Mother: “Our eldest (15) has been diagnosed with autism. Late diagnosis, because she functions quite well. She raised the alarm herself because she was having panic attacks and told us that she felt that everything was much more difficult for her than for her peers. She is now receiving good help. Her sisters (10 and 13) have had her as an example all their lives. A big sister who doesn’t care except by enforcing rigid rules. Who often does not help, does not share, and makes her own plans first. Cannot empathize with her sisters. As a result, the youngest two do not have a strong bond with each other. The youngest in particular copies the behavior of the eldest to the middle one. How can I change that, now that we know that the eldest lacks some social intelligence, so that the youngest two can benefit from each other?”
Strengthen mutual relationships
Susan Bögels: “Every parent wants the family to become a close-knit group in which everyone is closely involved. That often turns out differently, and that also applies to a family with a child with autism. You may experience grief that a certain type of bonding will not develop.
“Experiment with strengthening mutual relationships. For people with autism, one-on-one contact is often easier than in a group. Maybe your daughter can go on holiday with her father, and you with the youngest daughters. Children with autism are usually easier for fathers than for mothers, who expect more of a reciprocal relationship. Fathers are more likely to do something with their children. Perhaps the oldest and youngest can play sports together, and the middle child and the oldest have a different connection.
“Research shows that children who grow up with a brother or sister with a disability such as autism develop more socially than average because they learn to take others into account. So it is not the case that they automatically become ‘infected’ by it. Children get their examples from everywhere, and also learn to develop reciprocal relationships with the peers they choose.
“It remains to be seen whether the autism of the eldest will come between the two youngest. It may be that they develop a stronger bond as a result.”
Understanding each other
Anneke Louwerse: “How nice that your eldest can indicate so well what she needs. I wouldn’t be too quick to write off her social role in the family; she has independently taken an important step in her development, which shows decisiveness and self-insight. Everyone with autism is different, and people with autism also need contact.
“I would recommend that you organize a family meeting through your eldest’s therapist in which the sister and therapist can clearly explain what her strengths are and what she finds difficult. What exactly runs differently in her head than in others? The youngest girls can, in turn, explain what they find difficult to the eldest. This creates mutual understanding, and you also learn how to discuss this together.
“Now that it is becoming more visible what autism means for your family, there is also an opportunity to strengthen mutual ties. What do you all like, what do you all enjoy? Can you use these activities more consciously? And are there things some members can do together, like watch a TV show or play a game?”
Susan Bögels is professor of family mental health & mindfulness at the University of Amsterdam. Anneke Louwerse works as a clinical psychologist in the child and adolescent psychiatry/psychology department of Erasmus MC-Sophia.
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