Siblings of kids with disabilities or chronic illness
Brothers and sisters carry their own feelings, questions and love. They deserve to be seen too.
Growing up alongside a brother or sister with extra needs
A mix of ordinary sibling life and some extra weight.
Siblings of children with disabilities or chronic illness share all the usual things: games, fights, inside jokes. They may also live with hospital visits, changed plans, extra chores and a lot of adult attention going to one child.
A review that pooled many studies found that, on average, siblings of children with chronic health conditions had slightly more emotional and behavior difficulties than other children. The overall difference was small, and many siblings do well.
The same review found more risk for older siblings, and when a brother or sister’s condition was life-threatening or affected daily family life a lot. Those siblings may need extra attention.
Big feelings siblings may have
Love, worry, jealousy and guilt can all show up.
The American Academy of Pediatrics describes many feelings siblings may have. Most are a normal response to a hard situation, and none of them make a child “bad”.
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Some siblings feel guilty for being healthy, or secretly wonder if something they did or thought caused their sibling’s condition.
Saying it out loud helps: “Nothing you did or thought caused this. It is nobody’s fault.”
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Siblings may worry their brother or sister will get worse, or that they could catch or develop the same condition.
Simple, true information usually calms worry better than silence. Children often imagine something worse than the truth.
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When a sibling gets lots of time, care and attention, it’s natural to want some too.
Jealousy is a signal of a need, not a character flaw. Regular one-on-one time (see below) often eases it.
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Siblings may resent doing more chores than their brother or sister, then feel bad for feeling that way.
Let them know: “It’s okay to be frustrated sometimes and still love your sibling.”
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Siblings may feel embarrassed or angry when strangers stare at a brother or sister in a wheelchair, or when other kids tease a sibling who looks different.
Practice short replies together, such as “That’s my brother. He uses a wheelchair to get around,” or “Please don’t stare. She’s just like you.”
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Many siblings feel deep pride and love, and find meaning in helping their brother or sister.
Strengths siblings often grow
Empathy and resilience, without needing to be perfect.
The AAP notes that living with a brother or sister with a chronic condition can help children grow empathy, responsibility, adaptability, problem-solving and creativity.
Strengths you might notice
- Acceptance of people who are different
- Kindness and patience with younger children
- Speaking up when someone is treated unfairly
- Flexibility when plans change
- Maturity beyond their years
The “easy” child: when siblings stay quiet
Some siblings hide their needs to protect busy parents.
Some siblings notice how stretched their parents are and decide not to add to it. They may hide worries, downplay problems at school or try to be perfect.
The AAP warns that siblings can feel invisible unless they demand attention. It lists pushing too hard to achieve as one sign a sibling may need more support.
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- Never asking for anything
- Taking on adult worries or tasks without being asked
- Being very hard on themselves about grades or mistakes
- Saying “I’m fine” very quickly
- Spending a lot of time alone
These can also just be personality. Gently checking in is the best way to know.
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- “What’s the hardest part about our family right now?”
- “Is there anything you wish we knew?”
- “What’s something you’d like more of with me?”
- “Do you ever worry about your sister? What about?”
Side-by-side times, like car rides or cooking, often feel easier for kids than face-to-face talks.
Honest talk about their sibling’s condition
True, simple information, growing as they grow.
The AAP says siblings need honest information about the condition and answers to their questions. What they need to know changes with age.
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- “Sam’s body works differently. His legs don’t walk, so he uses a wheelchair.”
- “You can’t catch it.”
- “Nobody did anything to cause it.”
- “We will always take care of you too.”
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School-age children may want to know what the condition is called, how it affects their sibling, and what to say when friends ask. Help them practice a one-line answer.
Invite questions often. Children may not ask unless they know it’s welcome.
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Teens can understand a lot and may have private worries about the future, their own children, or who will care for their sibling later. Let them ask anything, and include them in family decisions where it makes sense.
One-on-one time and fairness
Small, regular moments that say “you matter”.
The AAP suggests spending time with each child on their own and building a special relationship with each one. It doesn’t need to be long or expensive.
Ideas for special time
- 10 minutes of their choice before bed, every night
- A monthly “date” with one parent or a favorite relative
- Cooking, building or playing a game together
- Coming to watch their game, show or recital
- A walk or drive with music they choose
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You might say: “Your brother needs more help with some things. You need different things from me, and you matter just as much.”
Try to protect a few things that are only theirs: their activities, their friends and their space.
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When a sibling misses out, name it: “I know you were looking forward to that. I’m sorry. Let’s plan a new time.” Then follow through when you can.
Helping out without becoming a “third parent”
Pitching in is good. Carrying adult loads is not.
Helping at home can give siblings pride and a sense of belonging. Problems start when a child carries too much responsibility for their age, or feels it is their job to keep everyone okay.
Questions to ask yourself
- Are their chores similar to what other kids their age do?
- Do they still have time for friends, play and homework?
- Do they feel able to say no sometimes?
- Are they worrying about adult things like money or medical decisions?
- Do they get thanks and a break when they help?
Sibshops and sibling groups
Fun, peer support with kids who get it.
Sometimes the best support comes from other kids who live the same life. Sibling groups give siblings a place where they don’t have to explain.
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Sibshops, created by the Sibling Support Project, give siblings of kids with disabilities peer support and information in a fun, recreational setting.
The Sibling Support Project lists Sibshops near you at siblingsupport.org. Some states, like Michigan, help fund and train local Sibshop leaders.
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The AAP lists sibling support groups, child life specialists, social workers and family therapists as places siblings can find support.
Ask your child’s clinic, your Parent Center or a condition-specific organization what is offered locally.
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Some sibling organizations run moderated online groups for teen and adult siblings. As with any online space, help younger teens use them safely.
Teen and adult siblings: the future
Quiet worries about later life deserve open talks.
As siblings grow up, many wonder what their role will be when parents get older. Some want to be closely involved; others want to support from a distance. Both are valid.
Ways families can plan together
- Talk openly about long-term plans before a crisis
- Ask adult siblings what role they want, rather than assuming
- Write down key information about care, routines and contacts
- Include the disabled family member in plans about their own life
- Get general information from official or legal aid sources on planning ahead
Signs a sibling needs more support
When to reach out, and where to go.
The AAP says to watch for
- Anxiety or low mood that lasts
- Withdrawal or a lot of anger
- Losing interest in friends or favorite activities
- School performance dropping
- Pushing too hard to achieve
- Rebellious or attention-seeking behavior
If you notice these, talk with the sibling’s own pediatrician or clinical provider. Psychologists, social workers and family therapists can help, and you don’t have to solve it on your own.
📝 Worksheets for this guide
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Sources
- Journal of Pediatric Psychology (peer-reviewed) (2012). Psychological functioning of siblings in families of children with chronic health conditions: a meta-analysis (Vermaes, van Susante & van Bakel, Journal of Pediatric Psychology 37(2): 166–184)
- American Academy of Pediatrics (AAP), HealthyChildren.org. Siblings of Children with Chronic Illnesses or Disabilities
- Sibling Support Project. Sibshops
- Michigan Department of Health and Human Services, Family Center for Children and Youth with Special Health Care Needs. Sibling Support
- 988 Suicide & Crisis Lifeline. 988 Suicide & Crisis Lifeline
- Substance Abuse and Mental Health Services Administration (SAMHSA). 988 Suicide & Crisis Lifeline
- Crisis Text Line. Crisis Text Line
- Substance Abuse and Mental Health Services Administration (SAMHSA). Crisis Text Line (resource listing)
- Find A Helpline (ThroughLine). Find A Helpline
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.
