Brothers as Playmates for Their Siblings with Developmental Disabilities: A Multiple-Baseline Design Study

  • Ling-Ling TsaoEmail author
Original Paper



The feasibility of using typically developing siblings as social interaction intervention agents has been suggested in the literature addressing interactions and relationships between children with disabilities and their siblings. However, the outcomes are not completely understood.


This study evaluated an intervention that targeted the social play of children with developmental disabilities (DD) that was implemented by typically developing brothers in the children’s home settings.


A multiple-baseline design across three sibling dyads was used to examine the effectiveness of the social interaction intervention.


The findings resulted in a moderate change in social behaviors of children with DD and increased social skill strategies used by typically developing boy siblings. Percentage of non-overlapping data and Tau-U indices were provided and discussed for the use of sibling-mediated social play intervention with children with DD.


The goal of sibling-mediated social interaction intervention is to provide typically developing siblings with specific techniques to engage children with disabilities in play, with the intention of encouraging their active participation to improve the quality of their interaction. By individually fine-tuning the activities to meet the interests of both children with disabilities and their siblings, typically developing siblings can be taught some social competencies that have value not only for children with disabilities, but also for themselves. They can become cognitively aware of their own thought processes.


Typically developing boys Brothers with developmental disabilities Sibling-implemented social interaction intervention 



This research report was supported by the National Institute of Child Health and Human Development of the National Institutes of Health under award 5R03HD58800-2. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.

Compliance with Ethical Standards

Conflict of interest

The author declares that she has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board (IRB) for the Protection of Human Subjects (Protocol: 09-157).

Informed Consent

Informed parental consent and child assent were obtained for all study participants.


