Hindawi
Child Development Research
Volume 2019, Article ID 9576484, 9 pages
https://doi.org/10.1155/2019/9576484
Research Article
Sibling Relationships, Personality Traits, Emotional, and
Behavioral Difficulties in Autism Spectrum Disorders
C. Longobardi
,1 L. E. Prino
,2 F. G. M. Gastaldi,1 and T. Jungert3
1
Department of Psychology, University of Turin, Via Verdi, 10, Italy
Department of Philosophy and Educational Science, University of Turin, Via Gaudenzio Ferrari, 9, Italy
3
University of Lund, Department of Psychology, Sweden
2
Correspondence should be addressed to L. E. Prino; lauraelvira.prino@unito.it
Received 9 April 2019; Revised 4 August 2019; Accepted 16 August 2019; Published 25 November 2019
Academic Editor: Elena Nicoladis
Copyright © 2019 C. Longobardi et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This study focused on parents’ perceptions of the quality of sibling relationship and its association with some behavioral and
emotional characteristics of the typically developing sibling. The participants were parents of children with autism spectrum disorder
and typically developing siblings. The sample size was 43. The group comprised 14 fathers (32.6%) and 29 mothers (67.4%) aged
33–53 years (𝑀 = 43.56; SD = 5.23). The parents completed measures of siblings’ emotional and behavioral difficulties, siblings’
personality, and sibling relationships and their impact on families and siblings. The results showed that behavioral difficulties such
as emotional symptoms, conduct problems, hyperactivity/inattention, and peer relationship problems were significantly associated
with negative sibling relationships—characterized by rivalry, aggression, avoidance, and teaching behavior toward the brother
or sister with an autism spectrum disorder. The implications are that sibling-focused interventions should focus on improving
negative sibling relationships to reduce the impact on the difficulties of the typical development of the sibling of both genders and
shape the content and delivery framework accordingly. This can be done by providing skills and approaches for enhancing sibling
relationships so both parties benefit.
1. Introduction
For many decades, research on the effects children with disabilities have on families has focused on parents—mothers in
particular—although the relationship with siblings is one of
the most enduring aspects of an individual’s life and can affect
adaptation and well-being throughout the entire period of
development. A positive relationship with one’s siblings—
marked by warmth, affection, and emotional and practical
support—is correlated with psychological well-being, while a
negative relationship correlates with negative psychological
adaptation [1]. It was during the 1980s that research finally
focused on siblings, analyzing the effects of the presence of a
child with a disability on the other siblings in-depth [2, 3, 4].
The literature on the effects of growing up with a disabled
sibling—in particular, one with an autism spectrum disorder
(ASD)—is incomplete, and there is much that needs to be
clarified. Due to the relatively small sample sizes of the existing
studies, as well as the differences in methodology, a number
of conflicting results have emerged [5, 6].
Research analyzing the effects of the presence of a child
with a disability on the other siblings in the family has produced contradictory results. Several studies have highlighted
a series of risks for typically developing (TD) siblings—such
as solitude and annoyance at the other sibling’s behavior
[7, 8], internalization and externalization of problems [9, 10],
attention deficits [11], reduced sibling interaction [12], and
peer relationship problems [13, 14].
ASD can threaten the quality of sibling relationships. This
is mainly due to the limited repertoire of social skills and play
behaviors and the impairment of communication and social
response skills that characterize children with ASD [15, 16].
These deficits often appear alongside problem behaviors such
as physical aggressiveness, a proneness to throwing tantrums,
and a destructive attitude when playing with toys [17, 18].
Consequently, siblings of children with ASD report that sometimes they are disturbed by the behavior of their brother or
sister [12, 19]. Furthermore, children with ASD seem to spend
less time with their siblings compared to children with down
syndrome or TD children. Some studies [20, 21, 22] have
2
pointed out that the siblings of children with ASD tend to be
more tolerant than the siblings of non-ASD children but also
suffer from higher levels of embarrassment, the fear of being
judged by friends and relatives, and the feeling that they cannot share the burden of their experience with their friends.
