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Keywords:

  • adults;
  • developmental disabilities;
  • relationships;
  • siblings

Abstract

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

The authors' first study compared participants' relationships between their siblings with and without a developmental disability (DD) and examined the effect of gender on sibling relationships. The second study explored how adults with a DD perceived their sibling relationships. Adults (n = 128) who had a sibling with and without a DD completed questionnaires about relationship closeness and contact. Participants reported more in-person and telephone contact with siblings with a DD and more positive feelings about the sibling relationship. Gender was not related to the relationship with a sibling with a DD, whereas sisters reported closer relationships and more contact with sisters without a DD as compared to brothers without a DD. Seventeen adults with a DD also completed interviews about shared activities, contact, and sibling support. Participants indicated a desire to spend more time with siblings and reported that they provided support to and received support from their siblings.

Siblings play an important role in the lives of individuals with and without disabilities. Cicirelli (1995) outlined five characteristics of sibling relationships that make them unique relative to other relationships. First, sibling relationships are often the longest relationships people will have in their lifetime as they typically start at birth or in the early childhood years and last until the death of one of the siblings. Second, unlike relationships with friends or intimate partners that are purposely selected, the relationship with the sibling is automatically created at birth (or in early childhood if a sibling is adopted). Regardless of whether siblings maintain contact with one another, they will always maintain the status of siblings. Third, sibling relationships tend to follow a pattern of closeness that changes over the life course. In childhood, most siblings live together and interact on a daily basis, whereas early and middle adulthood are characterized by decreased frequency of contact. In later adulthood, sibling relationship closeness tends to increase as the support network of older adults begins to decrease (Goetting, 1986). Fourth, despite differences in age, sibling relationships tend to be relatively egalitarian with both siblings having mutual feelings toward one another. Finally, siblings have shared and nonshared life experiences, and both types of experiences can influence the personal development of each sibling and can affect the sibling relationship.

Relationships with Siblings with a Developmental Disability in Adulthood

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

The presence of an individual with a developmental disability (DD) in the family can alter the experience of siblings without a disability. The relationship between the siblings with and without a DD often takes a more hierarchical form as the sibling with a DD is more reliant on the brother or sister without a DD for emotional and instrumental support. Additionally, siblings may have fewer shared life experiences, particularly as disability severity increases (Stoneman, 2005). Many siblings, including young children, also take on a caregiver role for their brother or sister with a disability (Bigby, 1997; McHale & Gamble, 1989). In adulthood siblings often anticipate greater caregiving responsibilities of their sibling with a DD as parents age (Greenberg, Seltzer, Orsmond, & Krauss, 1999; Krauss, Seltzer, Gordon, & Friedman, 1996), and many take on the role of primary caregiver once parents are no longer able (Bigby, 1997).

In recent years, there has been an increased interest in understanding the experiences of adults who have a sibling with a DD. Despite the changes that occur in the sibling relationship as a result of one sibling having a DD, adult siblings report close relationships (Hodapp, Urbano, & Burke, 2010) and regular in-person and telephone contact (Hodapp et al., 2010; Krauss et al., 1996) with their siblings with a DD. For many adults with a DD, their sibling is an integral component of their support network, particularly during adulthood (Krauss, Seltzer, & Goodman, 1992). However, the few studies that have included a comparison group show that siblings of individuals with a DD report less relationship closeness and less frequent contact than siblings of individuals without a DD (Doody, Hastings, O'Neill, & Grey, 2010; Taylor, Greenberg, Seltzer, & Floyd, 2008).

Relationship closeness and frequency of contact are important aspects of sibling relationships because they relate to psychological well-being of siblings, provision of support, and future caregiving expectations (Bigby, 1997; Greenberg et al., 1999; Seltzer, Greenberg, Krauss, Gordon, & Judge, 1997). Adult siblings who are emotionally close tend to desire a greater frequency of contact with one another (Scott, 1990) and provide more instrumental support to one another (Weaver, Coleman, & Ganong, 2003). Frequency of contact has typically been defined as in-person contact and telephone calls (e.g., Doody et al., 2010; Krauss et al., 1996; Orsmond & Seltzer, 2000; Spitze & Trent, 2006). However, with the proliferation of new technology, alternative forms of communication such as e-mail, text messaging, and social media Web sites are increasingly common methods of maintaining contact with siblings (Corti, 2009). Siblings' use of these newer methods of communication has not yet been examined in families of individuals with a DD.

Relationships between Siblings without a DD in Families of Individuals with a DD

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

One sibling relationship that has largely been ignored is the relationship between siblings without DDs who also have a sibling with a DD. Based on family systems theory, the relationship between two members of a family affects the relationship between other family members (Seltzer, Begun, Seltzer, & Krauss, 1991). In families that include an individual with a DD, parents may direct more attention to their child with a disability (Ferraioli & Harris, 2010; Schuntermann, 2007) because these children are less independent with activities of daily living skills and many have more frequent behavioral problems (Baker, Blacher, & Olsson, 2005; Stores, Stores, Fellows & Buckley, 1998). Additionally, having a child with a DD can contribute to marital discord between parents (Floyd & Zmich, 1991). In adulthood, siblings and parents are faced with finding a balance in caregiver expectations related to the sibling with a DD, and they often have to navigate the process of making decisions regarding care for the individual with a DD when parents can no longer perform this function.

Family systems theory would suggest that the parent/children, parent/parent, and sibling with a DD/sibling without a DD interaction described earlier will affect the relationship between siblings in the family who do not have a DD. Thus, the research that shows that sibling dyads that do not include an individual with a DD have greater relationship closeness and more frequent contact as compared to dyads that include an individual with a DD cannot be generalized to sibling pairs that do not include an individual with a DD but who have another sibling with a DD (Doody et al., 2010; Taylor et al., 2008). An investigation of this latter type of sibling pair is warranted to determine whether siblings of an individual with a DD are closer to their siblings without a DD, similar to the general population, or whether the family environment alters this relationship.

