feelings out loud, and connect them with other siblings who understand. Most siblings do well. Some need extra care, and they're easy to overlook.

This page uses "brother or sister with a disability" and "sibling with support needs". Use whatever words your family and your child prefer, and use your children's names most of all.

What siblings often feel

Siblings carry a mix of feelings, often at the same time. The American Academy of Pediatrics (AAP) lists some common ones on its page about siblings of children with chronic illnesses or disabilities (opens in a new tab):

• Guilt about not being sick ("Why him and not me?").
• Worry about getting sick themselves.
• Jealousy of the attention, and wanting to be the focus sometimes.
• Resentment about extra chores or plans that change.

Many also feel deep love, pride and protectiveness. None of these feelings cancels the others.

What does research say about how siblings fare? A meta-analysis that pooled studies of siblings of children with chronic health conditions found a small negative effect on average (opens in a new tab): slightly more emotional and behavior problems, and slightly lower positive self-views, than comparison children (Vermaes and colleagues, 2012). The same review found that older siblings, and siblings of children with life-threatening or highly intrusive conditions, were more at risk. So most siblings cope well, but some need you to look a little closer.

Information they need at each age

The AAP says siblings need to have honest information about the condition (opens in a new tab). Silence leaves room for scary guesses. Match the details to their age:

The AAP also suggests involving all of your children in shared decision making (opens in a new tab) about health care, in ways that fit their age.

One-on-one time and their own lives

Siblings can feel like the "easy one" who has to need nothing. Make room for their needs too.

• Time alone with you. The AAP says spending some time with each child individually may help (opens in a new tab). Even short, regular time counts.
• Their own activities. Protect their sports, lessons and friends, even when the calendar is full of appointments.
• Fair chores. Some extra help is fine. Notice when it's becoming too much.
• Celebrate them. Their wins matter as much as anyone's.
• Let them be ordinary. Siblings may feel pressure to be perfect so they don't add stress. Tell them they don't have to be.

For more on balancing help and childhood, see older siblings as caregivers. For fairness when children need different things, see how differences in treatment affect siblings.

Peer support for siblings

Siblings often feel no one else understands. Meeting other siblings changes that.

• Sibshops. The Sibling Support Project (opens in a new tab), founded in 1990, is best known for helping communities start Sibshops: peer support groups for school-age brothers and sisters of kids with disabilities and health concerns (opens in a new tab). The project describes Sibshops (opens in a new tab) as lively events where kids meet other siblings, have fun, play games, and talk about the good and not-so-good parts of having a sibling with support needs. Its site has a map to find one near you.
• For young adults: Sib20 (opens in a new tab) is an online group for siblings in their twenties.
• For adults: SibNet (opens in a new tab) is an online community for adult brothers and sisters of people with disabilities.
• Ask your child's care team. The AAP suggests asking your pediatrician about support groups for siblings (opens in a new tab) of children with chronic health problems or disabilities.

Siblings as adults

The sibling relationship often outlasts the parents' care. Many adult siblings take on new roles: advocate, guardian, co-caregiver or simply the person who visits.

• Plan together. Talk with your adult children about future care while you're able to. Ask what they want, not just what you need.
• Don't assume. One sibling may want a big role; another may not be able to.
• Include spouses. Researchers at Vanderbilt surveyed 102 siblings-in-law of people with disabilities. Those whose experience was positive or mixed had better understood sibling-in-law responsibilities before marriage (opens in a new tab) (Zemke and colleagues, 2020). Talk openly with new partners. See when in-laws become siblings.

Water safety for the whole family

Some conditions raise drowning risk. CDC says deaths among people with autism are nearly 40 times as likely to be caused by drowning (opens in a new tab) as deaths in the general population, and that people with seizure disorders also face higher risk. Siblings love to help, but they should never be the safety plan. The AAP advises never leaving a young child in or near any body of water under the care of another child (opens in a new tab), and says another young sibling should never supervise a child in the bath (AAP (opens in a new tab)). An adult is always the Water Watcher.

For a plan that fits your child, see water safety for autistic children. Our guide to raising siblings who stay close has more ideas for building the bond.

What you can do today

• Ask your child, "What's the hardest part of being a brother or sister in our family?" and just listen.
• Explain your other child's condition again, in words that fit their age now.
• Book ten minutes of one-on-one time with each sibling this week.
• Look up a Sibshop or sibling group near you on the Sibling Support Project (opens in a new tab) site.
• Check that no child is ever in charge of another child near water.