Parents with multiple children often struggle to balance their kids’ individual needs.
When one of those children has special needs, it can get even more complicated. Beyond the daily requirements of navigating a medical, developmental or physical disability or condition, parents also try to support their typically developing children who can experience everything from separation anxiety to outright resentment.
Caroline Buzanko is a registered psychologist with Koru Family Psychology who works with families of special needs children. We reached out to her to give families strategies to support all of their children.
LG: What are some of the common issues that parents with special needs children and typically developing children tend to come up against?
CB: The siblings actually tend to have greater needs than the child with the disabilities. That’s what I have found… there’s numerous concerns but the big three are lack of parental attention, whether the parents are having to go to medical doctors appointments or there’s therapies going on, there’s just lots of attention. Extra care is often given to those kids. The other one is differential attention, and so what that means is different expectations from the parents in terms of doing chores, eating broccoli. One child might have to eat the whole serving of broccoli, the other child might just have to touch it. So there are different expectations. The other piece too is just how the family is functioning is often different. Maybe families won’t go out to dinner for example, or they modify what they are doing because of the other sibling’s difficulties, where it’s behavioural or there’s medical pieces. They might not go on the same trips as other kids. Some children — just their own extracurricular activities — you know, they are not going out on as many play dates or they can’t get to different activities that they normally would because their parents are busy focusing on the other children.
LG: How does that present itself in the average child in terms of behaviour?
CB: There’s a few different ways that it kind of comes out. Sometimes it’s the externalizing, acting-out behaviour — the aggression, the temper tantrum — those sorts of things. So it’s very obvious. Sometimes it’s attention-seeking. Sometimes kids actually regress to more baby-like behaviour so they are talking like babies, sucking their thumbs. There might be those types of things.
Other kids, they internalize those types of difficulties. They become quiet. They withdraw. Those are the ones that, they might be irritable but they are also anxious. They might have difficulties separating from their parents so there’s more mood difficulties, anxiety, just withdrawing.
Other kids try to become overachievers. They seem like they are doing really well but they are working so hard to be successful, whether it’s academically or in their sports, so that over-accomplishment. There are different reasons why they do that. Sometimes it’s to feel like they are compensating for their siblings’ difficulties, but sometimes it’s, ‘I want to be recognized. Maybe if I win gold, and maybe if I do this, I’ll be recognized.’ The problem there is lots of perfectionist-types of tendencies is what we see. The other piece too is we have kids who have symptomatic complaints — headaches, stomach aches, they’re complaining about physical ailments. Those are generally how we see the difficulties typically developing siblings have manifesting.
LG: What basic strategies would you give families to deal with this?
CB: Well, I’ve done a lot of research and my research has spanned all the different disabilities — whether it’s medical or developmental delays and those sorts of things — and there’s a few key needs that siblings have that we really need to target. The first thing is parent education. Parents are already aware that there are things going on for their other child, right? So they really have to understand what their needs are. One of the needs is the need for information. Sometimes parents won’t tell their typically developing child what’s going on for their sibling. They just make up, ‘Oh, they need medicine to help with learning,’ or whatever it is. The diagnosis itself is so vague and the problem is if they don’t have concrete information that they can understand, kids start making up these stories to make sense of things themselves. Like, ‘Mom and Dad don’t love me. I caused my brother or sister’s disability.’ Those sorts of things. So that’s why information is so important.
What types of information? Well they need to know how the diagnosis affects their brother or sister, how we see that manifesting in their sibling, what types of medicines they need and why, what they help them with. Or if it’s therapy, why therapy is needed and what skills their brother or sister is learning. Why parents need to be involved, that’s a big one just because they are spending so much time with their sibling.
It’s really looking at what your family needs are and what type of information will best suit that child. You don’t want to give too much information and you want to make sure it’s developmentally appropriate. A three-year-old’s need for information is going to be different once they are 10. But it’s going to be an ongoing conversation. You can’t just tell them once and assume that they understand… so that’s one need that they have.