Gender and Sibling Relationships

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

The general sibling literature and the DD sibling literature show that gender is an important aspect of sibling relationship characteristics. Akiyama, Elliot, and Antonucci (1996) outlined two gender-related principles thought to play a role in close relationships in adulthood. The principle of femaleness suggests that a greater number of women within a relationship pair will result in a closer relationship. Based on this principle, sister–sister dyads would have the closest relationships, with brother–brother dyads being the least close, and sister–brother dyads falling in between. In contrast, the principle of sex commonality suggests that greater relationship closeness is found in same-sex pairs as opposed to opposite-sex pairs. Thus, based on this principle, sister–sister and brother–brother dyads would have closer relationships than sister–brother dyads. Although findings are mixed, the general sibling literature seems to offer more support for the principle of femaleness than the principle of sex commonality. For example, sisters have been found to be more frequent providers of sibling support than brothers (Campbell, Connidis, & Davies, 1999; Connidis, 1994; Connidis & Campbell, 1995; Wilson, Calsyn, & Orlofsky, 1994), report closer relationships, and contact each other more frequently via telephone (Spitze & Trent, 2006).

Orsmond and Seltzer (2000) examined the principles of femaleness and sex commonality in adult siblings of individuals with a DD. In support of the principle of femaleness, they found that compared to brothers, sisters provided more instrumental support to their siblings with a DD and reported more positive feelings toward their sibling with a DD. Similar to these findings, Greenberg et al. (1999) reported that sisters provided more emotional support and were more likely to expect to be a future caregiver for their sibling with a DD as compared to brothers. Orsmond and Seltzer (2000) concluded that the increased prominence of the principle of femaleness in siblings of individuals with a DD may relate to the greater caregiving expectations placed on sisters from early childhood onward.

The Orsmond and Seltzer (2000) study and the Greenberg et al. (1999) study support the principle of femaleness because sisters reported closer relationship characteristics with the sibling with a DD than did brothers. However, in both studies, the gender of the sibling with a DD was irrelevant. The support, positive feelings, and caregiving expectations from sisters without a DD were the same toward sisters with a DD as they were toward brothers with a DD. To fully support the principle of femaleness, which posits that more females in the sibling dyad result in closer relationships, sister–sister dyads should report closer relationship characteristics than sister–brother dyads. The failure of these studies to fully support the principle of femaleness may relate back to Orsmond and Seltzer's (2000) conclusion regarding the greater caregiving expectations placed on sisters, as these expectations are likely equally prominent regardless of the gender of the individual with a DD, thus resulting in similar relationship closeness for sister–sister and sister–brother dyads. Additionally, Taylor et al. (2008) posit that families of individuals with a DD may have higher levels of solidarity compared to families that do not include a child with a disability, which results in siblings sharing a belief from a young age that they play an important role in the care of their brother or sister with a DD. To our knowledge, no studies have examined how gender relates to sibling relationship characteristics in adult sibling dyads that do not include an individual with a DD but who have another sibling with a DD.

Perspectives of Siblings with a DD

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

By their very nature, sibling relationships are bidirectional, and thus, they affect both members of the sibling dyad. For over a decade, researchers have highlighted the need to include adults with a disability as participants in sibling research (e.g., Heller & Kramer, 2009; Seltzer & Krauss, 1993; Stoneman, 2005); however, little progress has been made in this regard. Bigby (1997) conducted a qualitative study examining the role of siblings in the lives of older adults with a DD. Although she interviewed adults with a DD, the qualitative data from those interviews were combined with the data collected from other informants (e.g., siblings, service providers, etc.). To our knowledge, no other studies have examined adult sibling relationships from the perspective of individuals with a DD.

Proxy respondents (e.g., mothers, caregivers) are often used in research related to individuals with a DD. Froese, Richardson, Romer, and Swank (1999) compared the responses of proxy respondents to those of individuals with a DD to determine the consistency of responses between the two groups. They found that although the agreement in responses was high between the two groups on many questions, a considerable portion of relationship questions (e.g., questions regarding where people with a DD would like to meet new people and whether they would like a romantic relationship) showed disagreement between the responses given by the individuals with a DD and the proxy respondents. These findings highlight the importance of including the perspectives of individuals with a DD in relationship research. Regarding sibling relationships, proxy respondents can likely provide accurate information regarding frequency of sibling contact or help provided to the sibling with a DD. However, proxy responses may be less accurate for more subjective information, such as whether the individual with a DD is satisfied with the amount of time spent with siblings, how the individual with a DD perceives the exchange of support between siblings, and the sibling with a DD's understanding of the reasons their siblings do not spend more time with them.

Study Objectives and Hypotheses

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

We conducted two studies to examine sibling relationship characteristics from the perspective of adults with and without a DD. In the first study, we aimed to compare participants' relationships with their siblings with a DD to their relationships with their siblings without a DD. Additionally, we examined the impact of gender on the sibling relationship. In the second study, we sought to examine the sibling relationship from the perspective of adults with a DD.

In Study 1, we addressed four research questions. First, we compared the frequency of sibling contact between participants (adults without a DD) and their sibling with a DD to contact between participants and their sibling without a DD. Second, we compared the sibling relationship closeness between these two sibling dyad types. We anticipated that as per family systems theory, the relationship with the sibling with a DD would affect the relationship with the sibling without a DD (Seltzer et al., 1991). Thus, we predicted that the greater caregiving responsibility and family solidarity toward the sibling with a DD would result in more frequent contact and increased relationship closeness as compared to the relationship with the sibling without a DD.

The third research question examined whether sisters had more frequent contact with their sisters or brothers, with and without a DD. The final research question explored whether sisters had greater relationship closeness with their sisters or brothers, with and without a DD. (It should be noted that due to the small sample size of brothers who volunteered to participate, we were not able to examine frequency of contact and relationship closeness for brothers.) Consistent with previous research (Greenberg et al., 1999; Orsmond & Seltzer, 2000), we predicted that sisters would report no difference in frequency of contact or sibling relationship closeness in their relationships with their brothers with a DD versus their sisters with a DD. In contrast, we anticipated that the principle of femaleness (Akiyama et al., 1996) would be withheld in the sibling dyads that did not include an individual with a DD. Thus, we predicted that sisters would report greater frequency of contact and sibling relationship closeness with their sisters without a DD as compared to their brothers without a DD.