Other difficulties and problems might emerge from the
sense of guilt that follows the realization of one’s own “normality” compared to the other sibling’s “vulnerability” and the
fear that one might develop a disability [23]. In addition, there
may also be feelings of resentment and envy toward siblings
with disabilities because they might be seen as receiving all
the parental attention [24].
Conversely, various studies have also focused on the positive aspects of having a sibling with ASD. Specifically, children
with an autistic brother or sister seem to have a relationship
that is characterized by less conflict and competitiveness [25]
and more warmth [9] compared to relationships between TD
siblings. Furthermore, these siblings have better scholastic and
behavioral adjustment and positive self-concepts [26], and
they report more admiration toward their atypically developing brothers and sisters compared to the siblings of TD
children.
Nevertheless, siblings of children with ASD also experience numerous difficulties—such as receiving less parental
attention and having more chores around the house, which
results in less free time to spend with friends [3], as well as
experiencing higher parental pressure (since parents often rely
on them to compensate for the limits of their sibling with
ASD). These difficulties are shared with the siblings of children
with other disabilities, but some features are specific to siblings
of children with ASD. For example, siblings of children with
ASD experience more embarrassment from strangers’ reactions to their brother or sister’s stereotyped behaviors [27] and
suffer more violent behavior from them [7]. Consequently,
researchers have asked themselves if siblings of children with
ASD are more at risk of developing psychosocial adjustment
problems compared to those with non-ASD siblings. To evaluate this, researchers have often considered the presence of
problem behaviors that are externalizing (e.g., hyperactivity
and aggressiveness) and internalizing (e.g., somatization, anxiety, and depression). Studies have yielded conflicting results
on the issue of sibling adjustment, with a number of them
reporting higher externalizing and internalizing problems in
children that have a sister or brother with ASD [7, 28, 29],
while others did not find any significant differences between
them and the siblings of children with other disabilities or
typical development [30, 6]. At this point, it is difficult to draw
firm conclusions on the effect of having a brother or sister with
ASD [31].
The quality of the relationship with siblings also seems to
affect the individual’s personality traits. For instance, according to some studies, less conflict and rivalry and more warmth
in relationships lead to greater agreeableness in children and
young adults [32, 33, 34]. Considering the risk of a poor quality relationship with a sibling affected by ASD, the latter’s possible negative impact on the adaptation of the TD sibling, and
the emotional experiences triggered by his/her sibling’s disability, it seems important to investigate whether, as mentioned
above, having a sibling with ASD can affect the personality
Child Development Research
traits of the TD sibling. While some studies have investigated
the personality traits of children with ASD [35], the literature
contains no research focusing on the TD siblings of individuals
with ASD.
Meadan et al. [36] highlighted that the family structure
can partially explain the variability, but more studies are necessary to deeply analyze predictors of adjustment of TD siblings. One aspect that must be taken into account in studies
on the relationship between TD siblings and siblings with ASD
is gender. Females tend to be more involved in the management of siblings with intellectual disabilities and are more at
risk of developing anxiety–depressive symptoms [37, 38].
However, not all studies find females at greater risk of symptoms of anxiety and maladjustment [39]. Moreover, having a
sister with ASD has proved to be associated with a better quality relationship and better psychological adaptation in TD
siblings [40].
The birth order is another relevant characteristic of the
family structure that has been studied. Younger siblings can
be in a disadvantageous condition as a result of the dilution
of family resources [41]; this is even more evident when the
older child presents special needs [42, 43]. TD children born
after their siblings with ASD are more at risk of maladjustment
[10, 44]. Tomeny et al. [43], in particular, reported that when
older siblings with ASD have high levels of externalizing
behavior, the younger TD siblings are more at risk of exhibiting
externalizing problems. These results are congruent with
studies on sibling relationships among TD children [42] and
consistent with theories of social learning and modeling.
Nevertheless, the literature on the dilution effect is not
consistent. Lawson and Mace [45], for example, observed a
higher level of prosocial behavior and cooperative abilities in
youngest siblings.
