Hastings R P, Petalas M A
Centre for Educational Development Appraisal and Research, University of Warwick, Coventry, UK.
Child Care Health Dev. 2014 Nov;40(6):833-9. doi: 10.1111/cch.12131. Epub 2014 Jan 27.
There are few published research studies in which siblings of children with autism spectrum disorder (ASD) provide self-reports about their own behavioural and emotional problems and their sibling relationships. Reliance on parent reports may lead to incomplete conclusions about the experiences of siblings themselves.
Siblings 7-17 years and their mothers from 94 families of children with ASD were recruited. Mothers reported on family demographics, the behavioural and emotional problems of their child with ASD, and on their own symptoms of depression. Siblings reported on their relationship with their brother or sister with ASD, and siblings 11+ years of age also self-reported on their behavioural and emotional problems.
Compared with normative British data, siblings reported very slightly elevated levels of behavioural and emotional problems. However, none of the mean differences were statistically significant and all group differences were associated with small or very small effect sizes - the largest being for peer problems (effect size = 0.31). Regression analysis was used to explore family systems relationships, with sibling self-reports predicted by the behaviour problems scores for the child with ASD and by maternal depression. Maternal depression did not emerge as a predictor of siblings' self-reported sibling relationships or their behavioural and emotional problems. Higher levels of behaviour problems in the child with ASD predicted decreased warmth/closeness and increased conflict in the sibling relationship.
These data support the general findings of recent research in that there was little indication of clinically meaningful elevations in behavioural and emotional problems in siblings of children with ASD. Although further research replication is required, there was some indication that sibling relationships may be at risk where the child with ASD has significant behaviour problems.
很少有已发表的研究让自闭症谱系障碍(ASD)儿童的兄弟姐妹就自身行为和情绪问题以及他们与兄弟姐妹的关系进行自我报告。依赖家长报告可能会导致对兄弟姐妹自身经历得出不完整的结论。
招募了来自94个ASD儿童家庭的7至17岁的兄弟姐妹及其母亲。母亲报告家庭人口统计学信息、患有ASD的孩子的行为和情绪问题以及她们自己的抑郁症状。兄弟姐妹报告他们与患有ASD的兄弟姐妹的关系,11岁及以上的兄弟姐妹还自我报告他们的行为和情绪问题。
与英国的标准数据相比,兄弟姐妹报告的行为和情绪问题水平略有升高。然而,所有平均差异均无统计学意义,且所有组间差异的效应量都很小或非常小——最大的是同伴问题(效应量 = 0.31)。采用回归分析来探索家庭系统关系,用患有ASD的孩子的行为问题得分和母亲的抑郁情况来预测兄弟姐妹的自我报告。母亲的抑郁并未成为兄弟姐妹自我报告的兄弟姐妹关系或其行为和情绪问题的预测因素。患有ASD的孩子行为问题水平较高预示着兄弟姐妹关系中的温暖/亲密程度降低以及冲突增加。
这些数据支持了近期研究的总体发现,即几乎没有迹象表明ASD儿童的兄弟姐妹在行为和情绪问题上有具有临床意义的升高。尽管需要进一步的研究重复验证,但有迹象表明,当患有ASD的孩子有严重行为问题时,兄弟姐妹关系可能会受到影响。