The objective of Study 2 was to examine how individuals with a DD perceive the following sibling relationship characteristics: sibling relationship closeness, activities enjoyed with siblings, satisfaction with time spent with siblings, methods of sibling contact, and exchange of support between siblings. This study was exploratory in nature, and although we did not propose specific hypotheses, we expected that adults with a DD would perceive their sibling relationships as beneficial and important.

Method

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

Participants

Study 1

This study included 128 adults (108 women and 20 men), age 19 to 63 (M = 39.82, SD = 11.86), who had at least one living adult sibling with DD and at least one living adult sibling without DD. We excluded adults whose siblings were children or were deceased.

Study 2

Seventeen adults with a DD (7 men and 10 women) and their parent/guardian participated in this study. The adults with a DD ranged in age from 22 to 66 (M = 35.88, SD = 12.96). Of the 17 adults with a DD, four had an intellectual disability due to an unknown cause, eight had Down syndrome, one had an autism spectrum disorder (ASD), two had an intellectual disability caused by birth trauma, and two had other syndromes. The parents/guardians (1 man and 16 women) included ten biological parents, one adoptive parent, five siblings, and one caregiver who had known the adult with a DD for 7 years. They ranged in age from 31 to 78 (M = 58.12, SD = 13.82). Eight of the parents/guardians lived with the adult with a DD, two lived with them part-time, and seven did not currently live with them.

It is important to note that the participants in Study 1 were not related to the participants in Study 2.

Measures

Study 1

The Demographic Questionnaire asked participants about their gender, age, marital status, employment status, annual household income, the highest level of education they have achieved, the number of children they have, their country of origin, and the country in which they currently live.

The Family Structure Questionnaire was developed for this study and asked participants to provide the following demographic information about their parents: type of parent relationship (e.g., biological, step, etc.), gender, age, and whether the parent is deceased. This measure also asked participants to provide demographic information about all of their siblings, including type of sibling relationship (e.g., biological, step, etc.), gender, age, whether the sibling has a DD, whether the sibling is deceased, whether the sibling lived with the participant during childhood, and whether the sibling is currently involved in the participant's life.

In the Information about Siblings Questionnaire, participants provided information about their siblings' gender, age, cause of disability, level of intellectual ability, and where their sibling lives (e.g., with parents). This measure also asked about the age and gender of the participants' siblings without a disability.

The Scales of Independent Behavior–Revised Short Form (SIB-R; Bruininks, Woodcock, Weatherman, & Hill, 1996) assesses an individual's everyday living skills. Participants only completed this scale based on their sibling with a disability, not on their sibling without a disability. The SIB-R measures adaptive behavior including motor, social interaction, communication, and personal living skills, as well as maladaptive behavior. This study only included the Adaptive Behavior scale, which consists of 40 tasks that are progressively more difficult. Respondents rate the ability of the individual with DD to do each of the tasks using a 4-point scale ranging from 0 (never or rarely) to 3 (does very well). Total raw scores on the Adaptive Behavior scale range from 0 to 120, and higher scores indicate higher adaptive functioning. The SIB-R Short Form has good test–retest reliability (.86) and construct validity (.95 overall; Bruininks et al., 1996).

The Sibling Contact Questionnaire was designed for this study. It contains six items and asks participants about the type, frequency, and quality of contact they have with their siblings. The first three items ask about frequency of three types of contact: in-person, telephone, and other contact (e.g., e-mail, letters, text message, etc.). Participates rate each item using a 6-point scale (0 = never, 1 = less than once per month, 2 = 1 to 3 times per month, 3 = 1 to 3 times per week, 4 = 4 to 6 times per week, 5 = daily). If the participants indicate that they never have a certain type of contact with their sibling, they are asked to indicate the reason. The fourth item asks participants whether they have had any changes in contact with their sibling over the past 2 years, and if yes they are asked to describe the change and the reason for it. The fifth item asks about how long it takes for participants to get to their sibling's home, and responses were made on a 6-point scale (0 = N/A, my sibling lives with me, 1 = less than 30 minutes, 2 = 30 to 60 minutes, 3 = 1 to 2 hours, 4 = 2 to 3 hours, 5 = more than 3 hours).The final question asks participants to provide a qualitative response that describes the quality of contact they have with their sibling. Participants completed this measure twice–once based on their relationship with their sibling with a disability and once based on their relationship with their sibling without a disability.

The Lifespan Sibling Relationship Scale (LSRS; Riggio, 2000) measures an adult's perceptions about the sibling relationship. It consists of six scales containing eight items each: three of the scales focus on childhood and three focus on adulthood. This study only included the three adult scales: Adult Affect, which measures feelings toward the sibling and sibling relationship (e.g., “My sibling makes me happy”); Adult Behavior, which measures behaviors with and toward the sibling (e.g., “I presently spend a lot of time with my sibling”); and Adult Cognitions, which measures thoughts about the sibling and sibling relationship (e.g., “My sibling is a good friend”). Items are rated on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree), with higher scores representing more positive perceptions about the sibling relationship. The LSRS has good psychometric properties, including high internal consistency (Cronbach's α ranges from .87–.91 for the three adult scales) and good test–retest reliability (Riggio, 2000). Consistent with Riggio's (2000) findings, the LSRS demonstrated good internal consistency for this study. When completed based on the relationship with the sibling with a disability, Cronbach's α ranged from .83 to .89 for the three adult scales. When completed based on the relationship with the sibling without a disability, Cronbach's α ranged from .89 to .92 for the three adult scales.

