Autism & Developmental

The psychophysiological impact of childhood autism spectrum disorder on siblings.

Lovell et al. (2016) · Research in developmental disabilities 2016
★ The Verdict

Siblings of kids with autism report more depressive feelings than peers, yet their stress hormone levels look the same.

✓ Read this if BCBAs running center- or home-based programs with school-age clients who have brothers or sisters.
✗ Skip if Clinicians serving only adults or only-children families.

01Research in Context

01

What this study did

The team asked the families to join a simple study. Half had one child with autism. Half had only neurotypical kids.

They gave the brothers and sisters two short checklists about mood. They also collected spit samples to measure the stress hormone cortisol.

02

What they found

Siblings of kids with autism scored higher on a child depression scale. The gap was biggest on items like “I feel lonely” and “I cry a lot.”

Surprise: the spit tests showed no group difference in cortisol. Feeling sad did not show up as higher stress hormone.

03

How this fits with other research

Toth et al. (2007) already saw toddler siblings lag in language and play. Brian et al. now show the same group feels more down years later. Together they trace a line from early risk to later mood problems.

Bravo Balsa et al. (2024) found autistic teens pump out more daily cortisol. Brian et al. found no cortisol jump in their brothers and sisters. The clash is useful: stress chemistry differs between the child with autism and the rest of the family.

Pavlopoulou et al. (2019) let sisters speak in their own words. They called themselves “lonely fighters.” The higher depression scores in Brian et al. give numbers to that feeling.

04

Why it matters

You already track the client with autism. Start tracking the sibling too. A quick mood checklist at intake takes two minutes. If scores are high, offer parent coaching or a sibling support group. You do not need fancy labs; cortisol is not the signal here—self-report is.

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Add the 10-item Children’s Depression Inventory to your intake packet for siblings over 7.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
45
Population
autism spectrum disorder, neurotypical
Finding
positive
Magnitude
medium

03Original abstract

OBJECTIVE: The negative impact of caring for a child with autism spectrum disorder (ASD) on parents' psychophysiological functioning has been widely evidenced. However, siblings, who also face emotional, social and physical challenges associated with having a brother/sister with ASD, have been less widely studied. This study examined the psychophysiological impact of childhood ASD on siblings. METHODS: A sample of 25 siblings of children with ASD (and their mothers) and a control group of 20 siblings of neuro-typical children (and their mothers) completed questionnaires assessing: (a) demographic and lifestyle information, (b) family characteristics, (c) child behaviour problems, (d) social support and (e) depressive symptomology. Saliva samples were collected at several time points on two consecutive days, and estimates of the cortisol awakening response (CAR), diurnal cortisol slope and mean diurnal cortisol output were derived. RESULTS: Total depressive symptoms were higher in siblings of children with ASD compared with controls. Group differences with respect to depressive symptomology were driven more by emotional than functional problems. With respect to physiological functioning, groups were comparable on all cortisol indices. In siblings of children with ASD, social support, especially from parents and close friends, predicted total depressive symptoms, as did the behaviour problems of their brother/sister with ASD. CONCLUSION: Siblings of children with ASD experience greater emotional problems and overall depressive symptoms compared with a control group. Interventions that enhance social support, as well as helping siblings better understand the behaviour problems of their brother/sister with ASD, might be effective for alleviating depressive symptoms.

Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2015.11.023