Given these contradictory data, this study focuses on
parents’ perceptions of the quality of the siblings’ relationships
and their associations with some of the behavioral, emotional,
and personality characteristics of the TD siblings. This study
is grounded in the family systems model which includes the
following four components: social support and resources,
family strengths, capacity-building and help-giving practices,
and family needs (concerns and priorities). Our focus is on
the social support and resources component. From this
perspective, the well-being of one family member is likely to
affect the well-being of other individuals within the family and
sibling relationships highlighted in the current study. In
particular, the aim is to analyze, in greater depth, how sibling
relationship can affect the development of emotional and
behavioral difficulties, as well as the personality of the TD
siblings, in the presence of a disability such as ASD. As a
secondary aim, this study will investigate whether there are
gender differences and differences related to the birth order
of the TD sibling in relation to their diagnosed sibling.
Taking the international literature into account, we
hypothesize that there is a positive correlation between a positive sibling relationship and strengths and a negative correlation with psychological difficulties. Conversely, we
hypothesize that there is a negative correlation between a
negative sibling relationship and strengths and a positive correlation with psychological difficulties. On the issue of gender,
Child Development Research
we hypothesize that nonASD female siblings experience more
anxiety than their male counterparts. We also hypothesize that
based on the gender of the sibling with ASD and the TD sibling, there may be differences in some personality traits—such
as extroversion (higher among females).
2. Method
2.1. Participants and Procedure. The participants were parents
of children with ASD and TD siblings. The sample size was
43. The group comprised 14 fathers (32.6%) and 29 mothers
(67.4%) aged 33–53 years (𝑀 = 43.56; SD = 5.23). Among
the participants, 62.8% were parents of children who had
been diagnosed with autism, while 37.2% were parents of
children who had been diagnosed with Asperger syndrome.
In all, the parents had 22 sons (51%) and 21 daughters (49%)
without diagnosis aged 6–15 years (𝑀 = 10.20; SD = 2.88)
and 35 sons (81%) and 8 daughters (19%) with ASD aged
3–14 years (𝑀 = 8.52; SD = 3.17). About 33% of the siblings
with diagnoses were firstborns, and 67% of the siblings with
diagnoses were secondborns. The parents responded to the
questionnaires with reference to their TD children and their
relationships with the siblings with ASD, supported by the
researcher.
The University of Turin IRB approved the study (protocol
no. 47504). All the participants were contacted through associations that deal with ASD that showed interest in our study.
2.2. Instruments
2.2.1. Sibling Inventory of Behavior [46, 47]. This instrument
is used to assess sibling relationships in families with and
without children with disabilities. The Sibling Inventory of
Behavior (SIB) consists of 32 items that assess one sibling’s
behavior toward the other and measure six dimensions
of sibling behavior on a five-point Likert scale (1 = Never;
5 = Always). The six dimensions are: (a) empathy/concern,
(b) companionship/involvement, (c) rivalry, (d) conflict/
aggression, (e) avoidance, and (f) teach/directiveness scale.
These six dimensions can be further divided into two general
dimensions: positive (i.e., empathy/concern, companionship/
involvement, and teach/directiveness) and negative (i.e.,
rivalry, conflict/aggression, and avoidance). The parents were
asked to fill out the questionnaire referring to the way the
sibling with typical development related to the other sibling.
The scale was translated into Italian, following the criteria
established by Van de Vijver and Hambleton [48]. The two
general dimensions had acceptable alpha values (𝛼 = .91 for
the positive dimension that measures empathy/concern,
companionship/involvement, and teach/directiveness and
𝛼 = .86 for the negative dimension measuring rivalry, conflict/
aggression, and avoidance).
2.2.2. Strengths and Difficulties Questionnaire [49, 50]. This
instrument is a brief behavioral screening questionnaire
consisting of 25 items on psychological attributes, both
positive and negative, divided into 5 subscales, of which the
first 4 constitute difficulties—(a) emotional symptoms, (b)
3
conduct problems, (c) hyperactivity/inattention, and (d) peer
relationship problems—while the 5th measures strengths, (e)
prosocial behavior. Points 1–4 make up the Total Difficulties
Score. Each item is answered on a three-point Likert scale
(1 = Not true, 3 = Certainly true). The Italian parent version
for children/teens aged between 4 and 17 years [51, 52] used
in this study showed good reliability. Both the scale measuring
strengths and the one measuring difficulties had acceptable
alpha values (𝛼 = .79 for strengths and 𝛼 = .88 for difficulties).
