title: A longitudinal study of siblings of children with chronic disabilities.
abstract: OBJECTIVE
  To examine the unaffected siblings of 2 different groups with chronic disabilities, pervasive developmental disorder (PDD) and Down syndrome (DS), over 3 years, comparing their adjustment with each other and with the siblings of a nondisabled group.
  
  
  METHODS
  This study examines 137 siblings of children with PDD, children with DS, and developmentally normal children (control group) initially and 127 siblings at follow-up 3 years later. Their adjustment is measured by the Survey Diagnostic Instrument (SDI), completed by caregivers and teachers. Predictor variables include sibling self-perception, social support, and relationship with sibling, as indicated by siblings; caregiver psychosocial factors such as parental stress, caregiver depression, and marital relationship; family systems characteristics as viewed by both caregiver and sibling; and difficulty that disabled child causes as perceived by the primary caregiver.
  
  
  RESULTS
  Significantly more adjustment problems are found in the siblings of PDD children at both times when compared with siblings of DS and control children. Caregivers of PDD children report the highest levels of distress and depression, and this persists over time. Parent distress was found, at both times, to be related to sibling adjustment problems, regardless of study group.
  
  
  CONCLUSIONS
  These results have implications for preventive intervention for the unaffected siblings of PDD children.
authors.affiliation: Division of Child and Adolescent Psychiatry, Children's Hospital of Western Ontario, London. sfisman@julian.uwo.ca
authors.forename: S
authors.initials: S
authors.lastname: Fisman
authors.forename: L
authors.initials: L
authors.lastname: Wolf
authors.forename: D
authors.initials: D
authors.lastname: Ellison
authors.forename: T
authors.initials: T
authors.lastname: Freeman
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002659:Child Development Disorders, Pervasive; D002908:Chronic Disease; D003863:Depression / Q000523:psychology; D004314:Down Syndrome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology; D010290:Parents / Q000523:psychology; D012649:Self Concept; D012801:Sibling Relations; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology