Risk Factors for Behavioral and Emotional Difficulties in Siblings of Children With Autism Spectrum Disorder.

Walton (2016) looked at brothers and sisters of kids with autism. The team wanted to know which things raise the odds of anxiety, sadness, or behavior trouble in these siblings.

They used surveys and parent forms. The study pulled out six red-flag items: being male, living in a small family, having an older autistic brother or sister, lower income, the autistic child showing lots of problem behavior, and the sibling showing mild autism traits.

More risk flags meant more internalizing and externalizing problems. In plain words, the siblings got worried, withdrawn, or acted out.

The biggest helpers were the autistic child's behavior and the family's money stress. When both were present, sibling trouble rose fast.

Gabriels et al. (2001) first showed that autism families feel less warmth between siblings. Walton (2016) adds the why: certain risks stack up and turn into emotional pain.

Granieri et al. (2020) later found that many young-adult siblings still share close, happy ties. This seems like a clash, but age is the key. Early risks can fade if families teach closeness skills while the kids are young.

Andrews et al. (2024) carried the story into adulthood. They saw that support often flows one way, from sibling to autistic adult. The 2016 risk flags foreshadow this uneven flow, hinting that early stress shapes later caregiving roles.

If you run social-skills groups or home programs, scan for these six flags. When two or more show up, add sibling support goals. Teach emotion words, give the sibling their own reinforcers, and coach parents to carve out one-on-one time with the neurotypical child. A quick five-minute check on family income and the autistic child's behavior problems can guide how often you meet with the whole family.