Study 2

The Sibling Contact Interview for People with Disabilities was designed for this study and was used to collect information from the adults with a DD about how often they saw their siblings and how often they communicated with their siblings by telephone, e-mail, social networking, or other forms of communication. Participants were also asked a series of questions about the sibling they saw most often, including activities they enjoyed doing with the sibling, ways that their sibling helped them, the ways that they helped their sibling, whether they would like to spend more time with their sibling, and why they did not spend more time with their sibling.

The LSRS (Riggio, 2000) measures feelings, behaviors, and thoughts related to sibling relationships in adulthood and childhood. For this study, the LSRS was modified for use with the participants with a DD. We modified the language of the measure to a level that was appropriate for use with adults with mild to moderate intellectual disability. Similar to Study 1, this study only included the three adult scales: Adult Affect (e.g., “My sibling makes me happy”), Adult Behavior (e.g., “My sibling and I share things with each other”), and Adult Cognition (e.g., “My sibling thinks I am important”). Prior to completing the LSRS, each participant was asked a series of questions to determine their level of understanding of rating scales. If a participant was deemed able to use a 3-point scale, they made responses by indicating yes, sometimes, or no (responses were coded as 2, 1, and 0, respectively). If a 2-point scale was more appropriate, they made their responses by indicating yes or no (responses were coded as 2 and 0, respectively). Total possible scores for each scale ranged from 0 to 16, with higher scores representing greater relationship closeness. The internal consistency of the Behavior scale was good (Cronbach's α = .88); however, the internal consistency of the Affect and Cognition scales was unacceptably low (Cronbach's α = .38 and .49, respectively). The test–retest reliability was in the acceptable range for the Behavior and Cognition scales (r = .79 and .78, respectively); however, it was in the poor range for the Affect scale (r = .52).

The parent/guardian of the adults with a DD completed the Information about Adults with an Intellectual Disability–Parent Version in a telephone interview. This questionnaire was designed for this study and was used to collect further information about the adults with a DD who participated in the study. The questionnaire included demographic information about the parent/guardian (i.e., gender, birth year, and relationship to adult with a DD). Parents/guardians also provided information about with whom the adult with a DD lived, how long the parent/guardian had known the adult with a DD (if the parent/guardian was not a biological parent), and about the siblings of the adult with a DD (gender, age, and frequency of contact). Finally, the parent/guardian was asked about the cause(s) of the adult with a DD's disability.

Procedure

Study 1

This study consisted of a set of online questionnaires that took approximately 60 minutes to complete. We recruited participants through organizations across Canada and the United States that support people with disabilities and their family members, and we posted online notifications about the study on several public Web sites that are targeted toward family members of individuals with disabilities through the social media sites facebook.com and yahoo.com.

Participants completed the questionnaires using one of two methods. Most participants (97.0%) completed the questionnaires online using a confidential database designed for the purpose of data collection. Participants who preferred to complete the questionnaires in a paper format (3.0%) were mailed a paper copy of the questionnaires. Consistent with the approach used in previous sibling research in the DD field (e.g., Bigby, 1997; Orsmond & Seltzer, 2007; Seltzer et al., 1997), if the participant had more than one sibling with a disability or more than one sibling without a disability, they were asked to complete the sibling-related questionnaires based on the sibling with whom they had the closest relationship. As a thank you for their participation, individuals had the option of entering their name into a draw to win one of four $25 gift certificates to the Amazon Web site.

Study 2

We contacted various local community organizations that support individuals with DDs and requested their help with recruitment. If they were interested in assisting us, we then agreed on an approach to recruitment. One organization requested that we speak to the adults with DD first about the project and then contact the parents if the adult with DD was interested in participating. The remainder of the organizations requested that they pass along our recruitment information (e.g., e-mail, fliers) to the parents of the adults with DD. Then, those families who were interested in participating contacted us directly, and we arranged a time to complete an individual, in-person interview with the individual with a DD that took approximately 20 minutes to complete. We conducted interviews in locations that were convenient for the participant (e.g., at the agency where the participant was recruited or at a local fast-food restaurant). In order to evaluate the test–retest reliability of the modified LSRS used in this study, the adults with DD completed this measure twice–once during the initial interview and a second time two weeks later. The second interview only included the LSRS and took approximately 5 minutes to complete. We also conducted a telephone interview with the parent/guardian of the adult with DD that took about 15 minutes. During the interview, we completed the Information about Adults with an Intellectual Disability–Parent Version questionnaire with the parent and made arrangements to interview the adult with DD if necessary. As a thank you for their participation, individuals with a DD had the opportunity to enter their name into a draw to win a $10 gift certificate. The parents/guardians of the adults with DD did not receive any form of compensation for their participation.

Data Analysis

Study 1

To address the first research question, we conducted two paired samples t tests using frequency of in-person contact and frequency of telephone contact as the dependent variables (DVs) and sibling type (with a DD vs. without a DD) as the independent variable. Preliminary analyses showed a significant difference in age between siblings with and without a DD, and sibling age was correlated with use of “other” forms of communication. Thus, we conducted a repeated measures analysis of covariance (ANCOVA) with sibling age as a covariate to compare frequency of this type of contact between the two sibling types. Finally, we calculated the mean frequency of contact across the three modalities and conducted a paired samples t test to determine whether total contact with siblings with a DD differs from total contact with siblings without a DD.

The second research question was examined using independent samples t tests and ANCOVA. Due to the small number of men in the sample (n = 20), we excluded them from the gender analyses. To examine the effect of gender of the sibling with a DD, we divided female participants into two groups: (a) participants with a sister with a DD (n = 43) and (b) participants with a brother with DD (n = 65). We then conducted three paired samples t tests with the frequency of in-person, telephone, and other contact as the DVs. To examine the effect of gender of the sibling without a DD, we similarly divided the female participants into two groups: (a) participants with a sister without a DD (n = 59) and (b) participants with a brother without a DD (n = 49). We then repeated the three paired samples t tests using frequency of in-person, telephone, and “other” contact as the DVs.

