'That's just the Way it is': The Experiences of Co-habiting Spanish Siblings of Individuals with Autism Spectrum Disorder

Journal of Child and Family Studies https://doi.org/10.1007/s10826-024-02979-9 ORIGINAL PAPER ‘That’s just the Way it is’: The Experiences of Co-habiting Spanish Siblings of Individuals with Autism Spectrum Disorder Sofía Baena1●Victoria Hidalgo 2●Lucía Jiménez2 Accepted: 10 December 2024 © The Author(s) 2025 Abstract Although the literature has provided a large body of evidence about the impact of having a child with Autism Spectrum Disorder (ASD), studies on how this influences typically-developing (TD) siblings are scarcer and less consistent in their findings. Moreover, fewer studies have included TD siblings from non-English speaking countries as informants from a qualitative perspective. Semi-structured interviews were conducted to explore the experiences of adolescents and adults with a sibling with ASD. The sample comprised 14 TD people from Spain aged between 12 and 29, currently living with a sibling with ASD. The thematic analysis revealed that participants identified seven domains of impact, grouped into three different levels: personal, dyadic, and family. The findings of the present study highlight the complexity and heterogeneity of TD sibling experiences and relationships among family members. This study presents topics that are of particular relevance to the Spanish context while identifying commonalities with other studies. These results highlight the importance of cultural factors in some family processes. In addition, results shed light on how TD siblings appraise differential parental treatment and potential protective factors for adjustment, incorporating the relevance of the individual parent-child relationship and certain parenting components as potential protective factors for TD siblings. Such information is important to develop more accurate and effective interventions and adjust the necessary resources to assist TD siblings. Keywords Autism spectrum disorders ●Siblings ●Qualitative study ●Family ●Cultural Highlights ●This study is one of the first to analyze the experiences of TD siblings in the Spanish context, considering cultural elements. ●The experiences of TD siblings are heterogeneous and complex, with TD siblings providing a realistic view of the sibling relationship. ●It underlines the importance of parenting practices and quality parent-to-child relationships in the experiences of siblings of individuals with ASD. ●There is a need for specific and continuous support for siblings of individuals with ASD, incorporating relational practices. Autism spectrum disorder (ASD), which is defined as a neurodevelopmental disorder, is characterized by difficulties in social communication and restricted interests or repetitive behavioral patterns (APA, 2013). It is important to emphasize the concept of spectrum, as there is a wide range of related clinical and behavioral manifestations (Barthèlemy et al., 2019). For example, within the difficulties in social communication, some individuals may *Victoria Hidalgo [email protected] 1Department of Psychology, Universidad Loyola Andalucía, Seville, Spain 2Department of Developmental and Educational Psychology, University of Seville, Seville, Spain 1234567890();,: 1234567890();,: exhibit extreme social inhibition, difficulties in adequately responding to social interactions, difficulty adapting to social communication situations, or even extreme social disinhibition, such as hugging strangers (Hervás, 2016). In addition, within restrictive behavioral patterns, stereotypical behaviors such as echolalia or hand flipping, and cognitive and behavioral inflexibility are frequent (APA, 2013). Multiple studies have indicated that individuals with ASD might also display a different sensory profile, with hyper or hypo-sensitivity to certain stimuli, such as loud noises, temperature, and touch (Siemann et al., 2020). These difficulties, along with the frequent occurrence of comorbidities and the context surrounding the person with ASD (going to different therapies, more attention needed…) imply that a child with ASD has the potential to have a great impact on the whole family system (Macks & Reeve, 2007). From a systemic perspective, the family system is composed of bidirectional relationships (marital, parental, fraternal…), that need to be adjusted when faced with a changing situation, to reach balance again (Andolfi,1984; Minuchin, 1985). Therefore, having a child with ASD influences the interactions and relationships between members in the family context. Sibling or fraternal relationships are one of the most significant and long-lasting bonds in a person’s life (Feinberg et al., 2012; Orsmond & Seltzer, 2007), often being the first social interaction experiences children have with peers. These relationships are characterized by rivalry and support (Barak-Levy et al., 2010) and are not elective (Feinberg et al., 2012). These experiences are the first situations where individuals have to share, compete, and help each other in a horizontal relationship. Thus, due to frequent interactions, siblings are an important source of learning and emotional and social support, playing an essential role in the cognitive, social, and affective development of individuals (McHale et al., 2016). Moreover, the cultural, family, and socioeconomic context shared by siblings is more similar than any context they may share with other people (Keirsey, 2016). Sharing the same family context also means that sibling relationships are influenced by other intrafamily factors, such as parent-child relationships, couple relationships, and differential parental treatment (Feinberg et al., 2012). Sibling relationships are also related to individual well-being and, as such, become an important risk or protective factor for individuals’mental health (Feinberg et al., 2012). These factors make sibling relationships a complex and unique type of relationship. Having a sibling with ASD often entails specific and differential characteristics in the sibling relationship that influence not only the interactions between siblings but also different aspects of the family dynamic. At an individual level, research has predominantly focused on the impact on the adjustment of TD siblings of individuals with ASD, reporting