Magazine article The Exceptional Parent

Sibling's Role in Occupational Therapy. (Cover Story)

Magazine article The Exceptional Parent

Sibling's Role in Occupational Therapy. (Cover Story)

Article excerpt

Three little faces were peering through the living room window as therapy equipment and activities were unloaded from the trunk of my car. Two-and-a-half-year-old triplets were waiting for my weekly visit. As I walked up the path to the entryway, all three little bodies scurried away from the window to appear at the front door with their mother. Squeals and screams of anticipation and excitement followed quickly as preparations began for home-based therapy. Although only one of the triplets was in need of therapeutic intervention, planning and implementing activities to include all three children was vital for success in this therapeutic process. The child with developmental delay had opportunity to maximize her occupational performance through the influence of sibling participation, while the others enjoyed the attention and activity that comes with inclusion.

Siblings experience many different conditions while living with a brother or sister with special needs. Since family contains such interactive depth, powerful and prolonged feelings develop that may affect behavior and interaction for a lifetime. Sometimes these feelings and memories affect marriages, work relationships and friendships. Guilt, shame, resentment and anger are written about in the literature regarding siblings of children with disabilities. Sensitive to these feelings, an occupational therapist must utilize her knowledge, skills and resources to help transform these negative feelings into tolerance, acceptance, patience and compassion.

Studies in occupational therapy professional literature look at the emotional impact of living with a child with special needs. Data is collected from interviews, self-completion questionnaires, home interviews, written diaries and/or video diaries. All this information relates memories of events, feelings and thoughts within the context of family experience. By addressing the emotional impact of living with a child with special needs, occupational therapy researchers emphasize the importance of attention to siblings' own needs as well as the impact they have on the child in therapy.


Occupational therapists often find it necessary to plan and implement selected therapeutic activities that include sibling participation (as with the triplets). First and foremost, the goals and objectives of children with delay or disability are planned and carefully based on results of evaluation and assessment tools. Developmentally appropriate positioning, movement patterns, activities and adaptive devices are then selected to meet their needs. Therapists no longer treat children as separate entities from their environments. The social contexts in which children live are as important as the physical and emotional contexts. Consequently, when children are treated in home settings in the company of siblings, effective therapeutic methods consider accommodation of that social situation. This becomes advantageous for the children being treated as well as for their siblings.

Activity or play therapy in sibling groups provides positive therapeutic outcomes for children requiring intervention and interactive learning for their siblings. Advantages readily emerge, sometimes surprisingly, when activities are experienced together. For children with disability, sibling group participation allows for imitation of movement patterns, grasp patterns, activity initiation and motivation, social interaction and speech and language stimulation. For siblings, tolerance, patience, compassion, sharing, a willingness to assist others and simple teaching skills are learned through well designed, well executed activities. Parents report that these values seem to carry over to school, play and sport activities.

Parents also gain from observing these "group sessions." By watching and listening to the therapist's methods, parents learn coaching, recognition and inclusion techniques effective for family activities. …

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