"All you have to do to get attention around here is act crazy or get sick."
That was the conclusion of at least one child whose sibling has a developmental disability, says Debra Lobato, an expert in child psychology. And it's a common response. Children who have a brother or sister with a chronic illness, like cancer, or a mental or developmental disability often receive less attention from their parents. They're just too busy looking after the needy child.
"In the early years, differential treatment can be a source of resentment for little kids. They don't understand why the other child is getting all the attention," says Lobato, director of child psychology at Hasbro Children's Hospital in Rhode Island. "All they see are the balloons, get-well gifts, and stuffed animals. They feel left out and ask: What about me?"
This preferential treatment can put healthy siblings at risk for problems like anxiety and depression. Also, concern over their siblings' illness can cause them to feel confused, worried, and scared.
Children might also have to deal with disruptive and potentially embarrassing behaviors from their siblings and peers. This includes teasing from peers who don't understand, or violent behavior from a mentally disabled sibling. Despite these challenges, however, brothers and sisters can adapt with the right guidance, Lobato says.
To help families cope, she helped develop a program called SibLink, based at Hasbro Children's Hospital. SibLink provides parents with guidelines for balancing the needs of all children in a family, and to avoid feeling like their lives are "dictated by one family member." Here are some suggestions.
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Be honest. Provide a simple explanation of the illness and treatment, including its name. "Children know when something is wrong," Lobato says. Give honest explanations about what's going on. Otherwise, they will invent them.
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Be fair. Don't dismiss a child's feelings when he says "no one's paying attention to me."
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Acknowledge the difficulties. Help a child feel included by giving her privileges and responsibilities, but never pressure him to make up for a sibling's problems. Show appreciation for her extra efforts and sacrifices.
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Express your feelings. Children learn how to express their feelings by observing their parents. Therefore, sharing experiences is a helpful form of therapy. Families can provide support only if they know what's going on.
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Be aware of your emotions. Talk openly with your children, and listen to their responses. Openness will encourage your kids to come to you with their questions and concerns.
Family is key to helping young siblings cope, especially because parents are often their main access to information and support. With the right guidance, Lobato says, siblings can learn to be caring and independent. And they can even gain an appreciation for life.
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