To evaluate the third research question, we conducted three paired samples t tests (one for each LSRS adult scale) to determine whether relationship closeness with the sibling with a DD differed from relationship closeness with the sibling without a DD.

The fourth research question was addressed using independent samples t tests. The female participants were divided into groups as outlined above in the description of the analyses for the second research question. Independent samples t tests were conducted with LSRS Affect, Behavior, and Cognition as the three DVs. For each DV, we compared female participants who had a sister with a DD to female participants who had a brother with a DD and then compared female participants who had a sister without a DD to female participants who had a brother without a DD. To control for the increased risk of type I error, we used Holm's sequential Bonferroni correction for all analyses.

Study 2

Descriptive statistics, including means, standard deviations, and frequencies, were used to address the research questions in Study 2.

Results

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

Study 1

Demographic characteristics

Most participants lived in Canada (n = 58, 45.3%) or the United States (n = 65, 50.8%); however, five participants (3.9%) lived in other countries (United Kingdom, Brazil, Zimbabwe, and Australia [n = 2]). The majority of participants were married or in common-law relationships (n = 84, 65.6%), and the remainder were single (n = 35, 27.3%) or separated/divorced (n = 9, 7.0%). Overall, the participants had completed a high level of education: 41 (31.8%) had a graduate or professional degree, 46 (35.9%) had an undergraduate degree, 16 (12.5%) had a college certificate, 13 (10.2%) had partial college or university, and 12 (9.4%) had a high school diploma.

We examined family demographic information to provide context for the sibling relationships evaluated in this study. Most participants reported at least one living parent: 22 participants (17.2%) had one living parent, 71 (55.5%) had two living parents, and 9 participants (7.1%) had three or more living parents (including step-parents). The remaining 25 (19.5%) reported that their parents were deceased. Fifty-nine (46.1%) participants were older than their sibling with and without a DD, whereas 25 (19.5%) were younger than both siblings. Of the remaining participants, 27 (21.1%) were younger than their sibling without a DD, but older than their sibling with a DD, and 14 (10.9%) were the opposite. Approximately half (n = 69, 53.9%) of the participants had at least one sibling in addition to the two that were reported on in this study. Table 1 includes the demographic information about the siblings with and without DD that participants reported on in this study.

Table 1. Sibling Demographic Information
 Siblings with DDSiblings without DD
(n = 128)(n = 128)
  1. Note: DD = developmental disabilities; ASD = autism spectrum disorder; ID = intellectual disability; SIB-R = Scales of Independent Behavior–Revised.

  2. a

    Other diagnoses include Down syndrome (n = 1), Fragile X syndrome (n = 2), tuberous sclerosis (n = 1), cerebral palsy (n = 1), fetal alcohol spectrum disorder (n = 1), fetal alcohol spectrum disorder + cerebral palsy (n = 1).

  3. b

    n = 127.

  4. c

    Possible scores range from 0 to 120.

Number of women (%)47 (36.7)57 (44.5)
Mean age in years (SD)37.76 (12.17)40.34 (14.54)
Age range in years17–6917–82
Primary diagnosis n (%)  
Down syndrome49 (38.3) 
ASD14 (10.9) 
ASD + other diagnosis7 (5.5)a 
Cerebral palsy15 (11.7) 
Intellectual disability due to unknown cause28 (21.9) 
Brain injury6 (4.7) 
Other syndrome or disorder9 (7.0) 
Level of ID n (%)b  
No impairment3 (2.4) 
Mild/borderline ID19 (15.0) 
Moderate ID64 (50.4) 
Severe ID28 (22.0) 
Profound ID6 (4.7) 
Unknown7 (5.5) 
SIB-R adaptive behavior  
Mean score (SD)76.82 (21.54) 
Range of scoresc4–110 
Mean age equivalent in years (SD)7.86 (4.25) 
Age equivalent range in years0–18 
Current residence n (%)  
With participant14 (10.9) 
With parent/other family member63 (49.2) 
Group home/supported living34 (26.6) 
Alone/with roommate or partner17 (13.3) 
Sibling contact

We examined three aspects of participants' contact with their sibling with a disability: frequency of in-person contact, frequency of telephone contact, and frequency of contact through other forms of technology (e.g., text messaging, e-mail, etc.; see Table 2).

Table 2. Frequency of Contact with Siblings with a Development Disability (DD)
 Siblings with a DDSiblings without a DD
In-person  
Weekly or more54 (42.2%)28 (21.9%)
1–3 times per month30 (23.4%)29 (22.7%)
Several times per year or less44 (34.4%)71 (55.5%)
Telephone  
Weekly or more56 (43.7%)36 (28.1%)
1–3 times per month39 (30.5%)52 (40.6%)
Several times per year or fewer33 (25.8%)40 (31.3%)
Other technology  
Weekly or more19 (14.8%)66 (51.6%)
1–3 times per month15 (11.7%)32 (25.0%)
Several times per year or less94 (73.4%)30 (23.4%)

The t test related to frequency of in-person contact was significant, t(127) = 5.06, p < .001 (α = .016); participants reported a greater frequency of in-person contact with their sibling with a DD (M = 2.36, SD = 1.34) as compared to their sibling without a DD (M = 1.71, SD = 1.17). Likewise, the t test related to frequency of telephone contact was significant, t(127) = 2.14, p = .03 (α = .05); participants reported a greater frequency of telephone contact with their sibling with a DD (M = 2.36, SD = 1.43) as compared to their sibling without a DD (M = 2.05, SD = 1.18). The ANCOVA for frequency of other contact showed a significant main effect of sibling type, Wilks's Λ = 0.94, F(1, 125) = 8.31, p = .005 (α = .025). After controlling for the age of the sibling with a DD and the sibling without a DD, participants reported a significantly greater frequency of other technology-based forms of contact with their sibling without a DD (M = 2.55, SD = 1.40) than with their sibling with a DD (M = 0.93, SD = 1.31). Finally, the t test for total contact was significant, t(127) = 2.15, p = .03. Participants reported greater total contact with their sibling without a DD (M = 2.10, SD = 0.99) as compared to their sibling with a DD (M = 1.88, SD = 0.89). However, it should be noted that when Holm's sequential Bonferroni correction is applied, this difference is no longer significant.