2.2.3. Hierarchical Personality Inventory for Children [53, 54,
55]. This instrument is a developmentally appropriate parentreport measure of the five-factor model for personality (i.e., Big
Five; Goldberg [56]) to be used with children aged between 6
and 12 years. More specifically, the dimensions are: emotional
stability (anxiety and self-confidence; 𝛼 = .71), extraversion
(energy, expressivity, shyness, and optimism; 𝛼 = .72),
imagination (creativity, intellect, and curiosity; 𝛼 = .85),
benevolence (irritability, egocentrism, compliance, dominance,
and altruism; 𝛼 = .86), and conscientiousness (order,
achievement/motivation, perseverance, and concentration;
𝛼 = .67).
3. Data Analysis
First, preliminary analyses were carried out among the study
variables. Second, in relation to the first aim of the study,
regression analyses, based on the analysis of the covariance
matrix, were utilized to examine whether the positive and
negative sibling relationships were associated with the development of emotional and behavioral difficulties and personality. Finally, gender differences between siblings with a
diagnosis and gender differences between siblings without a
diagnosis, as well as differences between TD siblings born
before and after their diagnosed sibling, were calculated, using
𝑡-tests.
4. Results
4.1. Correlations and Regressions with Measures of SIB
and Strengths and Difficulties. As outlined in Table 1, all
correlations among the study variables were in the expected
directions and similar for males and females at the point
they were entered in the regression equation. It can be seen
that positive sibling relationships were significantly and
positively related to strengths (𝑝 = .007), while negative
sibling relationships were significantly and negatively related
to strengths (𝑝 = .023) and positively related to difficulties
(𝑝 < .001).
Two separate hierarchical multiple regressions were performed with the dependent variables of prosocial behavior
and difficulties. The first set of predictors in each regression
was gender, which was represented by a dummy variable indicating whether the siblings were female or male, and the order
of birth of the sibling, represented by a dummy variable indicating whether the TD child was born before or after the ASD
sibling. Positive as well as negative parent ratings of sibling
4
Child Development Research
Table 1: Cronbach alphas, means, standard deviations, and correlations among positive sibling relationships, negative sibling relationships,
strengths (prosocial behavior), and difficulties.
(1) Positive sibling relationships
(2) Negative sibling relationships
(3) Prosocial behavior
(4) Difficulties
∗
p < .05,
𝛼
.91
.86
.79
.88
𝑚 (SD)
3.34 (0.68)
2.07 (0.57)
1.67 (0.46)
0.50 (0.38)
1
—
2
∗∗
3
4
—
−.57
∗∗
∗
.41
−.25
—
−.35
∗∗
∗∗
.65
∗∗
—
−.47
p = .01.
relationships were entered as a second set. Table 2 presents the
results.
In the regression of prosocial behaviors, the predictors
accounted for a multiple 𝑅 of 67, 𝑅2 = .45, 𝐹(4, 38) = 7.91,
𝑝 < .001. Birth order of the sibling was significantly and negatively associated with prosocial behaviors (𝛽 = −.46), indicating the diagnosed child displayed more prosocial behavior
when the sibling was born before the diagnosed child. Gender
was not a significant predictor. Parental ratings of sibling relationships were not associated with prosocial behaviors either.
The regression of difficulties was also significant. The predictors accounted for a multiple 𝑅 of .71, 𝑅2 = .50, 𝐹(4, 38) = 9.44,
𝑝 < .001. Neither the order of the sibling nor gender was significantly associated with difficulties. As hypothesized, parental ratings of negative sibling relationships (𝛽 = .88) was
significantly and positively related to difficulties, whereas
positive sibling behaviors was not related to difficulties.
4.2. Differences in Gender and Order of Birth. 𝑡-tests comparing
SIB, strengths, difficulties, and personalities of males and
females were carried out between siblings according to both the
gender of the sibling with ASD (Table 3) and the gender of the
TD siblings (Table 4). When the sibling with a diagnosis was a
male, the child with ASD showed significantly more emotional
stability and less extroversion, and parents’ ratings of the sibling
relationship were significantly less positive. The effect sizes were
very strong, ranging from a Cohen’s 𝐷 value of .82–.96. When
the TD sibling was a male, he had significantly less anxiety and
was timider compared to his female counterpart.
