From a family systems perspective (Minuchin, 1985) each individual family member is embedded in a multitude of systems that affect the behaviors of the individual members, both directly and indirectly (Broderick & Smith, 1979). Systemic theories imply that family factors, such as stress and coping in one or more members of the family, affect the functioning of the entire system. Research from a family systems model has involved exploration of the impact on the family of having a child with autism in the family unit. Investigators have explored effects on both parents and siblings of children with autism. Research on sibling impact has included examination of family adjustment, sibling age and birth order, parental stress and marital adjustment, and parental attitudes about the child with autism, in particular. Research on parental adjustment has included parental stress, marital satisfaction, and parental psychological well-being. Careful consideration of the literature reveals several important limitations; whereas many studies have concluded that there is a relationship between parental adjustment and sibling adjustment, few studies have explored intervening variables to understand this relationship. One of the most noteworthy of these concerns is the relative lack of attention to parenting and parent perceptions as variables that impact sibling adjustment and that are affected by the context of autism in the family. This critical literature review elucidates the interrelationships among factors that ultimately contribute to sibling adjustment. Conclusions from this review indicate that parents of children with autism experience increased stress as compared with parents of children with other disabilities or parents of typically developing children. Additionally, parents of children with autism report increased rates of depression and marital distress relative to comparison groups. This review concludes with a proposed conceptual model that includes both empirically supported and postulated mediating linkages governing the relationship between parental adjustment (conceptualized here as parental stress) and the adjustment of siblings of autistic children.
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