mixed and inconsistent findings (McHale et al., 2016; Meadan et al., 2010; Orsmond & Long, 2021). Some authors have found that TD siblings have a negative adjustment, including high rates of or a higher risk of developing emotional and behavioral difficulties (e.g., Griffith et al., 2014; Lovell & Wetherell, 2016; Orm et al., 2021; Ross & Cuskelly, 2006). Other studies have reported no significant differences between these children and other sibling populations (e.g., Dempsey et al., 2012; Hastings & Petalas, 2014; Shivers et al., 2013); in fact, they have even reported positive outcomes, such as higher levels of social competence (Meadan et al., 2010), prosocial behaviors (Orm et al., 2021) or perspective taking (Shivers, 2019), in comparison with other populations. A recent meta-analysis by Shivers, Jackson et al. (2019) concluded that while TD siblings of children with ASD were found to have higher rates of internalizing problems, worse psychological functioning, and more social functioning impairment than comparison groups, there were no differences found in the development of externalizing or total behavior problems. Concerning TD sibling relationships with individuals with ASD, research in this area has again found mixed and inconsistent results (McHale et al., 2016; Orsmond & Long, 2021; Orsmond & Seltzer, 2007), with some authors reporting negative interactions between siblings that are characterized by less intimacy, less nurturance (Kaminsky & Dewey, 2001) and significantly poorer sibling relationships than siblings of TD individuals (Shivers et al., 2019). Ross and Cuskelly (2006) reported aggressive behaviors in the sibling with ASD as a problem for 52% of the TD siblings in their study, highlighting it as one of their main stressors. Other studies have found no differences with other disabilities or typically developing sibling pairs (Shivers & McGregor, 2019). Research has also emphasized the complexity of sibling relationships, establishing that while TD siblings develop positive feelings about their ASD sibling, such as feelings of pride, love, and appreciation for the qualities of their ASD sibling, that experience is often accompanied by feelings of anger, embarrassment, and increased responsibility (Leedham et al., 2020; Mandleco & Webb, 2015; Schmeer et al., 2021; Watson et al., 2021). Alongside sibling relationships, the parent-child relationship is an essential component of a person’s development. Previous research has shown that parental stress or depression are related to TD siblings’adjustment (Giallo & Gavidia-Payne, 2006; Quintero & McIntyre, 2010); however, the impact on this dyadic relationship itself has been largely overlooked. The few studies that have addressed this topic have reported an overall positive relationship between TD siblings and their parents, despite the conflicts (Keirsey, 2016; Pavlopoulou & Dimitriou, 2019; Pavlopoulou & Dimitriou, 2020). Moreover, most TD siblings feel that they Journal of Child and Family Studies receive less attention than their brother or sister with ASD (Cridland et al., 2016; Corsano et al., 2017; Leedham et al., 2020; Tsai et al., 2018; Ward et al., 2016). These feelings are often accompanied by an acknowledgment of their sibling’s increased level of needs (Keirsey, 2016; Safran, 2017). However, studies specifically focusing on this topic are scarce. Finally, at the family level, research has consistently provided evidence on the impact of having a child with autism on family dynamics from the parents’perspective. Parents perceive higher levels of social isolation and consider that family routines and dynamics often revolve around the person with ASD (Degrace, 2004; Fletcher et al., 2012; Ludlow et al., 2011). The few studies that have included the TD siblings’perspective have drawn similar conclusions, namely, that siblings perceive a reduction or limitation in their family’s social life (Cridland et al., 2016; Gorjy et al., 2017; Keirsey, 2016; Petalas et al., 2009). It is important to highlight that most studies in this field have been conducted in English-speaking contexts; therefore, it is important to expand our knowledge of other sociocultural environments. Using the ecological model as a framework, interactions between the person and the context are important for their psychological functioning (Bronfenbrenner, 1979). This model describes different levels of influence including microsystem, mesosystem, exosystem, and macrosystem. Macrosystemic influences such as cultural factors, and mesosystemic influences, such as how the services are organized, are an important influence on the development and adjustment of individuals but are often overlooked. Recent studies have found differences among the experiences of TD siblings in different cultures (e.g., Long et al., 2021; Tsai et al., 2018) and have incorporated cultural elements in their interpretations (e.g., Hwang & Charnley,2010); Kao et al., 2012). In Spain, familism, defined as a form of social structure in which the family plays a central role in providing social support and care (Marin & Marin, 1991), is a core cultural value. As such, communal orientation might be more frequent or valued. More specifically, (1) family members of different generations live together for longer than in other countries, and (2) care of dependent members falls mainly to kin (Calzada & Brooks, 2013; del Valle et al. 2013). In addition, in Spain, similarly to other Mediterranean countries, there is a high rate of individuals spending longer co-residence time with their nuclear families due to delays in leaving the parental household (Eurostat, 2021). Finally, other characteristics of the Spanish context that are key elements to consider are (1) the tendency to stay near one’s nuclear family, often living in the same city—even in the same neighborhoods—after leaving the parental household, and (2) the relevance of family traditions. For instance, some of the most relevant family traditions in Spain are weekend family meals, family celebrations of birthdays, patrons’days, and spending holidays together, often including the extended family. Additionally, religious celebrations are still important and are mainly celebrated with the family (López, 2010). All these idiosyncrasies of the Spanish context involve differences with other countries in family