𝑇-tests comparing the impact of birth order on SIB,
strengths, difficulties, and personalities were carried out
between siblings born before and after the sibling with ASD
according to the TD siblings (Table 5). Two significant differences were found. In cases where the TD sibling was born after
the diagnosed sibling, the TD child showed significantly more
prosocial behavior and more expressivity compared to the TD
siblings born before their siblings with ASD.
5. Discussion
Drawing from the literature on ASD, the present investigation
was primarily designed to examine whether sibling relationship, in the presence of ASD, influences the development of
emotional and behavioral difficulties, as well as the personality
of the other TD siblings. The regression analysis shows that
behavioral difficulties are related to sibling relationship, which
is in line with previous studies [5, 28]. Previously, there was
Table 2: Standardized regression coefficients and 𝑡 -tests for sibling
relationships, prosocial behaviors, and difficulties.
Pro-social behaviors
𝛽
𝑡 -test
Diagnosis
(asperger vs.
autism)
Order of birth
Negative
sibling
relationships
Positive
sibling
relationships
∗∗∗
.02
.14
−.46
−3.25
∗∗
Difficulties
𝛽
𝑡 -test
∗
.35
2.37
.21
1.41
−.26
−1.43
.84
.36
1.
.33
∗∗∗
4.67
1.81
𝑝 < .001; ∗∗ 𝑝 < .01; ∗ 𝑝 < .05.
some evidence that family relationships and process variables
may operate differently for different types of families [57]. This
study adds to that literature by confirming that behavioral
difficulties such as emotional symptoms, conduct problems,
hyperactivity/inattention, and peer relationship problems are
significantly associated with negative sibling relationships—
characterized by behaviors of rivalry, aggression, avoidance,
and teaching toward the brother or sister with ASD.
Concerning gender differences in sibling relationships and
strengths, difficulties, and personalities of the TD children,
our findings reveal only a few significant differences between
males and females. When the sibling with ASD was a boy, the
diagnosed child had more emotional stability and less
extroversion and experienced the relationship with the sibling
as being significantly less positive. This would suggest that in
the case of a male sibling with a diagnosis, in general, the
relationship is experienced as less positive than when the
diagnosed child is a girl. To the best of our knowledge, there
are no previous studies on this topic. Some studies have
focused on same-sex or different-sex dyads [58, 59, 12, 60] but
not on the differences based on the sex of the sibling with ASD.
We think that in future research, it would be interesting to
analyze this result more deeply by making a comparison with
dyads of TD siblings, for example.
When the nondiagnosed sibling was female, she had
significantly more anxiety and was less timid compared to her
male counterpart. These results are only partially in line with
previous research [61], but the data on this topic are
contradictory. On the one hand, some studies involving male
siblings have reported a higher risk of depression, lower
Child Development Research
5
Table 3: Mean differences in sibling behavior, strengths, difficulties, and personalities, according to gender of the ASD siblings.
Variable
HIPICEmotional stability
HIPICExtraversion
HIPICBenevolence
SIB positive sibling relationship
SIB negative sibling relationship
SDQ prosocial behavior
SDQ difficulties
HIPICEmotional stability, anxiety
HIPICEmotional stability, self-confidence
HIPICExtraversion, energy
HIPICExtraversion, expressivity
HIPICExtraversion, optimism
HIPICExtraversion, shyness
HIPICBenevolence, altruism
HIPICBenevolence, dominance
HIPICBenevolence, egocentrism
HIPICBenevolence, compliance
HIPICBenevolence, irritability
Female
mean (SD)
32.00 (6.89)
82.63 (10.45)
93.50 (12.30)
3.80 (0.45)
1.90 (0.34)
1.63 (0.29)
0.35 (0.19)
14.75 (6.32)
17.25 (2.25)
21.00 (3.16)
18.38 (3.50)
23.13 (3.36)
20.13 (2.80)
25.25 (2.82)
14.88 (4.94)
17.63 (2.62)
20.75 (2.66)
15.00 (5.81)
Male
mean (SD)
37.23 (5.22)
74.49 (9.30)
90.63 (10.40)
3.24 (0.69)
2.12 (0.61)
1.68 (0.49)
0.54 (0.41)
19.69 (4.28)
17.54 (2.50)
17.31 (4.12)
17.83 (2.72)
20.77 (4.71)
18.57 (2.13)
24.77 (4.30)
13.17 (4.46)
17.60 (2.30)
20.23 (3.61)
14.86 (7.23)
𝑡 -test
𝑡 (41) = −2.41, 𝑝 = .021, C’s 𝑑 = .86
𝑡 (41) = 2.19, 𝑝 = .035, C’s 𝑑 = .82
—
𝑡 (41) = 2.21, 𝑝 = .033, C’s 𝑑 = .96
Table 4: Mean differences in sibling behavior, strengths, difficulties, and personalities, according to gender of TD siblings.
