Influence of hearing loss on sibling relationships: Perspectives of the normal hearing sibling.

BACKGROUND: Sibling relationships, one of the most extended relationships in life, contribute to an individual's social and emotional development. However, this relationship may be influenced if one sibling has a hearing loss. OBJECTIVES: This study explored the influence of a hearing loss on the sibling relationship by gaining the perspectives of the sibling with normal hearing. METHOD: Adopting a phenomenological research design, semi-structured online interviews were conducted using Zoom and WhatsApp with nine participants who have siblings with hearing loss. RESULTS: Hearing loss may significantly impact the normal hearing sibling's quality of life, affecting their psychological and social well-being, familial and peer relationships and overall experiences. Personal development, independence, maturity and closer sibling bonds were some of the positive influences reported by the participants. Attendance to aural rehabilitation therapy sessions, knowledge of hearing loss, personalities and household living arrangements positively influenced the relationship between siblings. The lack of attendance to aural rehabilitation sessions resulted in communication difficulties between siblings. CONCLUSION: There is a need to include siblings in aural rehabilitation and family engagements related to the child with hearing loss to provide a holistic and more effective rehabilitation and adjustment process.Contribution: This study aimed to improve family-centred intervention as it is focussing on the siblings' perspectives of the hearing loss. Furthermore, previous studies have generally focussed on adults and not much research has been conducted surrounding the sibling relationship.

Factors Affecting Quality of Life in Adolescent Siblings of Children With Autism Spectrum Disorder.

OBJECTIVE: To compare the quality of life (QoL) of adolescent siblings of children with autism spectrum disorder (ASD-Sibs) with siblings of typically developing children (TD-Sibs), and study the factors affecting the QoL. METHODS: Between 1 February, 2021 and 31 September, 2021, 40 children aged 10-18 years, whose sibling was suffering from ASD, were enrolled (Study group). 40 age- and sex-matched siblings of children with no clinically apparent neuro- developmental abnormality or behavioral problem were also enrolled (Control group). Severity of autism was assessed by using the childhood autism rating scale 2 (CARS-2) score. QoL was assessed by a validated version of the World Health Organi-zation Quality of Life questionnaire Brief version (WHO QoL BREF), and compared between cases and controls using Wilcoxon rank sum test. RESULTS: The mean (SD) age of study participants was 13.55 (2.75) years. The mean (SD) CARS-2 score of our sample was 35.78 (5.23). Mild to moderate autism was seen in 23 (57.5%) children, and 13 (32.5%) had severe autism. The median (IQR) QoL in ASD-Sibs was worse than TD-Sibs in physical domain (24 (19,26) vs 32 (29,32); P<0.001), psychological domain (22 (17,23) vs 25 (23,25); P<0.001), social domain (11 (8,12) vs 13 (11,14); P<0.001), and environmental domain (28 (26,31) vs 35 (31,35); P<0.001). Among the ASD-Sibs, severity of the sibling's ASD and the family's socioeconomic status were the only two factors significantly affecting one of the domains of QoL. CONCLUSION: The observed lower QoL score in adolescent siblings of children with ASD, more so in those whose siblings had more severe ASD, suggests the need for targeting the family as a unit while formulating plans for holistic management of children with ASD.

Was Cinderella just a fairy tale? Survival differences between stepchildren and their half-siblings.

The death of a parent, particularly the mother, is linked to a suite of negative outcomes across the life-course. Compounding concerns for child outcomes are expectations of poor treatment by step-parents after parental remarriage. Indeed, folk tales of step-parental abuse abound cross-culturally and are embedded into stories taught to children. To understand why child outcomes might be sensitive to levels of relatedness within the household, evolutionary-oriented research targets patterning in parental expenditure in ways predicted to maximize inclusive fitness. In particular, parents are expected to prioritize investments in their biological children. However, stepfamilies are only formed after children experience multiple unfortunate events (e.g. parental loss, poverty), blurring causal interpretations between step-parental presence and stepchild outcomes. Moreover, stepchildren have been shown to be integral to household functioning, caring for their half-siblings and stabilizing relationships. These results challenge narrow views of adaptive behaviour; specifically, that step-parents, unlike biological parents, do no stand to reap fitness benefits from the care that they provide to their stepchildren. To evaluate these critiques, we analyse the survival outcomes of stepchildren. We include over 400 000 individuals from across a natural fertility period (1847-1940) in the United States state of Utah and examine the consequences of parental loss and step-parental introduction. Our analyses yield three key results: (i) exposure to maternal loss in childhood is associated with elevated mortality risk, (ii) parental remarriage does not increase the risk of mortality among stepchildren compared to non-stepchildren who too had lost a parent, and (iii) stepchildren enjoy higher survival than their half-siblings within the same family. Ultimately, this work contributes to the increasingly recognized importance of cooperative relationships among non-kin for childcare and household functioning. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Association of Maternal Prenatal Vitamin Use With Risk for Autism Spectrum Disorder Recurrence in Young Siblings.

