Quality of the sibling relationship when one sibling has autism spectrum disorder: A randomized controlled trial of a sibling support group

When one sibling has autism spectrum disorder, the sibling relationship is often characterized by poorer quality with fewer interactions. Because sibling relationships provide a vital social framework for development, they have the capacity to be a risk or protective factor, depending on the quality of the relationship. One way to improve the quality of the sibling relationship is through typically developing sibling participation in a support group. In this study, researchers randomly assigned typically developing siblings to a 10-week support group or attention-only control group. Typically developing siblings in the support group showed significant improvements in the quality of their sibling relationship and interactions with their sibling with autism spectrum disorder compared to the control group. Autism spectrum disorder severity and externalizing behavior moderated the effects of the support group on positive affect. Findings suggest the positive impact of a support group on sibling relationships, a relationship that has the potential to be protective. Lay abstract The sibling relationship can be negatively impacted when one child has autism spectrum disorder. One way to improve the quality of that relationship is through typically developing sibling participation in a support group in which they learn about autism spectrum disorder and coping skills, develop a peer network, and discuss their feelings. Compared to participating in a similar group without a focus on autism spectrum disorder, siblings in the support group showed improvements in the quality of the sibling relationship. Findings suggest that sibling support groups can be a valuable resource to improve sibling relationship quality when one sibling has autism spectrum disorder.

Audit of Psychosocial and Palliative Care Support for Children Having Allogeneic Stem Cell Transplants at the New Zealand National Allogeneic Transplant Centre

Psychosocial and palliative care support during stem cell transplants (SCT) is known to improve outcomes. Aim: evaluate the support provided to children and families at the New Zealand National Allogeneic Stem Cell Transplant unit (NATC). Method: the psychosocial and palliative care support for children who received SCT between December 2012 and April 2018 was audited. Results: of the 101 children who received SCT, 97% were reviewed by the social work team (SW) and 82% by the psychiatric consult liaison team (CLT) at least once during their illness. However, pre-transplant psychological assessment only occurred in 16%, and during the SCT admission, only 55% received SW support, and 67% received CLT support. Eight out of eighty-five families (9%) were offered support for siblings. Eight of the sixteen children who died were referred for pediatric palliative care (PPC) with all supported and half the families who experienced a death (n = 8; 50%) received bereavement follow up. Conclusion: although the majority received some social work and psychological support, auditing against the standards suggests the consistency of involvement could be improved. Referrals for PPC were inadequate and largely for end-of-life phase. Sibling support, in particular donor siblings, had insufficient psychological assessment and support. Key recommendations are provided to address this underperformance.