Variable
HIPICEmotional stability
HIPICExtraversion
HIPICBenevolence
SIB positive sibling relationship
SIB negative sibling relationship
SDQ prosocial behavior
SDQ difficulties
HIPICEmotional stability, anxiety
HIPICEmotional stability, self-confidence
HIPICExtraversion, energy
HIPICExtraversion, expressivity
HIPICExtraversion, optimism
HIPICExtraversion, shyness
HIPICBenevolence, altruism
HIPICBenevolence, dominance
HIPICBenevolence, egocentrism
HIPICBenevolence, compliance
HIPICBenevolence, irritability
Female
mean (SD)
37.9524 (5.95)
73.8571 (11.90)
89.0952 (9.88)
3.44 (0.77)
1.95 (0.44)
1.63 (0.48)
0.57 (0.46)
20.76 (4.58)
17.19 (3.01)
18.19 (4.76)
17.48 (3.06)
20.33 (5.69)
17.86 (2.10)
24.14 (5.22)
13.14 (4.94)
17.76 (2.77)
19.33 (3.94)
14.71 (8.18)
prosociality [28, 62], and overall difficulties, especially in the
areas of hyperactivity and peer problems [6], but on the other
hand, female siblings are more vulnerable to anxious and
depressive symptoms [38]. Lastly, our data revealed that when
the TD sibling was born after the diagnosed sibling, the TD
child showed significantly more prosocial behaviors and more
expressivity compared to TD siblings born before their sibling
with ASD. Respect the aims, our data are scarce and a few
conclusive. The results seem to contradict previous literature,
which seems to indicate worse maladjustment in subjects born
after their brothers with ASD [63, 10, 43, 44]. More
investigation will be needed on the possible factors that may
Male
mean (SD)
34.6364 (5.40)
78.05 (7.29)
93.14 (11.26)
3.21 (0.54)
2.22 (0.69)
1.71 (0.44)
0.44 (0.29)
16.86 (4.76)
17.77 (1.74)
17.82 (3.66)
18.36 (2.61)
22.05 (3.02)
19.82 (2.13)
25.55 (2.39)
13.82 (4.22)
17.45 (1.87)
21.27 (2.62)
15.05 (5.66)
𝑡 -test
ns
ns
ns
ns
ns
ns
ns
𝑡 (41) = 2.73, 𝑝 = .009
ns
ns
ns
ns
𝑡 (41) = − 3.04, 𝑝 = .004
ns
ns
ns
ns
ns
have influenced the results, including cultural variables. It is
possible that prosocial behaviors are the result of learning and
modeling, derived from the way parents have taught their
brother to assist their brother with ASD. However, this
hypothesis has not been investigated and remains speculative
at the moment.
This study has some limitations. First of all, the small size
of the sample did not allow for more extensive analyses, such
as investigations of how sibling gender and birth order may
interact. Moreover, we only collected data from parents of
siblings. In future research, it would also be important to
include self-reports of siblings or to use some observational
6
Child Development Research
Table 5: Mean differences in sibling behavior, strengths, difficulties, and personalities, according to the birth order of the TD siblings.