relationships and their interactions with society. These particularities justify the possibility of differences with other cultures in the experiences of TD siblings and how relationships are shaped and influenced by growing up with a sibling with ASD. To our knowledge, there are no studies in Spain that have addressed the experiences of TD siblings. To date, research in the field of TD siblings has mainly been quantitative and has relied on parents as informants of both adjustment and sibling relationships (e.g., Dempsey et al., 2012; Griffith et al., 2014; Shivers et al., 2013; Tudor et al., 2018); however, there has been an increase in selfreporting (e.g., Hastings & Petalas, 2014; Tsai et al., 2016). These approaches have greatly contributed to our understanding of TD siblings in the context of a family with a child on the autism spectrum. However, due to the complexity of sibling relationships, it is important to incorporate siblings’voices into research using complementary approaches, such as qualitative methodologies. These methodologies are a way of having a more in-depth understanding. This in turn will enable us to understand better and incorporate the complexity and intricacies of the impact of having a sibling with ASD into service provision for these families. In sum, having a sibling with ASD has an impact at different levels. The current literature reports mixed findings regarding the adjustment of TD siblings and the quality of their sibling relationships, with few studies focusing specifically on parent-child relationships and family impact. In addition, despite the importance of macrosystemic influences on the development of individuals and more specifically the evidence on cultural differences on the impact on TD siblings, there are few studies in contexts with familistic values, particularly in Spain. Finally, as mentioned, most studies have not included the self-reported experiences of TD siblings. This study aims to address these gaps using a qualitative methodology with a sample from Spain and to explore the impact in a broad sense, while explicitly asking about relationships within the family. The general aim of the present study is to analyze the experiences of adolescents and young adults living with a sibling with ASD in the Spanish context. Thus, we ask the following research questions: RQ1. How does having a sibling with ASD influence TD siblings? RQ2. How does having a sibling with ASD influence the relationship of TD siblings within the family? Journal of Child and Family Studies Method We addressed these research questions by conducting faceto-face semistructured interviews with TD siblings from Spain who were recruited via referral by their parents. We used a thematic analysis approach to create themes representing the influence or impact of having an ASD sibling on the life of TD siblings. In this section, we will detail in more depth the participants, measures, procedure, and data analysis used in this study. Participants Participants were 14 TD adolescents and adults aged between 12 and 29 years (M=16.86, SD =5.01) from southern Spain who had a sibling with ASD. Of the total sample, 42.90% (n=6) were adults, and 50.00% (n=7) were female. Siblings with ASD ranged in age from 3 to 25 years (M=13.36, SD =7.01), and 35.70% (n=5) were female. The severity of the symptoms manifested by participants’siblings with ASD, varied according to the Childhood Autism Rating Scale (CARS; Schopler et al., 2002), with 57.14% of them having moderate symptoms, 7.14% having mild symptoms and 7.14% having severe symptoms. We did not have information about the severity in 28.54% of the cases. The majority of participants (85.71%) were older than their siblings with ASD, and all of them lived with their parents and their siblings with ASD. This living situation meant that despite not having a primary caregiving responsibility per se, they shared daily time and experiences with both the sibling with ASD and at least one parent; this means that for long periods, these individuals dealt with possible difficulties related to their household context. Measures To collect descriptions of both the TD sibling and the sibling with ASD, as well as of exploring the first-person experiences of TD siblings, participants completed a sociodemographic questionnaire and participated in a oneto-one face-to-face semistructured interview. In addition, professionals working with the child with autism spectrum disorder completed a questionnaire. Next, we provide a detailed description of the measures we used in this study. Sociodemographic Profile Participants completed an ad hoc questionnaire about their gender, age, occupation, and genogram. The genogram is a visual representation of the family and their relationships. It was used to know who was part of the family (grandparents, parents, children), who lived together, if parents were divorced, and if they were a reconstituted family. Childhood Autism Rating Scale (CARS; Schopler et al., 2002) The Spanish version of the 15-item Childhood Autism Rating Scale (García-Villamisar & Polaino-Lorente, 1992) was used to assess the severity of the symptoms manifested by the sibling with ASD. Although originally created to assess children, this scale can also be a useful tool for screening adolescents and adults (Mesibov et al., 1989). The scale was completed by a professional currently working with the person with ASD, who rated their behavior ranging from 1 (no autism) to 4 (severe autism). Semistructured Interview The interview protocol was created ad hoc, using as a guideline the one used in the study by Jensen et al. (2021); the contents were deemed relevant by the research team after a literature search taking into account the research questions. An initial proposal of general and specific contents was presented in a research team meeting and then further refined and developed. The final interview protocol was divided into four general sections. The first section included introductory questions about the participants themselves and their siblings with ASD (Tell me a bit about yourself, how would you describe your sibling with ASD?). The second section focused on the diagnosis communication and their needs at that time (How did you determine your sibling’s diagnosis? What did you find difficult to understand at that moment? What