We also examined the relationship between gender and sibling contact for female participants. Table 3 shows the results of the t tests. There were no significant differences between female participants who had a sister with a DD and those who had a brother with a DD on any of the three types of sibling contact. In contrast, female participants who had a sister without a DD reported significantly greater frequency of telephone and “other” contact with their sibling than participants who had a brother without a DD. No difference was found in frequency of in-person contact between participants who had a sister without a DD versus a brother without a DD.

Table 3. Independent Samples t Tests Comparing Sibling Gender for Frequency of Contact
Contact typeSibling TypeM (SD)t Test
Female SiblingMale Sibling
  1. Note: These analyses only include female participants. DD = developmental disability.

  2. a

    Other contact refers to e-mail, text message, etc.

In-personWith a DD2.60 (1.42)2.23 (1.31)t(106) = 1.41, p = .16
Without a DD1.93 (1.20)1.57 (1.12)t(106) = 1.60, p = .11
TelephoneWith a DD2.23 (1.36)2.55 (1.49)t(106) = 1.14, p = .26
Without a DD2.59 (1.19)1.51 (0.89)t(106) = 5.26, p < .001
OtheraWith a DD0.88 (1.12)1.05 (1.47)t(106) = 0.62, p = .54
Without a DD3.22 (1.34)2.04 (1.17)t(106) = 4.82, p < .001
Relationship closeness

Sibling relationship closeness was evaluated using the three adult scales of the LSRS. The t test for adult affect was significant, t(118) = 3.33, p = .001 (α = .025). Participants reported more positive feelings toward their sibling with a DD (M = 33.55, SD = 5.34) than they did toward their sibling without a DD (M = 31.29, SD = 6.59). The t test for adult behavior was also significant, t(118) = 3.58, p < .001 (α = .017); however, the participants reported less closeness in their behaviors toward their sibling with a DD (M = 22.80, SD = 6.67) as compared to their sibling without a DD (M = 25.46, SD = 7.08). The t test for adult cognition was not significant, t(118) = 1.42, p = .16 (α = .05). The participants' thoughts about the closeness of their relationship with their sibling with a DD (M = 30.82, SD = 5.93) did not differ from their thoughts about the closeness of their relationship with their sibling without a DD (M = 29.82, SD = 7.33).

We also examined the relationship between gender and relationship closeness for female participants. Table 4 shows the results of the t tests. There were no significant differences between female participants who had a sister with a DD and those who had a brother with a DD on any of the three aspects of relationship closeness. In contrast, female participants who had a sister without a DD reported significantly greater relationship closeness with their sibling on the Affect, Behavior, and Cognition scales than participants who had a brother without a DD.

Table 4. Independent Samples t-Tests Comparing Sibling Gender for Relationship Closeness
LSRS ScaleSibling TypeM (SD)t Test
Female SiblingMale Sibling
  1. Note: These analyses only include female participants. LSRS = Lifespan Sibling Relationship Scale.

AffectWith a DD32.43 (5.87)34.46 (4.83)t(103) = 1.94, p = .06
Without a DD32.76 (6.24)29.93 (6.84)t(102) = 2.20, p = .03
BehaviorWith a DD23.73 (6.70)22.94 (7.16)t(103) = 0.57, p = .57
Without a DD28.58 (6.78)22.59 (5.90)t(102) = 4.74, p < .001
CognitionWith a DD30.48 (6.45)31.49 (5.65)t(103) = 0.85, p = .40
Without a DD32.50 (6.43)27.09 (7.55)t(102) = 3.95, p < .001

Study 2

We examined the descriptive statistics of the LSRS scales: MAffect = 15.24 (SD = 1.09), MBehavior = 9.29 (SD = 5.18), and MCognition = 14.71 (SD = 1.83). Due to the low internal consistency of the Affect and Cognition scales of the LSRS, we did not conduct further statistical analyses.

We also explored sibling contact. All of the adults with a DD reported that they spent in-person time with their brothers and sisters, and Table 5 provides descriptive information about the activities they enjoyed doing with their sibling. Additionally, 15 (88.2%) participants said they spent time talking with their sibling on the telephone, and 9 (60.0%) reported using other forms of technology to communicate with their siblings. Such communication included e-mail, text messaging, on-line video (e.g., Skype), on-line chat (e.g., msn), and social media Web sites (e.g., Facebook). Twelve (70.6%) participants reported that they would like to spend more time with their sibling than they currently did. The main reasons for not spending more time with siblings included the distance between where the participant and the sibling lived (n = 7, 58.3%) and the sibling being too busy to spend more time with the participant (n = 4, 33.3%).

Table 5. Activities Participants with a Development Disability (DD) Enjoy Doing with their Siblings
Activityn (%)
  1. Note: Activities are not mutually exclusive.

Engaging in physical activity (e.g., swimming, bowling)6 (35.3)
Going shopping5 (29.4)
Eating in restaurants4 (23.5)
Going to movies4 (23.5)
Talking/visiting4 (23.5)
Watching TV/playing videogames/listening to music3 (17.6)
Playing games2 (11.8)
Going to a cottage2 (11.8)
Other activities5 (29.4)

Finally, we asked participants about helping behaviors in their sibling relationship. Twelve (70.6%) of the participants indicated that their sibling provided them with help and 12 (70.6%) of the participants reported that they provided help to their siblings (see Table 6).

Table 6. Activities in which Participants with a Developmental Disability (DD) and Siblings Help Each Other
 Sibling Helps Participant with a DDParticipant with a DD Helps Sibling
n (%)n (%)
  1. Note: Activities are not mutually exclusive.

