How to help siblings when you make a home visit

Each time you make a visit to the family of a disabled child is an opportunity to support and provide information for siblings. Even a very small intervention by you can make a huge difference to a sibling who has never been acknowledged as having specific needs of his or her own.

Many families will have more than one sibling and each will have different needs and experiences even though they are in the same family. Each sibling needs to be assessed and supported in their own right.

These are some of the things you can do:

Acknowledge the sibling’s presence when you visit

If you normally visit when a sibling is at school, make some visits at a time when the sibling will be at home.
Talk to the sibling. Find out his or her name and always use this. Never refer to a sibling as ‘Anja’s brother’. Talk to the sibling about school, hobbies, or a forthcoming event.
Bring something fun for the sibling to do when you make your visit. This is especially important for pre-school siblings who are likely to feel very jealous when a professional is playing with or has brought toys for the disabled child. Not only is this important for the sibling, but for the parent too – sibling rivalry can be increased after a home visit where all the focus of attention is on the disabled child.

Acknowledge the sibling’s feelings and experiences

Ask the siblings about things in their family – what sort of games they play with their disabled brother or sister; about any things they do to help with care; about any things they find difficult; about how things are at school. Use open ended questions to help the sibling give you information rather than just a yes or no answer. For example ‘I can see that you are helping Josh with his drink, what else do you do to help him?’
Acknowledge any feelings that the sibling expresses. Do not underestimate the value of this. You may be the first person to do this for the sibling. See our sheet for parents Acknowledge siblings’ feelings. By doing this you are also modeling good practice for parents for when they talk to sibling.
Let them know that they are not the only one. Tell them (without breaking any confidences) about some of the other siblings you meet.

Help the sibling access information

The need for ongoing information is the same for siblings as it is for parents. Siblings will need age appropriate information about the condition: How it will affect a brother or sister; the genetic implications of the condition; what treatments and therapies a brother or sister is having; how they can help their brothers or sisters.

Ask siblings to tell you what they already know. From this you can gauge the right discussion level for that child. Encourage parents to provide information - do this together if that is easier.
In some cases you may need to persuade parents to provide more information, especially on topics such as life expectancy, life threatening illness, or degenerative diseases. Information about disability and it consequences are best received by siblings if is delivered on a way that is honest, matter of fact, and age-appropriate. Siblings whose families use open communication around disability cope better in the longer term.
Where the disabled child has a known condition, contact the UK organisation for that condition and get information for yourself so that you understand it well enough to be able to explain it to a child.
If you are not able to answer a question there and then, tell the sibling you don’t know and that you will find out for them.

Involve the sibling in the session

If you are provding a therapy or treatment session, think about how you can involve a sibling in a way that will help him or her feels valued as a family member. For a young sibling this may be by getting a chance to experience what physiotherapy feels like, for an older child it may be through explaining how the therapy works on his/her brother or sister. The sibling who is lingering in the living room door, or who is interrupting the session, may be indicating a need to be involved.
If you are visiting to collect information for a case conference, ask an older sibling for his or her contribution and in many cases it is very appropriate to invite an older sibling to attend.

Make an assessment of the sibling’s needs

See Making a sibling assessment

Identity any siblings who are young carers

Some siblings will be involved in proving an amount of care that is not appropriate for a child of that age. See Siblings and caring

Talk to the sibling about having a young carers assessment and getting involved with a local young carers’ project
With the sibling’s consent, co-ordinate practical help and support at home.

Look out for issues related to challenging behaviour

For siblings of children with challenging behaviour the following may be relevant:

Physical or sexual abuse of a sibling by the child or young person with challenging behaviour - this can sometimes be tolerated by family as the person ‘cannot help it’ or may not be noticed because sibling is too embarrassed to tell a parent or does not want to burden the parent.
Many siblings help their brothers and sisters with care tasks that involve physical intimacy – e.g. toileting, lying in their bed to help then get to sleep. When a brother or sister reaches puberty many siblings (especially of the opposite sex) feel very uncomfortable about this. Ask siblings of teenagers if they carry out intimate care tasks and how they feel about doing so. Help the family find more suitable alternatives.
Help the family look at how to give the sibling some personal space. Identify environment solutions such as quiet space in the house for homework or having friends round and a locked cupboard for keeping their things safe. Identify respite solutions such as care being arranged for e.g. when the sibling has a sleepover at his/her house.

Refer siblings to appropriate support

Inform siblings about any local sibling groups – make sure you know about the referral criteria first so that you know the sibling will be eligible.
Refer siblings to other types of support such as relevant such as CAMHS, counseling and child bereavement services.
Tell siblings they can contact Sibs for information and support.

Give parents information on supporting siblings

Talk to parents about how they can support siblings and you can download tips on a range of topics in Tips for parents.
Tell parents they can contact Sibs for further support and ideas.