did you find helpful at that moment and what do you think would have helped more?). The third section included questions about the participants’relationship with their sibling with ASD and their parents, as well as their perception of the impact of having a sibling with ASD in their lives (How is your relationship with your sibling? How is your relationship with your parents? How is your relationship with your parents compared to that of your sibling with ASD? What has been the impact on your life of having a sibling with ASD? What do you think you need at this moment or would find useful?). Finally, the last section focused on participants’expectations and hopes for their sibling with ASD (How would you like to see your sibling in 10 years? What support and resources do you think you and your sibling might need in the future?). In the present study, we focused on the impact of having a sibling with ASD and participants’relationship with the sibling with ASD and their parents. The interview protocol was reviewed by experts in the field of family support. Procedure This study was carried out within the framework of a broader research project conducted in 2018, entitled Journal of Child and Family Studies “Families that live with a person with ASD. An analysis of the complexity of the experiences from a psychosocial perspective”(MVH_AUT_2017_1). This research project focused on the experiences and needs of families with a child on the autism spectrum in the Spanish sociocultural context. It is a cross-sectional study using a sample of convenience. We collected both qualitative and quantitative information. Approval from a regional ethics committee was obtained (1517-N17). Families were recruited via email, phone calls, and meetings with regional and local associations, schools, and centers that provide services to people with ASD using a referral sampling technique. Siblings were recruited through their parents and interviewed if they fit the following inclusion criteria: 1) to be at least 12 years old or turning 12 years old in the following three months; 2) living in the south of Spain; 3) not being diagnosed with ASD. Parents of underage participants explicitly consented to their participation. In addition, every informant participated in the study voluntarily after signing an informed consent document, in accordance with the Declaration of Helsinki. The informed consent included information such as the objective of the study, the voluntary, the confidential nature of the study, and the right to withdraw their participation from the study at any moment, without there being consequences in the services. A member of the research team with clinical training and experience in qualitative methodology conducted a semistructured, one-to-one face-to-face interview with each participating sibling in Spanish. We carried out these interviews during 10 months, from February 2018 until November 2018. We interviewed TD siblings in the space they decided they felt more comfortable and adjusted to their schedule. All siblings signed a consent form and were asked if they would allow their interview to be audiotaped. This permission was granted in all but two interviews, during which extensive notes and verbatim quotes were taken instead. Informants received no compensation for participating in the study. After the data collection, we dissociated the recordings from the informed consent and sociodemographic questionnaires so the individual could not be identified, and each family was assigned an identification number. Data from the questionnaires were analyzed using SPSS. Data Analysis After the interviews, we conducted a thematic analysis, following Creswell and Poth’s(2018) instructions for qualitative analysis and using an intercoder reliability approach to thematic analysis. Steps were taken to achieve the quality standards needed to ensure an adequate level of rigor, validity, and credibility in the qualitative analysis (Patton, 2002; Tracy, 2010). Specifically, the interviews were transcribed verbatim and verified by a second member of the research team. We then performed an inductive analysis of the transcriptions to generate the categories. We created an initial codebook using three randomly selected interviews, i.e., coding them jointly, writing down possible names for the codes, then doing a refining process and defining each code in more depth. We then coded the other interviews independently, using a flexible approach and incorporating new codes as and when needed. We held biweekly meetings with a supervisor to audit the coding process and to discuss differences in the coding process. We reached an intercoder reliability rate of 86%, where decisions were jointly made by the two coders and supervised during the auditing process (Campbell et al., 2013). The use of a detailed coding book, two independent coders who discussed and had to agree in every code in each interview, and the auditing process of the coding helped to avoid and address coder drift. Finally, we performed a thematic analysis by going back and forth through the transcriptions to identify themes, having regular meetings to verify the themes and go in more depth about the meaning, identifying nuances and overarching themes. We started with 11 themes and then refined and interrelated the content to reach the final seven themes and two subthemes. We used NVivo (Version 12) to organize the coded data and the themes and to retrieve the quotes used to illustrate them. The quotes were translated into English by one of the authors, reviewed by the research team, and finally proofread by a native English speaker. Results The interpretation of the initial and higher-level coding resulted in the identification of seven themes linked to participants’perceptions of the impact of having a sibling with ASD. For organizational purposes, we organized the themes into three subcategories according to the impact level: personal, dyadic or family (see Fig. 1). As presented in Fig. 1, within the personal subcategory, we identified three main themes: personal growth, life plans, and negative feelings. In the dyadic supra-category, we included two themes: desire for a typical relationship with a sibling with ASD, and they do not treat us the same way; the latter involved two subthemes: neutral/positive appraisal and