When a child is diagnosed with a chronic illness it is heartbreaking for everyone involved , especially the imediate family . Within this blog I’ am going to explore the common issues and psychological damage which can occur to siblings when trying to adapt.(Derouin & Jesse , 1996 ) found that the presence of a chronically ill sibling can have a profound effect on the remaining healthy siblings .(Williams , 1997 ) exposed through a meta analysis of studies that 60 percent of children with a chronically ill sibling were at an increased risk for developing adverse psychological problems then children with healthy brothers and sisters (Lobato & Kao , 2002 ).This could be due to the fact that the dynamics within the family drastically change upon a diagnosis of a chronical illness, the parents time and emotional efforts are tied up with helping the ill child and often what occurs is that the other children in the family are over looked, (Murray 1998).To contribute to this it has also been found that parents are less tolerant towards their healthy children ( Foster et al , 2001 ),as the correspondance that the children have with their parents is often neggetive due to the overwhelming stress the family is in .
However it is not just negative effects which have been reported from studies concerning chronically ill siblings .(Murray ,1998) , found that the healthy siblings could develop effective coping strategies, increased mental maturation and alongside this develop an understanding and ability to empathise with others more competently .
The effects of having a chronically ill sibling vary amongst people , because of indivdual differences which effect mental processes .These differences include : developmental level , gender , birth order , birth spacing and the severity of the condition of the sibling ,(Thibodeau ,1988). Controversially the spacing between the siblings has profound effects on the psychological damage which can be caused : the closer the children are in age is directly related to an increase in psychological damage .It has also been found that older sisters and younger brothers are the most effected as they show higher levels of behavioural problems .
So it is obvious that there is a margin for damaging effects to siblings of chronically ill children , the question is how can these effects be limited .Gursky, (2007) claims that educational interventions can limit the stress and anxiety of children with siblings who have been hospitalised . The study used 50 participants who were children visiting their siblings on a children’s ward . The participants were split into one of two conditions : a control group who did not receive an educational intervention and an experimental group which did .The educational intervention was administered by proffesional health care administors who had recieved training and had the relevant experience to sensitively conduct the intervention . The intervention itself focussed on educating the child about their brothers or sisters illness , and what it entailed .The level of information dispensed to the child was inline with their mental age . The study found that those who had recieved an educational intervention measured as having decreased levels of stress and anxiety preceding the experiment .
However one area of concern within this field of research is ethics ,with regards to how the information about the child’s stress and anxiety levels is accumulated. As if the questions are particularly stressfull this could be potentially damaging to the children involved , a made up example of an insensitive question could be :’how does your sisters illness make you feel,’ these kind of questions could be upsetting and as a consequence have a profound impact on the chronically ill child and the participant . For example most of the experimental methods used in this kind of research ,obtain information from participants by interviewing or administering questionnaires , this could potentially be damaging for the family : as it brings attention too quite negative issues and puts emphasis on the child’s illness which is unfair . Therefore it is imperative that the researcher has integrity and gains fully informed consent.