Importance: Maternal use of folic acid supplements has been inconsistently associated with reduced risk for autism spectrum disorder (ASD) in the child. No study to date has examined this association in the context of ASD recurrence in high-risk families. Objective: To examine the association between maternal prenatal vitamin use and ASD recurrence risk in younger siblings of children with ASD. Design, Setting, and Participants: This prospective cohort study analyzed data from a sample of children (n = 332) and their mothers (n = 305) enrolled in the MARBLES (Markers of Autism Risk in Babies: Learning Early Signs) study. Participants in the MARBLES study were recruited at the MIND Institute of the University of California, Davis and were primarily from families receiving services for children with ASD in the California Department of Developmental Services. In this sample, the younger siblings at high risk for ASD were born between December 1, 2006, and June 30, 2015, and completed a final clinical assessment within 6 months of their third birthday. Prenatal vitamin use during pregnancy was reported by mothers during telephone interviews. Data analysis for this study was conducted from January 1, 2017, to December 3, 2018. Main Outcomes and Measures: Autism spectrum disorder, other nontypical development (non-TD), and typical development (TD) were algorithmically defined according to Autism Diagnostic Observation Schedule and Mullen Scales of Early Learning subscale scores. Results: After exclusions, the final sample comprised 241 younger siblings, of which 140 (58.1%) were male and 101 (41.9%) were female, with a mean (SD) age of 36.5 (1.6) months. Most mothers (231 [95.9%]) reported taking prenatal vitamins during pregnancy, but only 87 mothers (36.1%) met the recommendations to take prenatal vitamins in the 6 months before pregnancy. The prevalence of ASD was 14.1% (18) in children whose mothers took prenatal vitamins in the first month of pregnancy compared with 32.7% (37) in children whose mothers did not take prenatal vitamins during that time. Children whose mothers reported taking prenatal vitamins during the first month of pregnancy were less likely to receive an ASD diagnosis (adjusted relative risk [RR], 0.50; 95% CI, 0.30-0.81) but not a non-TD 36-month outcome (adjusted RR, 1.14; 95% CI, 0.75-1.75) compared with children whose mothers reported not taking prenatal vitamins. Children in the former maternal prenatal vitamin group also had statistically significantly lower autism symptom severity (adjusted estimated difference, -0.60; 95% CI, -0.97 to -0.23) and higher cognitive scores (adjusted estimated difference, 7.1; 95% CI, 1.2-13.1). Conclusions and Relevance: Maternal prenatal vitamin intake during the first month of pregnancy may reduce ASD recurrence in siblings of children with ASD in high-risk families. Additional research is needed to confirm these results; to investigate dose thresholds, contributing nutrients, and biologic mechanisms of prenatal vitamins; and to inform public health recommendations for ASD prevention in affected families.

Arteterapia familiar en oncología pediátrica / Family art therapy in pediatric oncology

El cáncer infantil tiene efectos emocionales no solo en el niño enfermo, sino en todo el sistema familiar. En este estudio se exponen los resultados de una investigación sobre arteterapia con familias en fase de vuelta a casa tras el ingreso en oncología pediátrica. Objetivo: El objetivo de investigación principal consiste en comprender la dinámica familiar durante el proceso creativo para poder intervenir en la restructuración familiar mediante un programa de arteterapia. Con este estudio se busca desarrollar una metodología de trabajo específica con la que ofrecer un acompañamiento terapéutico a las familias en la fase de vuelta a casa. Método: Durante tres años se ha llevado a cabo un programa de arteterapia en el que han participado 10 familias (36 personas). Los datos obtenidos del trabajo de campo se han utilizado para posteriormente poder realizar un análisis cualitativo e inferir una fundamentación teórica al respecto (Grounded Theory). Resultados: Este estudio muestra que el trabajo arteterapéutico conjunto a lo largo de los meses ayuda a los miembros a explorar maneras alternativas de relacionarse, a adaptar sus roles a la realidad que están viviendo y a utilizar el lenguaje simbólico para expresar conceptos y emociones para los que habitualmente las palabras resultan insuficientes. Conclusiones: El programa arteterapéutico en la fase de vuelta a casa permite incidir en algunos problemas propios del proceso de readaptación. Ampliar el foco de intervención al sistema familiar ayuda a los miembros a compartir sus experiencias y crecimiento personal tras el impacto del cáncer infantil (AU)