negative appraisal. Finally, in the family supra-category, we identified two emerging themes: everyday life and family climate. Personal Impact The personal impact supra-category comprised different themes related to participants’perceptions of the impact of Journal of Child and Family Studies their situation at an individual level in areas such as their social relationships, careers and personality. Some participants stated that having a sibling with ASD had a marked impact on different aspects of their personal life. We identified three broad themes related to this individual dimension: personal growth,life plans, and negative feelings. Personal Growth Participants frequently stated that having a sibling with ASD had an impact on their personal growth, often identifying a positive impact in terms of being more tolerant, having more patience and generally being more sensitive toward others. A TD sister (18 years old) stated “I am more empathic with people; I appreciate more everything I have, and I am definitely more patient”. Other participants mentioned: It has made me a more sensitive person; those topics (related to disability or difficulties in general) touch me a lot. I think that if I hadn’t had Z (sibling with ASD) as a sister, I would know nothing about it. It has been eye-opening (15-year-old TD sister). Personal growth also involved recognizing a “silver lining”despite the difficulties of the situation, as well as the feeling that, in general, having such a sibling had benefitted them. Some participants stated that having a sibling with ASD had provided them with useful strategies for dealing with day-to-day problems more effectively, showing signs of resilience, and readjustment after the changes due to having a sibling with ASD. I think it has helped me a lot to get things into perspective. I mean, when I encounter different problems, I just say, “There are people who are having a harder time, and there are people who have things that are actually incurable and that cannot be fixed”. So, that helps me a lot in my daily life; it enables me to say to myself, “Look, this problem is not as serious as it seems”; it helps calm me down (18year-old TD brother). Finally, personal growth involved the acknowledgment that having a sibling with ASD had enabled participants to develop and express a side of themselves that would not have been possible otherwise, not only in terms of knowledge and capacities but also in terms of personality traits. For example, a 23-year-old TD sister stated “then there’s also the issue of being more affectionate. I’m often harsh with people, with my parents; however, with him, I have that moment when I know he’s always going to hug me. He is unconditional”. Another example could be: My brother (sibling with ASD) is very, very, very affectionate. So, when he sees me, he gives me kisses and hugs; I love him so much. I feel very connected to him, and he is the only person I am that affectionate with, and I constantly give him kisses and hugs. (18year-old TD sibling). In summary, the theme of personal growth reflected the perception of finding benefits directly derived from having a sibling with ASD. This theme also pointed toward resilience factors in the TD siblings of individuals with ASD, and the capacity to readjust and find balance after the changes. Fig. 1 Summary and organization of themes and subthemes Journal of Child and Family Studies Life Plans This theme reflected participants’feelings that having a sibling with ASD had influenced their plans for their current and future life. These feelings included perceptions of increased levels of responsibility related to caring for their sibling with ASD and to shouldering more family responsibilities, highlighting higher levels of involvement in the family relationships. Some participants talked about this sense of increased responsibility as something natural, part of the readjustment the family had to do, with no negative connotations, while others felt it to be a burden. I’ve perhaps had to be more responsible more often than other people my age. I’ve taken on more responsibility on many occasions, such as staying home with my brother and taking care of him (…). But from my point of view, this is normal. (…)I’ve learned things beyond, let’s say, learning how to cook and how to manage some things at home before…but that’s just the way it is (20-year-old TD brother). Taking care of her, especially in situations where my parents are not there. Sometimes I have wanted to be in another place and not with her, but I have stayed with her. I am the first to take care of her because I know what I have to do, and other people don’t. In the future, I would like to take care of her (18-year-old TD sister). This category also reflected how having a sibling with ASD had impacted participants’careers and personal relationships. Regarding career choice, the female participants reported either working in “helping professions,”such as social work, psychology, or social education, or considering pursuing this career path. In all cases, the participants said that having a sibling with ASD had a definite impact on this choice which seemed to derive mainly from their socialization experiences i.e., from their experience with providing the services that their sibling with ASD needed. Their choice was also influenced by their sensitivity toward the needs of others as a result of their own experiences as a TD sibling. Ten years from now, I don’t know, I would like to see myself living on my own, with a career, working in or studying (….) psychology (…). It’s an area that has interested me since my sister began to go to all those doctors, and I saw how they were helping her, how they worked (14-year-old TD sister). Regarding personal relationships, some participants stated that having a sibling with ASD did not have an impact on their friendships, with their friends being aware of and talking openly about the situation. A TD sister (15 years old) said “I feel very proud of my sister. So…all my classmates know her, and at school when we meet during recess, I say hello to her, and all of my friends greet her”. However, others felt that having a sibling with ASD has had an impact on their relationships, particularly during their sibling’s diagnostic process. A 17-year-old TD brother stated “when I first