Chores/household tasks3 (25.0)6 (50.0)
Going places in the community4 (33.3)0 (0.0)
Use of technology2 (16.7)1 (8.3)
Cooking2 (16.7)0 (0.0)
Finances2 (16.7)0 (0.0)
Other3 (25.0)3 (25.0)

Discussion

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

The goal of these two studies was to examine various sibling relationship characteristics from the perspectives of siblings with and without a DD. Study 1 used an approach not previously used in the literature, which involved comparing participants' relationships with their sibling with a DD to their relationships with their siblings without a DD. It also examined the effect of gender on these sibling relationships. Study 2 was unique in that it was the first study to focus solely on the perspectives of adults with a DD regarding their sibling relationships.

Consistent with our hypotheses, we found that participants without a DD had more frequent in-person and telephone contact, as well as more positive feelings about the sibling relationship, with their sibling with a DD as compared to their sibling without a DD. Previous research comparing sibling dyads that include an individual with a DD to dyads that include two siblings without a DD show that siblings of individuals with a DD report less relationship closeness and less frequent contact than siblings of individuals without a DD (Doody et al., 2010; Taylor et al., 2008). However, these studies compared sibling dyads from different families. Our findings can be interpreted in the context of family systems theory, which suggests that the relationships of each family member with the individual with a DD will impact the relationship between the family members without a DD. Thus, unique aspects of the family dynamic, such as increased caregiving responsibility of siblings (Bigby, 1997; Greenberg et al., 1999; Krauss et al., 1996) and greater family solidarity toward the sibling with a DD (Taylor et al., 2008) may contribute to more frequent contact and increased relationship closeness as compared to the relationship with the sibling without a DD.

The variables that did not support our hypotheses were frequency of contact using technology-based forms of communication (e.g., e-mail, text messaging, and social media Web sites) and the Behaviors scale of the relationship closeness measure. Participants' reports of using less technology-based communication with their sibling with a DD compared to their sibling without a DD may relate to the decreased access to technology that individuals with a DD have as compared to the general population (Palmer, Wehmeyer, Davies, & Stock, 2012; Tanis et al., 2012). Additionally, the limitations of some individuals with a DD, such as an inability to read or write, may further contribute to less use of technology for sibling communication. Thus, despite the factors that may contribute to greater frequency of in-person and telephone contact with siblings with a DD as compared to those without, certain barriers may limit the use of technology-based forms of communication for interacting with siblings with a DD.

Participants also reported less close relationship behaviors with their sibling with a DD as compared to their sibling without a DD. The Adult Behavior scale measures behaviors such as hanging out with siblings and talking about problems with siblings. The fact that participants engaged in less of these types of behaviors with their sibling with a DD, yet they spent more in-person time with these siblings, could indicate that time spent with siblings with a DD is less often spent in a social context or focused on providing emotional support and instead is more focused on providing instrumental support as compared to time spent with siblings without a DD. This explanation is supported by the findings of Doody et al. (2010), who reported that siblings of individuals with a DD spent more time with their brother or sister than siblings of individuals without a DD; however, when caregiving time was controlled for, there was no difference in frequency of contact between the two groups.

As we hypothesized, gender was an important factor in the relationship between siblings without DDs; however, it did not appear to affect the relationship with sisters and their siblings with a DD. Consistent with the principle of femaleness (Akiyama et al., 1996), sisters reported closer relationships and more telephone and technology-based contact with their sisters without a DD as compared to their brothers without a DD. The principle of femaleness has been attributed to the socialization of women to be more nurturing and caring (Weaver et al., 2003), which can foster closer relationships. Thus, the more sisters without a DD that are in a relationship, the closer the sibling bond. In contrast, the principle of femaleness was not supported for relationships that included a sibling with a DD. Consistent with previous research (Greenberg et al., 1999; Orsmond & Seltzer, 2000), we found that sisters reported no difference in frequency of contact or sibling relationship closeness with their brothers with a DD versus their sisters with a DD. These findings could be explained by previous research that shows siblings with a DD provide less emotional support to their siblings without a DD than they receive in return (Seltzer et al., 1991). Thus, the socialized caregiving role that sisters often play may not be as prominent in women who had a DD, therefore reducing the effect of the principle of femaleness in sibling dyads that include an individual with a DD.

The findings from the study focused on the perspectives of adults with a DD show that all of these participants reported spending in-person time with their brother or sister, although many expressed a desire to see their sibling more frequently. Similar to studies of adult siblings without disabilities (Scott, as cited in Cicirelli, 1995) and the reports of adults who have a sibling with a DD (Krauss et al., 1996), the most commonly enjoyed activities with siblings included engaging in physical activity, going shopping, eating in restaurants, going to movies, and visiting. In a qualitative study with children who had a brother or sister with a DD, Moyson and Roeyers (2012) found that siblings without a DD enjoyed spending time doing “normal” activities (i.e., activities that they would do with a sibling who does not have a DD) with their siblings with a DD. The findings from this study suggest that individuals with a DD shared this perspective and enjoyed doing activities that siblings without disabilities would do.

Participants in this study also reported interacting with their siblings using a variety of forms of technology. Nearly all participants reported that they talked to their sibling on the phone, and 60% also used text messaging and Internet-based forms of communication (e.g., e-mail, instant messaging, Skype) to interact with their siblings. These forms of communication are widely used tools for maintaining social contact with siblings (Corti, 2009), other family members, and friends in the general population (Tee, Brush, & Inkpen, 2009). Unfortunately, many people with a DD still have less access to social communication technology than people without a DD (Palmer et al., 2012; Tanis et al., 2012). In this study, 40% of adults with a DD did not use any type of computer-based communication to stay in contact with their siblings. This is consistent with the findings of Tanis and colleagues (2012) who found that 34% of adults with a DD in their study reported that they did not have an e-mail address. Technology-based communication appears to be an important method of maintaining contact with siblings for adults with a DD, and therefore, future research examining ways to increase technology use among adults with a DD may have positive benefits for sibling relationships.