Childhood cancer diagnosis has emotional effects not only on the child with cancer, but also on the family system. This study presents the results of a research project about art therapy with families of children with cancer after discharge from a pediatric ward. Objectives: The main objective of the research project is to understand the family dynamics during the creative process. The aim is to develop a specific methodology to offer a therapeutic support to the families when they return home. Method: Over three years 10 families (36 people) have taken part in the art therapy study. After the therapeutic program finalized, the results were analyzed using a qualitative methodology and relate with the Grounded Theory. Results: This studio showed that the overall effect of the family art therapeutic intervention during this period was helpful allowing family members to explore alternative ways of relating, to adapt their roles to the situation they are living and to use symbolic language to express ideas and emotion when words are not enough. Conclusions: The art therapeutic program on the return home after a pediatric ward admission helps the family to face some problems related to the readaptation process. Broaden the therapeutic approach to the family system helped the family members to share their experiences and personal growth after the impact of the childhood cancer (AU)

"It's Just for Us!" Perceived Benefits of Participation in a Group Intervention for Siblings of Children With Cancer.

Objective: This qualitative substudy aimed to investigate the outcomes of sibling group interventions from the perspective of siblings of children with cancer and their caregivers. Method: Siblings were randomized to receive the Siblings Coping Together intervention (SibCT) or attention control (CG). In all, 30 participants, 18 siblings (average age = 11.89 years, 9 CG and 9 SibCT) and 12 caregivers (4 CG and 8 SibCT), were interviewed following group participation. SibCT consists of eight 2-hr manualized sessions delivered weekly; in each session, it combines arts and crafts and cognitive-behavioral strategies structured around a specific theme (family or school). The CG is structured only around arts and crafts. Interviews were analyzed using content analysis. Results: Themes common to both groups included the following: having a group just for siblings, improving family relationships, and feeling reassured of parental role. Themes unique to the SibCT group included the following: learning program targets, increasing self-confidence, feeling less different, and connecting caregivers and siblings through homework. Themes unique to the control group included the following: being a good helper and being in the hospital for positive reasons. Conclusion: This study uncovered additional intervention effects not captured in quantitative measures. Whereas benefits were noted in both groups and speak to the importance of support for siblings in general, positive personal and relational changes unique to siblings in the SibCT group and their caregivers support the importance of specific interventions focused on problem-solving siblings' issues.

Effects of Art Intervention Program for Siblings of Children With Cancer: A Pilot Study.

Siblings of children with cancer often experience negative feelings, and art intervention can help them express their feelings and overcome hardships. This study aimed to develop an Art Intervention Program to improve the psychological adaptation of siblings of children with cancer and to evaluate its effects. Participants were seventeen 7- to 10-year-old siblings of children with cancer. The program comprised 12 sessions conducted once a week. The effects of the intervention were assessed in terms of self-esteem, anxiety, depression, and problem behavior. Self-esteem significantly improved after intervention compared with pretest. Children showed improved scores in externalizing problems and total behavior problems; however, anxiety and depression did not change. The study results indicated that the art intervention program helped improve the self-esteem and helped reduce somatic symptoms, aggressiveness, externalizing problems, and emotional instability among problem behaviors of siblings of children with cancer. However, the study was limited by its small sample size and the lack of a control group. Therefore, the study design allows no firm conclusions, and a randomized controlled trial is needed to investigate the effectiveness of the program.

SIBLING CONFLICTS IN FULL- AND HALF-SIBLING HOUSEHOLDS IN THE UK.