found out about it (sibling with ASD), I didn’ttell anyone. I kept it to myself. (…) I didn’t know how to tell people; I didn’t know how they were going to react…”. In summary, this theme reflected the ongoing process of the impact of having a sibling with ASD in different aspects of their lives, such as their caregiving role and their personal relationships. They not only perceived an influence in their current situation, such as their present relationship with their friends, but also reflected on how it has affected their past relationships and decisions about their future. Negative Feelings This theme reflected the emotional toll or negative impact associated with having a sibling with ASD. Although these negative feelings were not expressed frequently, they were particularly salient. The negative feelings expressed were solitude, anxiety/depression, and anger toward their sibling. Solitude emerged as a direct consequence of having a sibling with ASD. It was defined as a feeling of being alone even when surrounded by people. Feelings of solitude were accompanied by a sense of not being understood and a need to feel listened to. From the point of view of other siblings, maybe they need to talk and vent about that (referring to having a sibling with ASD) because none of the people I know understand my situation (…). So maybe I need that, too; I need to vent and say, “This is what’s happening to me”, but I don’t know how to do that (19-year-old TD sister). Other salient feelings were anxiety, depression, and anger. Although these feelings were discussed in general terms, they were usually associated with situations linked to the sibling with ASD and the inability to cope effectively with the negative emotions generated in situations of conflict. These negative feelings emerged more often when the sibling with ASD had either behavioral problems or aggressive episodes, which were seen to erode the relationship. A 12-year-old TD sister said “he hits a lot. When I don’t do what he wants, he hits me. When I’m too angry and stressed, I sometimes bite myself”and a 19-year-old TD sister mentioned “what is worse for me is when he hits me, when he comes to me and tries to hit me when I tell him Journal of Child and Family Studies no. He doesn’t understand when we tell him no. That makes me feel anxious”. In summary, TD siblings expressed negative emotions in certain situations, particularly when conflictive situations emerged or when the relationship with the sibling with ASD was negative; however, they did so rarely. Siblings in this study perceived an impact on different areas of their personal development, in both a positive and negative manner, which were not mutually exclusive. Some of these areas were related to their personality and identity construction, as individuals who are more tolerant or patient with others, as well as individuals who want to help others. They also reflected on the impact on their social, emotional and cognitive development. For example, some TD siblings mentioned their social relationships and feelings of solitude even when surrounded by others, along with the development of cognitive strategies they found useful to face other stressful situations. Dyadic Impact Dyadic impact encompassed themes linked to participants’ feelings of how having a sibling with ASD had impacted their relationship with their sibling and with their parents. We identified two broad themes related to these dyadic dimensions: desire for a “typical”sibling relationship and perceptions of differential parental treatment. Desire for a Typical Relationship with a Sibling with ASD This theme referred to the impact that having a brother or sister with ASD had on participants’relationship with that sibling. Participants sometimes defined their relationship with their sibling with ASD as being different from their relationships with other siblings or from their friends’ relationships with their siblings. They often expressed affection toward their sibling with ASD and generally defined their relationship in positive terms, indicating investment in the relationship. They even highlighted certain advantages such as arguing less or having a warmer and more affectionate connection. These positive feelings were often accompanied by a longing for a more typical relationship. This “normalized”relationship was mostly defined in terms of day-to-day subtleties (rather than significant changes in their relationship). What was hardest for me was…growing up and thinking “My friends act like older sisters to their siblings, and I act like an older sister too, but in a different way”. Not being able to talk about stuff, for example. But you understand it and accept it, and it’s worth it. Of course, I’d rather he didn’t have autism, but the role I play…I know I wouldn’t have the same relationship with him if he didn’t (23-year-old TD sister). I always think that if he didn’t have any problem, the small things, such as him saying hello, they wouldn’t have felt like an achievement, and now we are enjoying those little things. On the bad side, obviously I would have preferred for him not to have any problem and to be able to play calmly with him, for him to talk to me and all that (12-year-old TD sister). Interestingly, some participants not only longed for the positive aspects of a typical sibling relationship, such as confiding in each other but also for the negative ones, such as quarreling or arguing without feeling guilty, or having to behave as the “bigger person”. Even being able to fight back without having to always be in an understanding position. A TD brother (12 years old) stated “sometimes, when my brother is mad, he hits me, and I don’t like it, but I try not to hit him back, and I try to understand why he is mad”. Participants longed for more egalitarian investment in the sibling relationship with their sibling with ASD, where they could perceive a more equal contribution. This longing is common in both adolescent and young adult TD siblings, as in both cases they still lived at home, which is common in the Spanish culture. I think I feel worse because she has autism; if I had a sister who didn’t have this condition (referring to autism), I’d get mad at her, we’d argue, and then later, we’d talk about it and that would be that. But with her, it’s different. I can talk, but she