Another need is for emotional support from other children who are in the same boat. Other children who have brothers or sisters with the same sorts of difficulties… long term, that’s one of the most powerful healing powers is support from other families. The big piece is normalizing: ‘I’m not the only one in this situation who is struggling with these things,’ but also to help them express — they do have feelings of jealousy, of hate, of fear, of anger.
Often times as parents we want to [say], ‘Oh no, you don’t want to say that! You can’t hate your brother or sister!’ but it’s really important for them to express those because otherwise they internalize them and they live with guilt for the rest of their lives and increasing resentment and they start looking at their own self-worth… if they have other children and they’re hearing, ‘Other children are feeling this way too, I’m not feeling so bad.'”
If there’s no opportunity to have contact with families like that, it’s just important that families do empathize and allow those feelings to come out without judging them or kind of belittling them. Just saying, ‘It is hard. I get that it’s hard. It makes sense that you feel that way.’
In terms of parental attention, you have to be intentional with your time. I think that’s something a lot of us parents struggle with, with our kids anyways. Time will slip by so we need to be intentional and schedule it in. Make sure we have time together as a family and time one-on-one with each of our children — both parents. Sometimes it’s always the mom with one child and the dad with the other… it doesn’t have to be grand, big days to the amusement park or swimming, it could be doing things you’re already doing. So having them help you cook dinner for example, or having them help you do laundry. You could have love notes or notes of appreciation you slip under their door at night when they’re sleeping or put them in their lunch kit. Even just giving them a hug as they are leaving, and just saying, ‘Thank you so much for your help. I really appreciated how you handled the situation.’ Those little things add up to quite a bit of time and it’s more meaningful for those children that they’re feeling appreciated.
LG: Do you find in general it’s helpful when the typically developing child has a caregiving role?
CB: Only if they are willing… older sisters are usually at greatest risk for anxiety and depression and resentment and anger because they are forced into those roles…we need to make sure they can be involved as much as they want. Sometimes they have to have responsibilities, but forcing child caregiving sort of things onto their sibling can just increase those feelings as siblings. So having them as involved as we can but not forcing it on them.
LG: Some typically developing kids complain about going to so many of their siblings’ appointments, but then feel left out if they aren’t included. A parent I spoke with said she feels like it’s a constant scenario of being damned if you do, damned if you don’t. Is that common?
CB: Very common. Absolutely. That’s part of that attention, that, ‘Mom is spending all this time going to these appointments and I’m getting dragged along.’ That’s why it’s so important for the other sibling to have their own special things.
It’s not always about the child with the disability. In those moments, I say collaborate. If the child is old enough to not come along, then they don’t have to. But it’s having that discussion with that child. It’s not always making the decisions for them. So saying, ‘Hey, do you want to come to this appointment? What are some of the things we can maybe do afterwards if you stay home?’
If they do want to come, maybe you can get their input in terms of, ‘We can go to the park before or after. What are some things you want to bring that you can do at the appointment?’ Maybe it’s being proactive. If it’s a medical appointment and you’re seeing a medical doctor, seeing ahead of time if one of the nurses can show them some of the medical equipment and kind of make it about them as well. If you can incorporate those sorts of things… but really, asking their opinion: ‘What would make this better for you because I know it sucks, it’s boring going to another doctor’s appointment.’ I think that’s so valuable because even if nothing changes, just the fact that mom and dad are asking me for my input, that can be empowering and help some of the feeling of resentment.
LG: Did I miss anything you think is important?
CB: You have to know that there is a benefit of having a sibling with a disability as well. The typically developing kids, they are usually more patient. They’re usually more aware of their environment, sensitive, more appreciative of others. These families usually have closer bonds. The typically developing siblings have more pride in their sibling than other families. So there’s a lot of good things that come out of it and a lot of these siblings end up taking on a caregiving role themselves, whether it’s social work or psychology or those sorts of things, because there is that compassion there and that understanding. So there’s one side of things in terms of the difficulties of having a sibling with a difficulty but there’s so many amazing things as well.