In addition to spending time with siblings, most participants reported that their brother or sister provided them with instrumental support such as siblings taking the participants places in the community, helping them with household chores and cooking, and assisting them with finances. Previous research shows that when adults with a DD live with their parents, siblings typically provide little instrumental support (Seltzer et al., 1991), whereas when adults with a DD live with siblings or in settings other than the parental home, siblings provide a greater amount of instrumental support (Bigby, 1997). Twelve of the 17 participants in this study lived either with siblings or outside of the parental home, and therefore, the focus on instrumental support provided by the siblings in this study is supported by previous research.

Finally, this study examined ways that adults with a DD help their siblings. Most of the participants reported that they provide instrumental support to their brother or sister, and this primarily involved assistance with household tasks. Research on helping behavior of adult siblings in the general population shows that during early and middle adulthood, most siblings do provide each other with some instrumental support, including coordinated care of elderly parents, babysitting, sharing possessions, and so on (Goetting, 1986). Although the adults with a DD provided help to their siblings, the specific tasks they help with appear to differ somewhat from the tasks in which siblings without a DD may assist one another. The provision of emotional support is also common for siblings in early and middle adulthood (Goetting, 1986); however, only one participant in our study mentioned a form of emotional support (i.e., she said she listens to her brother). Seltzer et al. (1991) examined emotional support provided by adults with a DD to their siblings and found that these individuals did provide emotional support; however, the frequency of support they provided was lower than the frequency of support they received from their sibling.

Unfortunately, the modified version of the LSRS, which was used to measure adults with DDs' perceptions of sibling relationship closeness, had poor psychometric properties. Thus, limited conclusions can be drawn from these data. However, this information does highlight the additional challenges with measuring variables when working with individuals with a DD. It will be important for researchers to continue to develop psychometrically sound quantitative measurement tools that can be used to measure sibling relationship characteristics in adults with a DD who have a range of cognitive abilities. Additionally, qualitative research designs may provide useful information about sibling relationships, particularly when working with adults who struggle with rating scales commonly used on quantitative measures. Finally, the use of observational research could provide greater insight into how adults with a DD communicate with and interact with their siblings.

There are some important limitations to note about these two studies. First, the characteristics of the participants without a DD may limit the generalizability of the results. These participants were primarily women (i.e., sisters), which prevented an examination of whether sibling gender affects relationship closeness and contact for brothers. Additionally, the education level of the participants in this study was higher than the general population (Statistics Canada, 2010). Orsmond and Seltzer (2007) found that lower levels of education are related to closer sibling relationships in adult siblings of individuals with autism. Thus, scores on the measure of relationship closeness and frequency of contact may be higher if our study were repeated with a sample of participants who have lower socioeconomic status.

Second, participants who had more than one sibling with a DD (or without a DD) were asked to respond to the questionnaires based on their relationship with the sibling with whom they had the closest relationship. Only about 10% of participants had more than one sibling with a DD, whereas approximately one half of participants had more than one sibling without a DD. The large portion of individuals who had more than one sibling without a DD suggests that the results may not be generalizable to all sibling relationships. Furthermore, because most participants were recruited through agencies that support people with a DD and their families, it is likely that our sample represents siblings who are particularly involved in the lives of the individual with a DD, and thus, our findings may not apply to siblings who are less close or less involved with their brother or sister with a disability.

Finally, the focus on frequency of contact rather than duration or type of activities engaged in during contact is a limitation. Our data did not enable us to examine how much sibling contact was focused on the provision of instrumental support versus enjoyable social/leisure activities. Further research is needed to conduct a more in-depth examination of the specific types of activities that adults engage in with their siblings with and without a DD and the duration of these activities.

Finally, the research designs of these studies are limited in that each one only included the perspective of one sibling in the sibling dyad. Future research that included sibling pairs in which one sibling has a DD and the other does not would enable comparisons of the perspectives of each sibling. Such an approach would allow researchers to determine which aspects of the sibling relationship are perceived as mutually positive (or negative), and it could enable researchers to identify factors that lead to discrepant perceptions about the sibling relationship.

Practice Implications

The findings from these studies highlight several important implications for practitioners.

First, sibling relationships appear to be important for siblings with and without a DD. In addition to providing one another with support, both groups report positive feelings about their relationships with their siblings. Additionally, adults with a DD enjoy numerous activities with siblings, and many report a desire to spend more time with siblings. Service providers may be able to further foster sibling relationship closeness by placing emphasis on this relationship in their services. Examples could include organizing special events for individuals with a DD and their siblings (e.g., bowling, swimming, parties, etc.), providing necessary supports to facilitate sibling interactions, or providing educational information for families about how to help siblings stay connected.

New forms of technology such as text messaging, e-mail, social media Web sites, and so forth appear to be important means of communication for siblings. The participants without a DD reported fewer contacts with their sibling with a DD using these forms of communication as compared to their siblings without a DD. Likewise, a large portion of the participants with a DD did not use technology, other than the telephone, to communicate with their siblings. There are many barriers to technology use for adults with a DD, including lack of training on how to use computers, cost, lack of assistance with maintenance (Palmer et al., 2012; Tanis et al., 2012), group home staff attitudes that online communication is not a desirable form of social contact for individuals with a DD (Parsons, Daniels, Porter, & Robertson, 2008), and cognitive and physical impairments that make the use of technology more difficult. Given the importance of this form of communication for siblings, service providers should strive to find ways of facilitating the use of technology for adults with a DD. This may involve training on how to use technology or trouble shoot problems, as well as the development of equipment and programs that are user friendly for individuals with a DD.

Acknowledgment

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References

The primary author was supported by a Social Sciences and Humanities Research Council of Canada Doctoral Fellowship, a Canadian Institute of Health Research Studentship, and an Ontario Graduate Scholarship.

References

  1. Top of page
  2. Abstract
  3. Relationships with Siblings with a Developmental Disability in Adulthood
  4. Relationships between Siblings without a DD in Families of Individuals with a DD
  5. Gender and Sibling Relationships
  6. Perspectives of Siblings with a DD
  7. Study Objectives and Hypotheses
  8. Method
  9. Results
  10. Discussion
  11. Acknowledgment
  12. References