doesn’t talk back, or I can’t explain to her what happened, and that’s what makes me feel so bad (29-year-old TD brother). Finally, young adult TD siblings manifested changes in their sibling relationship as a result of reaching adolescence. Most young-adult TD siblings considered adolescence as an important point in their relationship, as the differences became more apparent, along with feelings of drifting apart from each other and lower levels of investment from the TD sibling. “Before, I used to be more present and do more things with her (sibling with ASD), but as time goes by, I do fewer things with her (29-year-old TD brother)”. When they were younger, it was easier to share games and play together, but in adolescence, going out with friends and sharing other activities became more difficult. However, adolescent TD siblings focused more on the present relationship and not on the changes that might have happened throughout their development. What I did notice was that there was some distancing between I (sibling with ASD) and me and my friends Journal of Child and Family Studies when we reached the adolescent years; we moved on from him more and more, and we did not pay him much attention, because he had other interests (20year-old TD sibling). In summary, TD siblings, despite being generally satisfied with their sibling relationship, perceived differences in their relationship with their sibling with ASD, indicating both positive and negative elements of this relationship. Interestingly, the sibling relationship was expressed in realistic terms, meaning that they did not idealize the fraternal relationship, referring to longing for both the positive and more negative aspects of the sibling relationship. Young adults also provided a developmental perspective, where relationships are not static and change over time, pointing toward adolescence as a relevant developmental stage for both the TD sibling and the sibling with ASD. Although there were shared aspects of the relationships as in both developmental moments they were living together. They Do Not Treat Us the Same Way This theme captured how participants perceived their relationship with their parents in comparison with their sibling’s relationship with them. Participants viewed this differential treatment in either a neutral/positive or negative way. Neutral/Positive Appraisal of Differential Treatment This subtheme involved participants either attributing the differential treatment perceived to situational factors with no negative connotations or perceiving no differences in how their parents treat them and their sibling with ASD. Most participants perceived at least some degree of differential treatment by parents, with the main focus being differences in the attention received, which they mostly attributed to situational factors. The most common reasons given by participants for the differences were the fact that their sibling with ASD needed more attention or circumstances such as the age difference. They also pointed out that despite those differences, their needs had systematically been met, and they perceived that their parents had highly contributed to the relationship. This child-parent relationship also had particularities due to the fact that even in adulthood, TD siblings were still living at home, as it is frequent in the Spanish culture. Some participants even highlighted the advantages of their parent-child relationship in comparison with that of their sibling with ASD, referring to more bidirectional communication and greater possibilities for being autonomous. I see that my sister needs more attention than me because I understand more than her and all that, but… I think they treat us the same. I know that if I need their help, they will always be there for me and my brother (other sibling without ASD). But I get that she needs more attention (14-year-old TD sister). The difference is that they have to behave as if he was a baby; I also get the care that I want, so we each get what we need but in a different way. They haven’t prioritized him, even if they believe so; I don’t have that perception (23-year-old TD sister). Few participants perceived their parents were totally fair and equal in their treatment. They highlighted the fact that their sibling with ASD was scolded just as much when they argued or were disobedient. “It’s never seemed to me that they pay more attention to me than to him, or the other way around. I certainly don’t feel they are always with him and ignore me”(18-year-old TD brother). I might feel that they have to dedicate more time to take him to one place to another, but then they have taken me to where I needed to go, so I don’t perceive much difference. Even when we were little and he hit me, they scolded him, and if I hit him, they scolded me (23-year-old TD sister). In summary, despite the perception of differential parental treatment, the perceived impact of these differences was not negative. The TD siblings in this study rationalized and understood the reason behind these differences, attributing them mainly to situational factors. They also placed great emphasis on their own relationship with their parents as a factor in their positive attribution process. Negative Appraisal of Differential Treatment This subtheme reflected participants’negative experiences of perceived differential treatment by their parents and how they mostly attributed it to personal factors. Although these feelings were less common, a few participants talked about unfair differences between the way their parents treated their sibling with ASD and the treatment they themselves received. These negative attributions were accompanied by negative feelings toward the sibling with ASD. The negative feelings aroused were envy, the sense of being misunderstood, and the sense of not having enough time alone with their parents. The perception of low levels of investment and communication by their parents influenced not only the parent-child relationship but also the sibling relationship. Negative appraisal of differential parental treatment was manifested by TD siblings who expressed negative feelings at a personal level and in a more difficult family climate. A 18-year-old TD sister expressed “envy. It’s not that they take more care of her; they just interpret Journal of Child and Family