Adam Blatner

In a conversation with a colleague who brought up the issue of the impact that a disabled child might have on siblings, I warmed up to the different constellations that might be involved. Here are just a few:

The type of disability certainly makes a difference. Mental, physical? Retardation, autism, paralysis or weakness of limbs, deafness, blindness, recurrent medical crises (e.g., hemophilia, sickle cell disease), atypical mental development—there are so many different types!

Was the disabled child born that way? Or did the disability emerge weeks or months or years later? Was it anything the parents could have noticed or prevented. Some disabilities are the result of home or auto accidents, neglect or abuse. Some are due to rare and mysterious illnesses and parents often blame themselves unnecessarily—or are blamed (wrongly) by doctors. (This happened with autism fifty years ago!)

Of course it was a disappointment, but in what way? This varies with type of disability and the hopes and expectations of parents. What is the age of the sibling(s) relative to the disabled child—younger, older, and by how many years. How many outlets does the healthy child have, re friends, opportunities to develop outside the home. Is the sibling expected to care for or watch out for the more disabled child, and in what way?

Once disabled child begins to grow, "worry" as such may become more intense, or in certain kinds of disability, worry becomes less intense. It is fixed, and let’s get on with it. Nothing more to do. Worry depends on many things Can the child benefit from either treatment or rehabilitation? How much hope does a parent have? How severe is the condition? (I was a sickly child who required special treatments; my parents were worried about whether I would survive. Mayo clinic performed surgery and cured me. That’s a very brief outline. I suspect I was a few years delayed in my maturity, though bright enough to keep up with my class. My older brother became a bit of a delinquent—not really bad, but enough to worry my parents.)

Does it evoke overprotectiveness of the disabled child or annoyance towards that child? By whom, one parent, both parents, one sibling, several siblings?  Also, some "disabled" kids are clearly unpleasant to relate to, to care for, and the healthy older or younger sibling gets more attention rather than less. Or the other sib gets more negative attention, more criticism, more displacement of aggression. Or, what you might expect, that the parents protect the disabled child, but this can vary: One parent over-protects, the other parent tries to counter it, or ignores it; both parent over-protect; or neither parent overprotect much. Even then, the degree to which positive attention goes to the sibling may not be a direct expression of feelings towards the disabled child, but rather degrees of sensitivity or psychological mindedness of the parent.

Now, what if one sibling begins to take on what most folks would judge to be unpleasant behavior, sulking, oppositional, etc. That complicates matters. The point is that I hesitate to make any generalizations. Each case involves so many themes.

For example, here’s another: Is the tele (rapport) between either or both parent strong or weak or negative towards the sibling?  What if there are more than two siblings—and there often are—it might be a mistake to consider preferences between child and parent as a reflection of the relationship to the disabled child

Meanwhile, there is the variable of worry, the sense that there are choices to make. How much to shop around for doctors or non-medical “miracle” cures? Or is there a clear sense that nothing more can be done. But even then, there is always more in the way of wrestling with the school or social services to obtain more special education, training, rehabilitation, respite, and other services.

Are allies available in the family, other uncles and aunts who work with the siblings or help the parent, grandparents, etc.? Is there a church community involved or does the family feel alienated from the community or family. Is the alienation because of shame or rejection about the disability?

These are just a few of the kinds of questions that came to mind. My friend wondered about research, and the presence of all these factors (and undoubtedly many I hadn’t even thought of) might make for a good case study. Just mentioning the variables might be useful, and how the family puts it all together. The name for this kind of case-study research is “idiographic” research, in contrast to research on a large number of people within a category in order to notice tendencies—that’s “nomothetic” research. The point here of course is that when there are ten or twenty variables with different strengths of intensity affecting each variable, it is impossible to do meaningful nomothetic research and we should recognize more vividly the necessity of case-study research.