Sibling relations are by nature ambivalent with high levels of both altruistic helping and competition. Higher relatedness is often assumed to reduce the occurrence of conflicts between siblings, but evidence of this has been scarce and mixed. Siblings typically compete over resources and parental attention, and parental constellations vary with sibship types. Since full-siblings compete over the same two biological parents, while half-siblings have only one shared biological parent and often a higher number of parents overall, it is hypothesized that conflicts are more common between full- than half-siblings. This study tested this assumption using the British Millennium Cohort Study (n=7527 children at age 11). Conflicts were measured as children's reports of how much siblings picked on and hurt each other. Households with full-siblings only, maternal half-siblings only, and both full- and maternal half-siblings were compared. The results show that children who were living with only their full-siblings were more likely to experience sibling conflicts compared with children living with their maternal half-siblings only. This was the case also after controlling for several potentially confounding variables. The results suggest that differential access to parental resources of available biological and step-parents may explain the higher amount of sibling conflict between full- compared with maternal half-siblings.

Constructing and enacting kinship in sister-to-sister egg donation families: a multi-family member interview study.

Although intra-familial egg donation has been practiced for more than 15 years in several countries, little is known about family relationships in this family type. Framed within the new kinship studies, this article focuses on the experiential dimension of kinship in sister-to-sister egg donation families: how is kinship 'unpacked' and 'reconstructed' in this specific family constellation? Qualitative data analysis of interviews with receiving parents, their donating sisters and the donor children revealed six themes: (1) being connected as an extended family; (2) disambiguating motherhood; (3) giving and receiving as structuring processes; (4) acknowledging and managing the 'special' link between donor and child; (5) making sense of the union between father and donor; and (6) kinship constructions being challenged. This study showed the complex and continuous balancing of meanings related to the mother-child dyad, the donor-child dyad and the donor-father dyad. What stood out was the complexity of, on the one hand cherishing the genetic link with the child allowed by the sisters' egg donation, while, on the other, managing the meanings related to this link, by, for instance, acknowledging, downsizing, symbolising, and differentiating it from the mother-child bond. (A Virtual Abstract of this paper can be accessed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA).

How holistic nursing can enhance the quality of life of children with cystic fibrosis.

Cystic fibrosis (CF) is one of the most common life-limiting genetic conditions. This article presents a case study of a teenager with one of the rarer presentations of CF. This case study explores the experiences of her and her family. It also discusses the effects of CF on the patient and her family, and how it affects their quality of life and well-being.

Maternal experience of Lego Therapy in families with children with autism spectrum conditions: What is the impact on family relationships?

This study aimed to explore mothers' experience of implementing Lego Therapy at home within the family. Following a Lego Therapy training session, mothers carried out hourly sessions with their child with an autism spectrum condition and the child's sibling, once a week, for 6 weeks. Mothers were interviewed following the intervention, and the data were analysed using interpretative phenomenological analysis. Themes emerged around improved family relationships, a positive impact on the child as an individual, and changed maternal, sibling and child perspectives. Challenging and facilitative aspects also emerged, as did some ambivalence about the impact of the intervention in the wider context. The findings are supportive of previous Lego Therapy studies and have implications for strengths-based service provision.

Psychological Adjustment of Siblings of Children with Autism Spectrum Disorder in Hong Kong.

OBJECTIVES: Findings about the psychological adjustment of siblings of children with autism spectrum disorder have been inconsistent in western literature and little is known among non-western societies. This study explored the psychological adjustment of siblings of children with autism spectrum disorder in Hong Kong. METHODS: A total of 116 families with siblings of children with autism spectrum disorders co-morbid with learning disability were included in the study. Parents completed questionnaires about sibling emotional and behavioural adjustment, and their own mental well-being, quality of life, and family functioning. Siblings completed a questionnaire on their relationship with the autistic proband. RESULTS: Parent ratings did not reveal any significant negative impact on the emotional and behavioural adjustment of the typically developing siblings of children with autism spectrum disorder, but there were concerns about their peer relationships and weak prosocial behaviours. When cut-off scores were used to screen for risk of mental health problems, a quarter of the siblings warranted further assessment. Parents' quality of life and family functioning were significant predictors of sibling adjustment. CONCLUSIONS: In managing children with autism spectrum disorder, it is necessary to bear in mind the adjustment of their siblings, especially their peer relationships and prosocial behaviour. Adopting a holistic approach to address the psychosocial needs of the parents can facilitate sibling adjustment.

Participation in siblings׳ birth at home from children׳s viewpoint.