Studies Petalas, M. A., Hastings, R. P., Nash, S., Dowey, A., & Reilly, D. (2009). “Ilikethathealwaysshowswhoheis”: the perceptions and experiences of siblings with a brother with autism spectrum disorder. International Journal of Disability, Development and Education,59(4), 381–399. https://doi.org/10.1080/103491203306715. Petalas, M. A., Hastings, R. P., Nash, S., Hall, L. M., Joannidi, H., & Dowey, A. (2012). Psychological adjustment and sibling relationships in siblings of children with autism spectrum disorders: Environmental stressors and the broad autism phenotype. Research in Autism Spectrum Disorders,6(1), 546–555. https:// doi.org/10.1016/j.rasd.2011.07.015. Quintero, N., & McIntyre, L. L. (2010). Sibling adjustment and maternal well-being: An examination of families with and without a child with an autism spectrum disorder. Focus on Autism and Other Developmental Disabilities,25(1), 37–46. https://doi. org/10.1177/1088357609350367. Rivers, J. W., & Stoneman, Z. (2008). Child temperament, differential parenting, and the sibling relationships of children with autism spectrum disorder. Journal of Autism and Developmental Disorders,38, 1740–1750. https://doi.org/10.1007/s10803-008-0560-z. Rodrigo, M. J., Amorós, P., Arranz, E., Hidalgo, M. V., Máiquez, M. L., Martín, J. C., Martínez, R. A., & Ochaita, E. (2015). Guía de buenas prácticas en parentalidad positiva. Un recurso para apoyar la práctica profesional con familias. FEMP. https://familia senpositivo.org/system/files/guia_de_buenas_practicas_2015.pdf. Ross, P., & Cuskelly, M. (2006). Adjustment, sibling problems and coping strategies of brothers and sisters of children with autistic spectrum disorder. Journal of Intellectual & Developmental Disability,31(2), 77–86. https://doi.org/10.1080/13668250600710864. Safran, S. (2017). Relationships between typically developing individuals and their siblings with autism spectrum disorder: A qualitative analysis (Master’s thesis), (Indiana University). https:// scholarworks.iu.edu/. Schmeer, A., Harris, V. W., Forthun, L., Valcante, G., & Visconti, B. (2021). Through the eyes of a child: Sibling perspectives on having a sibling diagnosed with autism. Research in Developmental Disabilities,119, 104066 https://doi.org/10.1016/j.ridd. 2021.104066. Scholte, R. H. J., Engels, R. C. M. E., de Kemp, R. A. T., Harakeh, Z., & Overbeek, G. (2007). Differential parental treatment, sibling relationships and delinquency in adolescence. Journal of Youth and Adolescence,36, 661–671. https://doi.org/10.1007/s10964006-9155-1. Schopler, E., Reichler, R. J., & Renner, B. R. (2002). The Childhood Autism Rating Scale (CARS). Western Psychological Services. Shivers, C. M. (2019). Empathy and perceptions of their brother or sister among adolescent siblings of individuals with and without autism spectrum disorder. Research in Developmental Disabilities,92, 103451. https://doi.org/10.1016/j.ridd.2019.103451. Shivers, C. M., & McGregor, C. M. (2019). Brief report: Sibling feelings toward their brother or sister with or without autism or intellectual disability. Journal of Autism and Developmental Disorders,49(1), 404–409. https://doi.org/10.1007/10803-0183694-7. Shivers, C. M., Deisenroth, L. K., & Taylor, J. L. (2013). Patterns and predictors of anxiety among siblings of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(6), 1336–1346. https://doi.org/10.1007/s1083-012-1685-7. Shivers, C. M., Jackson, J. B., & McGregor, C. M. (2019). Functioning among typically developing siblings of individuals with autism spectrum disorder: A meta-analysis. Clinical Child and Family Psychology Review,22(2), 172–196. https://doi.org/10. 1007/s10567-018-0269-2. Siemann, J. K., Veenstra-VenderWeele, J., & Wallace, M. T. (2020). Approaches to understanding multisensory dysfunction in autism spectrum disorders. Autism Research,13(9), 1430–1449. https:// doi.org/10.1002/aur.2375. Tracy, S. J. (2010). Qualitative quality: Eight “big-tent”criteria for excellent qualitative research. Qualitative Inquiry,16(10), 837–851. https://doi.org/10.1177/1077800410383121. Tsai, H. J., Cebula, K., & Fletcher-Watson, S. (2016). Influences on the psychosocial adjustment of children with autism spectrum disorder in Taiwan and the United Kingdom. Research in Autism Spectrum Disorders,32, 115–129. https://doi.org/10.1016/j.rasd. 2016.09.007. Tsai,H.J.,Cebula,K.,Liang,S.H.,&Fletcher-Watson,S.(2018). Siblings’experiences of growing up with children with autism in Taiwan and the United Kingdom. Research in Developmental Disabilities,83, 206–216. https://doi.org/10.1016/j.ridd.2018.09.001. Tudor, M. E., Rankin, J., & Lerner, M. D. (2018). A model of family and child functioning in siblings of youth with autism spectrum disorder. Journal of Autism and Developmental Disorders,48(4), 1210–1227. https://doi.org/10.1007/s10803-017-3352-5. del Valle, J. F., Canali, C., Bravo, A., & Vecchiato, T. (2013). Child protection in Italy and Spain: Influence of the family supported society. Psychosocial Intervention,22, 227–237. https://doi.org/ 10.5093/in2013a26. Walton, K. M. (2016). Risk factors for behavioral and emotional difficulties in siblings of children with autism spectrum disorder. American Journal on Intellectual and Developmental Disabilities, 121, 533–540. https://doi.org/10.1352/1944-7558-121.6.533. Walton, K. M. (2019). Leisure time and family functioning in families living with autism spectrum disorder. Autism,23(6), 1384–1397. https://doi.org/10.1177/1362361318812434. Ward, B., Smith-Tanner, B., Mandleco, B., Dyches, T. T., & Freeborn, D. (2016). Sibling experiences: Living with young persons with autism spectrum disorders. Pediatric Nursing,42(2), 69–76. Watson, L., Hanna, P., & Jones, C. J. (2021). A systematic review of the experience of being a sibling of a child with an autism spectrum disorder. Clinical Child Psychology and Psychiatry, 26(3), 734–749. https://doi.org/10.1177/13591045211007921. Zabriskie, R. B., & McCormick, B. P. (2001). The influences of family leisure patterns on perceptions of family functioning. Family Relations,50(3), 281–289. https://doi.org/10.1111/j.1741-3729. 2001.00281.x. Zabriskie, R. B., & McCormick, B. P. (2003). Leisure involvement and satisfaction with family life. Journal of Leisure Research, 35(2), 163–189. https://doi.org/10.1080/00222216.11949989. Journal of Child and Family Studies