According to Stevens, Kauer and Hamed (2015), ADHD is a common neurobehavioral disorder affecting children globally. The condition is known to exert a negative impact on the broader community, families as well as the children. According to Foley (2011), various studies have been done in developed Euro-Western countries, and from these studies, ADHD is associated with high levels of disrupted family function. The manifestation of behaviors associated with ADHD can impair or disrupt major life activities within a family. These activities include various social skills as well as schooling. Johnston & Mash (2001) carried out a literature review to evaluate the impact of ADHD on siblings without ADHD, especially in matters related to family functioning. Through this review, Johnson and Mash realized that if one child in a family has ADHD, the other siblings in the family were very likely to suffer due to family disturbance, high levels of parental stress, impaired parenting efficacy, disrupted parent-child relationships and disturbance in marital functioning.
ADHD causes negative impacts to both the siblings with the condition as well as those without. Although this study focuses on the effects/ impact of ADHD on siblings without ADHD, the recommendations can be adopted and be implemented to address both challenges. Family disturbance, high levels of parental stress, impaired parenting efficacy, disrupted parent-child relationships and disturbance in marital functioning are critical challenges experienced by other siblings without ADHD, and thus, it is vital to address the problem. This study takes a qualitative review approach to examine the effects of ADHD on non-ADHD siblings. The study aims at focusing on the non-ADHD siblings hoping to promote desired results for the relationships as well as development of the individuals as well as their families. Even though the effects of ADHD behaviors have been reported from the parents,’ educators’ perspective, adolescents as well as the ADHD sibling, there is less information on the perceptions of siblings of diagnosed children. Because of this, the study’s focus was to give air the feelings of non-ADHD children with the first-hand experience to evaluate the feeling of living with an ADHD sibling as well as the possible associated challenges.
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Methodology
A qualitative investigative method was used in the study, and owing to the study nature, a phenomenological research design was considered. Convenience sampling was used to access the participants. The additional participants were accessed through snowball sampling. The criteria used in enrolling study participants included age and the degree of fluency in English. The participants had to be in their early adulthood and with a reasonable degree of fluency in English. They also had to have resided with an ADHD sibling and a parent or a caregiver in the same household. Participants were blinded to the study hypothesis to prevent recall bias. No any form of reimbursement was made for taking part in the study. The participants were not subjected to any form of formal screening for ADHD. Open-ended questions were given to the participants, and the data collected using a semi-structured interview. Some of the items included:
• How was the relationship like within your family system?
• How did you perceive your parent or caregiver’s response when your ADHD sibling was diagnosed?
• What was your role as a sibling following the diagnosis of your ADHD sibling?
An assumption was made in the study that interaction was useful in understanding the experiences of the non-ADHD siblings. The focus in the research was to conduct exploration of the experience of the participants based on living with a sibling diagnosed with ADHD and the impact thereof if any. Each interview lasted for about 45 minutes to one hour, while all the interviews were done within a month. The language of communication during the study was English, and the collected, recorded data was transcribed via verbatim. The qualitative data was analyzed through a thematic analysis. An inductive approach was used in generating themes from the raw data by reading as well as re-reading the transcripts. Any recurring theme was categorized within the data instead of merely identifying the coded words. The perceptions of the participants were then analyzed and interpreted.
Results and Discussion
The results and discussion of the study are presented concurrently in the form of the themes relating to how the non-ADHD sibling perceive the impact a sibling diagnosed with ADHD and the impact of this on the family system. These themes are: parentified child, discipline discrepancies, non-ADHD sibling rejection and differential parental treatment at home with ADHD case.
Effects of differential parental treatment
Differential parental treatment was identified during data analysis and was presented in the forms of different attention accorded to the siblings as well as inconsistency in disciplinary methods. The non-ADHD siblings felt that they were not accorded adequate attention compared to the attention given to the ADHD siblings. More resources were directed to the ADHD siblings at the expense of the non-ADHD siblings. This was even though the non-ADHD siblings yearned for the extra help. An example is moments of shopping where an ADHD sibling may be given a chance to pick more things because he/she has ADHD. In other cases, parents with ADHD siblings were likely to hire additional support such as tutor for the ADHD sibling but insist that the non-ADHD sibling has to do the work alone. In this case, the parents ignore the feelings as well as some critical needs of the non-ADHD siblings. The effect of this is a compromised relationship between the parents, ADHD sibling, and non-ADHD siblings.