References
The Effect of Educational Interventions with Siblings of
Hospitalized Children
Barbara Gursky, MA, CCLS 2007
estherroseburt 
It is indeed important for there to be interventions in place to ensure that the siblings of chronically ill children receive enough care/support and attention from their loved ones. This would be as if not enough care is provided, this may cause the siblings to lease out in different ways to ensure their parents notice them as well, not having a normal childhood. (Vanderwerp, N.D) As you mentioned, parents may also be so preoccupied with their ill child then that have less patience with their healthy children. Recently when I was on the train, I witnessed how a mother with a learning disabled child took special care of him whereas her other younger child had to call her name repeatedly before she acknowledged him with a frustrated tone. Of course, this was from my view point but I felt bad for the younger child who suffered a lack of attention from his parent. As such, I believe that more research needs to be conducted to find out the other possible impacts having a chronically ill sibling could have on their siblings along with research to see what methods of preventing such problems would be most viable such as whether greater support in school or making sure parents understand the harm it may have to the healthy sibling if all the attention is focused on the ill child to mitigate the problems the siblings may encounter. (i.e. ensuring they make time for the healthy child as well even if its just an hour a day just devoted to the healthy child to show their care)
Tracy Yang
Vanderwerp, L (N.D.). Sibling and Ilness: A study of how children are differentially impacted by the chronic illness of a sibling.Retrieved from https://docs.google.com/viewer?a=v&q=cache:aJIVIjvd4-oJ:ejournals.library.vanderbilt.edu/ojs/index.php/vurj/article/download/2924/1223+siblings+of+chronically+ill+children+turn+bad&hl=en&gl=uk&pid=bl&srcid=ADGEEShl94B17uWnMNdVw6m3b1nOeWV84vwz9sP4N_DnhyDvscDYQGEPnzRHK-yKxpXdS3PlxGwSbrvL9HsPEJDKMNcd9NGCd-dh_NiUe1PzUN0DieO9_3MAdM2Rpa_WOL0Ve0F208o4&sig=AHIEtbSIzA5NfpASLaVYMCMJdMdqjhOUgQ
The impact of having a sibling suffering from a chronic illness has been found to elicit feelings of both distress and anxiety. Sargent et al., (1994) explored the responses of siblings of children with cancer. Their results indicated that siblings reported distress in relation to family disruption and separation, negative feelings in relation to themselves and a fear that the illness could culminate in the death of their sibling. Furthermore as you have highlighted the effects of age can moderate the experience of having a sibling with a serious illness. In the aforementioned investigation older siblings frequently reported more positive effects than younger siblings, signalling that the individual’s level of maturity can moderate the anxiety experienced, when a child in the family is afflicted with a serious illness. In addition Havermans and Eiser (1994) corroborated these findings in that siblings of a child with cancer in their investigation not only experienced heightened distress and anxiety regarding the potential death of their sibling, yet they often reported difficulties in relationships with their parents. This supports your idea that parents can often focus their time on the ill child at the expense of other children in the family. The researchers used the results to suggest that a greater effort should be made to ensure that siblings of ill children have the opportunity to both express their worries and discuss the implications of their sibling’s illness. Furthermore they suggested that siblings should also be prepared for hospital visits. Tritt and Esses (1988) investigated the psychosocial adaption of siblings of ill children. They found that siblings of ill children displayed significantly higher levels of behavioural problems than the controls, supporting your idea that siblings of ill children have the potential to display greater behavioural problems. Therefore as you have stated siblings of children with chronic illnesses are vulnerable to experiencing heightened fear, distress and anxiety. Furthermore in order to soothe the concerns many of the children have to contend with a greater effort needs to be made to not only recognise the fears but help children work through their concerns.
References
Havermans, T., & Eiser, C. (1994). Siblings of a child with cancer. Child: Care, Health and development, 20, 309-312. doi:10.1111//j.1365-2214.1994.tb00393.x
Sargent, J.R., Sahler, O.Z., Roghmann, K.J., Mulhern, R.K., Barbarian, O.A., Carpenter, P.J., Copeland, D.J., Dolgin, M.J., Zeltzer, L.K. (1994).Sibling adaptation to childhood cancer collaborative study: siblings, perceptions of the cancer experience. Journal of Paediatric Psychology, 20, 151-164. doi:10.1093/jepsy/20.2.151
Tritt, S.G., & Esses, L.M. (1988). Psychosocial adaption of siblings of children with chronic medical illnesses. American Journal or Orthopsychiatry, 58, 211-220. doi:10.1111/j.1939-0025.1988.tb01582.x
Maybe a care package for the siblings of the chronically ill child should be offered on diagnosis , such as family counselling sessions whereby the whole family would have an opportunity to talk through what has happened to them , however this may not be appropriate or necessary for some as every individual copes with this kind of news differently because of individual differences .However i do agree more research should be commissioned into the possible outcome for siblings of chronically ill children , as this is obviously a grey area , and interventions should be seen as a priority .