Variable
HIPICEmotional stability
HIPICExtraversion
HIPICBenevolence
SIB positive sibling relationship
SIB negative sibling relationship
SDQ prosocial behavior
SDQ difficulties
HIPICEmotional stability, anxiety
HIPICEmotional stability, self-confidence
HIPICExtraversion, energy
HIPICExtraversion, expressivity
HIPICExtraversion, optimism
HIPICExtraversion, shyness
HIPICBenevolence, altruism
HIPICBenevolence, dominance
HIPICBenevolence, egocentrism
HIPICBenevolence, compliance
HIPICBenevolence, irritability
Born before sibling mean
(SD)
35.1111 (6.73)
76.111 (11.14)
90.000 (10.44)
3.65 (0.79)
1.79 (0.57)
1.53 (0.50)
0.55 (0.41)
17.85 (5.88)
17.26 (2.60)
18.93 (4.30)
17.19 (2.56)
21.37 (5.46)
18.63 (2.26)
24.30 (4.51)
13.67 (4.70)
17.59 (2.61)
19.67 (3.52)
14.78 (7.81)
data and some clinical scales to reveal personality characteristics and/or specific difficulties and symptoms (such as trait
anxiety, anxiety disorders, and depressive symptoms). Other
observational tools could be used to assess the quality of the
relationship between siblings, and qualitative research could
help clarify and interpret the relationship between the variables considered. In addition, it is possible that the behavioral
difficulties of TD siblings and their relationships with their
siblings with ASD change over time, which may influence the
associations between these variables. Longitudinal studies are
needed to better understand this. Finally, we did not collect
data from a comparison group of only TD siblings. Conversely,
the purpose of this study was to focus on the quality of the
relationship between a TD child and a sibling with ASD.
Future research could also include a comparison group of
only TD children. In this direction, future research could
compare siblings with different forms of intellectual disability
and take into account the degree of severity of such
pathology.
It may be too preliminary to suggest changes to interventions based on the results of this stud; however, the implications of the overall results suggest that sibling-focused
interventions should focus on improving negative sibling
relationships to reduce their impact on the difficulties of the
TD sibling of both genders and shape the content and delivery framework accordingly. This could be done by providing
skills and approaches for enhancing sibling relationships so
both parties can benefit. An example is by enhancing engagement in daily activities, as suggested by McHale et al. [12].
An adequate assessment of the quality of sibling relationships could require psychotherapeutic interventions, which
could be conducted by referring to interventions inspired
by the theory of attachment or systemic-relational therapy.
Psychoeducational interventions and parent training could
Born after sibling mean
(SD)
38.2308 (3.42)
76.6923 (8.43)
94.9231 (11.58)
3.15 (0.82)
2.25 (0.98)
1.89 (0.24)
0.48 (0.34)
20.15 (2.76)
18.08 (2.22)
16.85 (3.87)
19.62 (2.87)
21.08 (2.60)
19.15 (2.70)
25.39 (3.15)
14.08 (4.42)
18.15 (1.57)
21.77 (3.35)
15.54 (5.67)
𝑡 -test
ns
ns
ns
ns
ns
𝑡 (38) = −3.13, 𝑝 = .003, C’s 𝑑 = 0.92
ns
ns
ns
ns
𝑡 (38) = −2.71, 𝑝 = .010
ns
ns
ns
ns
ns
ns
ns
be aimed at parents to support them in promoting positive
relationships between siblings and managing any conflict
situations.
Data Availability
The SPSS data used to support the findings of this study are
available from the corresponding author upon request.
Ethical Approval
All procedures performed in the studies involving human
participants were in accordance with the ethical standards of
the institutional and/or national research committee and with
the 1964 Helsinki Declaration and its later amendments or
comparable ethical standards.
Consent
Informed consent was obtained from all individual participants included in the study.
Conflicts of Interest
The authors declare that they have no conflicts of interest.
Authors’ Contributions
C. Longobardi: designed and executed the study and wrote
the paper. L. E. Prino.: collaborated with analyzing the
data and writing the paper. F. G. M. Gastaldi: collaborated
with analyzing the data and writing the paper. T. Jungert:
Child Development Research
7
collaborated with analyzing the data, writing, and editing
the manuscript.
[15]
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