Impacts of rejection faced by the non-ADHD sibling
The non-ADHD sibling experienced rejection in the form of neglected attention while the ADHD sibling enjoyed the full support as well as attention from the parents. In this case, the parents presumed that the non-ADHD sibling was just alright as they do not suffer the condition and that the ADHD sibling had to be given utmost attention and support since they were already suffering from the condition. An example is that in situations where the ADHD sibling and non-ADHD had disagreements, the parents were inclined in siding with the ADHD sibling making the non-ADHD sibling feel vulnerable. One sibling had to tell his parents, “Just go help your son; he needs you more than me.” The feeling of rejection could be so intense that the non-ADHD sibling was exposed to drug abuse risk, as reported by some participants.
Inconsistency with discipline
Most participants expressed concerns of leniency when disciplining the ADHD sibling but no tolerance when disciplining the non-ADHD sibling. The ADHD sibling is likely to receive a few consequences in homework bad behavior compared to the non-ADHD sibling. According to the participants, their ADHD sibling could break the family rules or exhibit general misbehavior, but they could not do that when they were young. One of the participants gave an example of inconsistency with discipline at home. He said that when he was in grade one, he was always compelled by the parents to have a minimum of an hour of homework every day but don’t the same for the non-ADHD sibling. The dad would always help the ADHD brother complete his homework even after just twenty minutes into the homework. Even if some children complained about these discrepancies, the parents would create an excuse and ultimately, justify their behavior. The effect of this was frustrated, irritated as well as an angry non-ADHD sibling. The sibling would have a changed perception of the parent or the caregiver in instilling authority. The discrepancy also hindered the development of the non-ADHD sibling because of the ruined relationship with the various subsets of the sibling microenvironment at home.
Impacts of parentified child
Most parents expected the non-ADHD sibling to take care of the ADHD sibling in more or less like parents. The parents expected the non-ADHD sibling to offer caretaking activities such as giving medication as well as assisting the ADHD sibling with their homework. Although it is not bad for a sibling to help the other siblings with such activities, what was evident from the study is that the non-ADHD siblings were made to do the activities against their will. According to Earley & Cushway (2002), parentification is the act of expecting a child to assume parent state by making him/her perform roles expected to be performed by a parent and more so when the child is not comfortable with the task. The role of a parent should be provided by primary adults, such as immediate caregiver or parent. The HIV pandemic has, however, reaped off may families their parents or immediate caregiver. This has made many children assume the role of a parent against their wish. ADHD has also plaid a significant role in parentification as it is common for parents to expect non-ADHD sibling to protect, guide as well as offer general care to the ADHD sibling.
Conclusion and Recommendations
From the study, it is evident that there are adverse effects or impacts experienced by the non-ADHD sibling because one of the siblings has ADHD. Even though the non-ADHD experiences some of the results, the parents or the caregivers are not fully aware that their actions in addressing ADHD amongst non-ADHD sibling have undesired impacts on the non-ADHD sibling. From the study, the results were expressed in the form of themes relating to how the non-ADHD sibling perceive the impact a sibling diagnosed with ADHD and the impact of this on the family system. These themes: parentified child, discipline discrepancies, non-ADHD sibling rejection and differential parental treatment at home with ADHD case are a clear indication of what the non-ADHD sibling goes through in the hands of their parents or other caregivers because of ADHD sibling. Parents or caregivers with ADHD siblings should exercise extra caution because they could be the reason for hatred or broken family ties between the ADHD and non-ADHD sibling. All the siblings should be accorded the same attention and support regardless of being ADHD or non-ADHD. The non-ADHD sibling would even be more supporting to the ADHD sibling if they don’t perceive unfairness at home. Although it might be somehow challenging for a parent to score 100% in balancing care and support to both ADHD and non-ADHD sibling, professional assistance can be vital in enforcing balanced support.
References
Earley, L., & Cushway, D. (2002). The parentified child. Clinical child psychology and psychiatry , 7 (2), 163-178.
Foley, M. (2011). A comparison of family adversity and family dysfunction in families of children with attention deficit hyperactivity disorder (ADHD) and families of children without ADHD. Journal for Specialists in Pediatric Nursing, 16(1), 39-49.
Hamed, A. M., Kauer, A. J., & Stevens, H. E. (2015). Why the diagnosis of attention deficit hyperactivity disorder matters. Frontiers in psychiatry, 6, 168.
Johnston, C., & Mash, E. J. (2001). Families of children with attention-deficit/hyperactivity disorder: review and recommendations for future research. Clinical child and family psychology review , 4 (3), 183-207.
