title: Assessing functional impairment in siblings living with children with disability.
abstract: OBJECTIVE
  The purpose of this study was to empirically test if siblings of children with disability had higher levels of parent-reported behavioral and emotional functional impairment compared with a peer group of siblings residing with only typically developing children.
  
  
  METHODS
  This was a retrospective secondary analysis of data from the Medical Expenditure Panel Survey. We included only households with at least 2 children to ensure sibling relationships. Two groups of siblings were formed: 245 siblings resided in households with a child with disability and 6564 siblings resided in households with typically developing children. Parents responded to questions from the Columbia Impairment Scale to identify functional impairment in their children.
  
  
  RESULTS
  On the basis of parent reports and after adjusting for sibling demographic characteristics and household background, siblings of children with disability were more likely than siblings residing with typically developing children to have problems with interpersonal relationships, psychopathological functioning, functioning at school, and use of leisure time (P < .05). The percentage of siblings of children with disability classified with significant functional impairment was 16.0% at the first measurement period and 24.2% at the second (P < .001). For siblings of typically developing children there was a smaller percentage increase from 9.5% to 10.3% (P < .001).
  
  
  CONCLUSIONS
  Functional impairment is a key indicator for the need of mental health services and, as such, early assessment and interventions to limit increasing severity and short- to long-term consequences need to be addressed. Health care professionals need to consider a family-based health care approach for families raising children with disability.
authors.affiliation: Center for Applied Research and Evaluation, Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. agoudie@uams.edu
authors.forename: Anthony
authors.initials: A
authors.lastname: Goudie
authors.forename: Susan
authors.initials: S
authors.lastname: Havercamp
authors.forename: Barry
authors.initials: B
authors.lastname: Jamieson
authors.forename: Timothy
authors.initials: T
authors.lastname: Sahr
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D002675:Child, Preschool; D019988:Children with Disabilities / Q000523:psychology*; D042241:Early Diagnosis; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D007859:Learning Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D007899:Leisure Activities; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D010379:Peer Group; D010552:Personality Assessment; D012189:Retrospective Studies; D012307:Risk Factors; D035781:Siblings / Q000523:psychology*; D012931:Social Environment; D014481:United States
keywords: disability; functional impairment; mental health; siblings
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