Assessing functional impairment in siblings living with children with disability

Abstract

Objective: The purpose of this study was to empirically test if siblings of children with disability had higher levels of parent-reported behavioral and emotional functional impairment compared with a peer group of siblings residing with only typically developing children.

Methods: This was a retrospective secondary analysis of data from the Medical Expenditure Panel Survey. We included only households with at least 2 children to ensure sibling relationships. Two groups of siblings were formed: 245 siblings resided in households with a child with disability and 6564 siblings resided in households with typically developing children. Parents responded to questions from the Columbia Impairment Scale to identify functional impairment in their children.

Results: On the basis of parent reports and after adjusting for sibling demographic characteristics and household background, siblings of children with disability were more likely than siblings residing with typically developing children to have problems with interpersonal relationships, psychopathological functioning, functioning at school, and use of leisure time (P < .05). The percentage of siblings of children with disability classified with significant functional impairment was 16.0% at the first measurement period and 24.2% at the second (P < .001). For siblings of typically developing children there was a smaller percentage increase from 9.5% to 10.3% (P < .001).

Conclusions: Functional impairment is a key indicator for the need of mental health services and, as such, early assessment and interventions to limit increasing severity and short- to long-term consequences need to be addressed. Health care professionals need to consider a family-based health care approach for families raising children with disability.

Keywords: disability; functional impairment; mental health; siblings.

FIGURE 1

Likelihood of siblings of children with disability having functional impairment problems compared with siblings of typically developing children. Interpersonal and behavior functioning problems were obtained from round 4. Odds ratios were adjusted for child age, gender, race/ethnicity, parents’ education, parent marital status, poverty status, birth order of siblings, and number of children in household. AOR, adjusted odds ratio. Source: Medical Expenditure Panel Survey panels 10, 11, and 12.

FIGURE 2

Adjusted change in average CIS composite score by functional impairment status at MEPS round 2. Source: Medical Expenditure Panel Survey panels 10, 11, and 12.