Helping your Children Get Involved in a Sibling’s Treatment Plan

Siblings can be a wonderful addition to a child’s ABA program, and participation of other children in your household can be a highly valuable experience for all involved. ABA therapy may bring about a wide range of experiences for a child with ASD, including great fun, favorite games, milestones achieved, and abundant reinforcement, in addition to some important moments of learning and growth. Sibling involvement can provide a fantastic opportunity for a child to continue to progress, reach new goals, or generalize skills learned to others of a similar age.

Older siblings have a unique opportunity to teach a child through naturalistic instruction, peer modeling, and by simply connecting and enjoying the time they are spending with their younger siblings. There are a few important things to keep in mind when incorporating older siblings into treatment sessions:

• Older siblings may at times feel like second fiddle as a result of the immense effort to enhance the progress of their sibling with ASD. Parents may find it helpful to schedule regular one-on-one time with the older sibling, placing special focus and attention on them. This time does not need to be extensive or elaborately planned – even running errands with the older sibling, completing a household task together, or going for a walk together can provide space for one-on-one connection.
• Encourage older children to ask questions about their younger siblings with autism, and respond with honest, age-appropriate answers. Let them know that you are open to hearing their thoughts, experiences, and needs.
• When incorporating older siblings into session, providing direct instruction can help empower them and increase engagement. Is your child with ASD learning how to let others play with his or her belongings? Teach the older sibling to play with these belongings in a specific way according to the child’s treatment plan, and how to respond to the child with ASD in a way that promotes learning.
• Be sure to praise and encourage the older sibling when they are participating during sessions! All children, including those without ASD, can benefit greatly from individualized attention, reinforcement, and affection from their caregivers.
• If an older sibling is resistant to participating in session, a supportive, encouraging approach is likely to be more successful than using authority to force participation. Threats of punishment for not participating should not be used. For time with peers to be successful, all parties should be in a relaxed and positive state of mind.

When considering participation of younger siblings into ABA therapy sessions, it is important to ensure that the appropriate behaviors of the child with ASD continue to be reinforced. Here are a few items to remember when involving younger siblings into treatment sessions:

• If younger siblings participate, parents and caregivers may be asked to maintain careful supervision of siblings during session time, to help the younger children respond to the client’s requests and behaviors in a way that supports the client’s positive behavior change. If a child with ASD has been learning to use their voice to ask for what they want, helping them to ask for a toy from a younger sibling (and then helping the younger sibling to comply) can be a wonderful naturalistic opportunity to strengthen and generalize those communication skills.
• Younger siblings, depending on their age, may have limits to their own communication and play skills, so helping them to play and interact with the child in treatment can be an excellent learning opportunity for both children. Activities in which both children have the skills to successfully participate should be chosen.
• When conflict arises, assist both children in appropriate problem-solving. If the child with ASD has practiced conflict resolution skills as part of their curriculum, providing slight hints (such as gestures or indirect suggestions) may help the child to learn to use these skills independently. If not, use short, simple directives to follow through with expectations, and praise each child for a job well done.

Consult your treatment team for additional support in creating individualized plans for sibling participation. In some cases, having structured time set aside for sibling interaction may be best, while in other cases it is most beneficial to have a more naturalistic session flow, where the sibling comes and goes throughout the session. Because all children have different personalities, preferences, and challenges, seeking the input of a professional who knows your family well can help contribute to positive outcomes for your child.

Elizabeth Carson, Psy.D., BCBA, Clinical Intake Manager
Tuesday, February 18, 2020