BACKGROUND: partners often participate in childbirth, and the effects on both partners have been intensively investigated, but children׳s participation is rare in western countries and less studied. Thus, the aim of this study was to explore and construct a comprehensive structure of meaning of Finnish children׳s experiences of participating in birth of a sibling at home. DESIGN: a phenomenological study based on analysis of open-interview transcripts by Colaizzi׳s approach and drawings. PARTICIPANTS: seven children aged five to 17 years who participated in birth of a sibling at home. FINDINGS: the children׳s experience of participating in a sibling׳s birth was multifaceted. Their feelings varied from joy to worry, they helped their mother and learned from the experience. They chose to participate. They experienced overwhelmingly strong and positive feelings, but were also worried about the well-being of other family members during the birth. Further, younger children were frustrated, especially if the birth took a long time and they were not allowed to do all they wanted, such as going to a birthing pool. It was important for the children to be able to help their mother and support younger siblings. They learned a lot about childbirth from their participation and information given by the adults. The children regarded home as safe, cosy and a better place to give birth than a hospital. The older children also regarded a home birth as a possible choice for them in the future. They celebrated the baby׳s arrival and remembered the birth day as being joyful and happy. Participation in the sibling׳s birth made relationships between the children closer and warmer. Children felt hurt when people outside the family were suspicious when told that the baby was born at home. CONCLUSIONS: the children׳s experience of participating in a sibling׳s birth at home included varying feelings, learning from their experience and helping mother. The findings could be utilised in parent education if they are going to have their children with them during the childbirth.

Latino families with a child with Prader-Willi syndrome: exploring needs for support.

Prader-Willi syndrome (PWS) is a complex, genetically based disorder; caring for a family member with a disability such as PWS brings significant challenges to the whole family. However, no research has been conducted focusing on the impact of PWS in the dynamics of Latino families. This qualitative study explored the challenges and need for support services among Latino families of children with PWS. Findings of the study suggest the need for support services geared toward the whole family unit to help members cope with daily challenges at home.

Phenomenological aspects of hypnotic interactions: the effect of kinship.

This study analyzes the relationship of various measures of hypnosis as a function of kinship. Subjects with varying degrees of kinship (mono- and dizygotic twins, siblings, and parent-child pairs) participated. The Stanford Hypnotic Susceptibility Scale, Form A (SHSS:A), as well as other measures-including the Dyadic Interactional Harmony (DIH) and the Phenomenology of Consciousness Inventory (PCI)-were used with both subjects and hypnosis practitioners. Findings indicated that the phenomenological experience of hypnosis is not determined genetically. The subjects apparently evaluated the session as related to the degree of kinship. MZ twins-on the basis of reactive interactional pattern-evaluate the hypnotic interaction similarly. This was not true for SHSS:A scores or the phenomenological aspects of the state (PCI). These findings were interpreted within the sociopsychobiological model of hypnosis.

Play as a mechanism of working through medical trauma for children with medical illnesses and their siblings.

Children's reactions to medical trauma have been recorded through play. In this study, participants were 15 children with medical illnesses, 14 siblings of children with a medical illness, and 6 children in the community who did not have any ill family members. Children participated in play groups and their play with medical toys was videotaped and coded for themes that would provide a window on their perspectives. The play of children with medical illnesses and siblings was similar. Medical play was a mechanism for imaginal coping and working through stress related to medical experiences. In contrast, children in the comparison group did not engage in much medical play and when they did, they did not demonstrate a rich play experience with detailed medical stories. Future research should focus on ways to use play therapy techniques to help medically ill children and their siblings cope with their feelings and reactions to medical events related to chronic illness.

The pediatric sibling donor experience in hematopoietic stem cell transplant: an integrative review of the literature.

This integrative review explored and described published research findings focused on the experiences of pediatric sibling hematopoietic stem cell donors. After a comprehensive search, nine studies met the inclusion criteria of the study. There was no evidence of coordinated programs of research to effectively advance and build knowledge about the experiences of pediatric sibling donors. The limited descriptive evidence revealed that differences in the experiences of sibling donors vary by age and developmental stages; however, the use of small or repeated samples and qualitative methods limited the generalizability of study findings. Collaborative research using prospective, longitudinal designs will build and advance the evidence base for the design of developmentally appropriate interventions for pediatric sibling donors and their families.