  1. Abramovitch, R., Corter, C., & Lando, B. (1979). Sibling interaction in the home. Child Development,50, 997–1003.CrossRefGoogle Scholar
  2. Abramovitch, R., Stanhope, L., Pepler, D., & Corter, C. (1987). The influence of Down’s syndrome on sibling interaction. Child Psychology & Psychiatry & Allied Disciplines. Scholar
  3. Ansbacher, H., & Ansbacher, R. (1956). The individual psychology of Alfred Adler. New York: Basic Books.Google Scholar
  4. Azmitia, M., & Hesser, J. (1993). Why siblings are important agents of cognitive development: A comparison of siblings and peers. Child Development,64, 430–444.CrossRefGoogle Scholar
  5. Bachraz, V., & Grace, R. (2009). Creating a different kind of normal: Parent and child perspectives on sibling relationships when one child in the family has autism spectrum disorder. Contemporary Issues in Early Childhood,10, 317–330.CrossRefGoogle Scholar
  6. Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. Scholar
  7. Barlow, D. H., & Hersen, M. (1984). Single case experimental designs: Strategies for studying behavior change (2nd ed.). New York: Pergamon Press.Google Scholar
  8. Binnoon-Erez, N., Rodrigues, M., Perlman, M., Jenkins, J., & Tackett, J. (2018). Sibling personality traits, dyadic gender composition, and their association with sibling relationship quality. Merrill-Palmer Quarterly,64(2), 175–194.CrossRefGoogle Scholar
  9. Breslau, N., Weitzman, M., & Messenger, K. (1981). Psychological functioning of siblings of disabled children. Pediatrics,67, 344–353.PubMedPubMedCentralGoogle Scholar
  10. Brody, G. (2004). Siblings’ direct and indirect contributions to child development. Current Directions in Psychological Science,13(3), 124–126.CrossRefGoogle Scholar
  11. Brody, G. H., Kim, S., Murry, V., & Brown, A. C. (2003). Longitudinal direct and indirect pathways linking older sibling competence to the development of younger sibling competence. Developmental Psychology,39(3), 618–628.PubMedCrossRefPubMedCentralGoogle Scholar
  12. Brody, G. H., Stoneman, Z., & MacKinnon, C. E. (1982). Role asymmetries in interactions among school aged children, their younger siblings, and their friends. Child Development,53, 1364–1370.CrossRefGoogle Scholar
  13. Brody, G. H., Stoneman, Z., MacKinnon, C. E., & MacKinnon, R. (1985). Role relationships and behavior between preschool-aged and school-aged sibling pairs. Developmental Psychology. Scholar
  14. Buist, K. L. (2010). Sibling relationship quality and adolescent delinquency: A latent growth curve approach. Journal of Family Psychology. Scholar
  15. Carr, J. E., Austin, J. L., Britton, L. N., Kellum, K. K., & Bailey, J. S. (1999). An assessment of social validity trends in applied behavior analysis. Behavioral Intervention,14, 223–231.CrossRefGoogle Scholar
  16. Cash, W. M., & Evans, I. M. (1975). Training preschool children to modify their retarded siblings’ behavior. Journal of Behavior Therapy and Experimental Psychiatry,6, 13–16.CrossRefGoogle Scholar
  17. Celiberti, D. A., & Harris, S. L. (1993). Behavior intervention for siblings of children with autism: A focus on skills to enhance play. Behavior Therapy,25, 573–599.CrossRefGoogle Scholar
  18. Chengappa, K., Stokes, J. O., Costello, A. H., Norman, M. A., Travers, R. M., & McNeil, C. B. (2013). Parent-child interaction therapy for severe sibling conflict in young children. Journal of Communications Research,5(1), 31–47.Google Scholar
  19. Colletti, G., & Harris, S. L. (1977). Behavior modification in the home: Siblings as behavior modifiers, parents as observers. Journal of Abnormal Child Psychology,5, 21–30.PubMedCrossRefPubMedCentralGoogle Scholar
  20. Corcoran, E. P. (2013). The influence of gender and birth order on adult sibling attachment relationships. Massachusetts School of Professional Psychology. Unpublished dissertation, UMI 3595218, Published by ProQuest LLC.Google Scholar
  21. Dallas, E., Stevenson, J., & McGurk, H. (1993). Cerebral-palsied children’s interactions with siblings II: Interactional structure. Journal of Child Psychology and Psychiatry,34, 649–671.PubMedCrossRefPubMedCentralGoogle Scholar
  22. Dirks, M. A., Persram, R., Recchia, H. E., & Howe, N. (2015). Sibling relationships as sources of risk and resilience in the development and maintenance of internalizing and externalizing problems during childhood and adolescence. Child Psychology Review,42, 145–155.Google Scholar
  23. Douglas, S. N., Kammes, R., Nordquist, E., & D’Agostino, S. (2018). A pilot study to teach siblings to support children with complex communication needs. Communication Disorders Quarterly. Scholar
  24. Dunn, J. (1983). Sibling relationships in early childhood. Child Development,54(4), 787–811.CrossRefGoogle Scholar
  25. Dunn, J. (1988). Sibling influences on childhood development. Journal of Child Psychology and Psychiatry,29(2), 119–127.PubMedCrossRefPubMedCentralGoogle Scholar
  26. Dunn, J., Brown, J. R., & Maguire, M. (1995). The development of children’s moral sensibility: Individual differences and emotion understanding. Developmental Psychology,31(4), 649–659.CrossRefGoogle Scholar
  27. Dunn, J., Brown, J., Slomkowski, C., Tesla, C., & Youngblade, L. (1991). Young children’s understanding of other people’s feelings and beliefs: Individual differences and their antecedents. Child Development,62, 1352–1366.PubMedCrossRefPubMedCentralGoogle Scholar
  28. Dunn, J., & Munn, P. (1986). Siblings and the development of prosocial behavior. International Journal of Behavioral Development,9(3), 265–284.CrossRefGoogle Scholar
  29. Dunn, J., Slomkowski, C., Beardsall, L., & Rende, R. (1994). Adjustment in middle childhood and early adolescence: Links with earlier and contemporary sibling relationships. Journal of Child Psychology and Psychiatry,35(3), 491–504.PubMedCrossRefPubMedCentralGoogle Scholar
  30. El-Ghoroury, N. H., & Romanczyk, R. G. (1999). Play interactions of family members towards children with autism. Journal of Autism and Developmental Disorders,29(3), 249–258.PubMedCrossRefPubMedCentralGoogle Scholar
  31. English, K., Shafer, K., Goldstein, H., & Kaczmarek, L. (1997). Interaction among preschoolers with and without disabilities: Effects of across-the-day peer intervention. Journal of Speech and Hearing Research,40, 33–48.CrossRefGoogle Scholar
  32. Ferraioli, S., Hansford, A., & Harris, S. (2012). Benefits of including siblings in the treatment of autism spectrum disorders. Cognitive and Behavioral Practice,19, 413–422.CrossRefGoogle Scholar
  33. Fisman, S., Wolf, L., Ellison, D., & Freeman, T. (2000). A longitudinal study of siblings of children with chronic disabilities. Canadian Journal of Psychiatry,45, 369–375.PubMedCrossRefPubMedCentralGoogle Scholar
  34. Furman, W., & Buhrmester, D. (1985). Children’s perceptions of the qualities of sibling relationships. Child Development. Scholar
  35. Garcia, M. M., Shaw, D. S., Winslow, E. B., & Yaggi, K. E. (2000). Destructive sibling conflict and the development of conduct problems in young boys. Developmental Psychology. Scholar
  36. Gast, D. L., Lloyd, B. P., & Ledford, J. R. (2014). Multiple baseline and multiple probe designs. In D. L. Gast & J. R. Ledford (Eds.), Single case research methodology: Applications in special education and behavioral sciences (pp. 251–296). New York: Routledge.CrossRefGoogle Scholar
  37. Goldstein, H., & English, K. (1997). Interaction among preschoolers with and without disabilities: Effects of across-the-day peer intervention. Journal of Speech, Language & Hearing Research,40, 33–49.CrossRefGoogle Scholar
  38. Howe, N. (1991). Sibling-directed internal state language, perspective taking, and affective behavior. Child Development,62, 1503–1512.PubMedCrossRefPubMedCentralGoogle Scholar
  39. Howe, N., Recchia, H., Porta, S. D., & Funamoto, A. (2012). The driver doesn’t site, he stands like the Flintstones: Sibling teaching during teacher-directed and self-guided tasks. Journal of Cognition and Development. Scholar
  40. Howe, N., & Ross, H. S. (1990). Socialization, perspective-taking, and the sibling relationship. Developmental Psychology,26, 160–165.CrossRefGoogle Scholar
  41. Jackson, N. F., Jackson, D. A., & Monroe, C. (1983). Getting along with others: Teaching social effectiveness to children. Champaign, IL: Research Press.Google Scholar
  42. James, S. D., & Egel, A. L. (1986). A direct prompting strategy for increasing reciprocal interactions between handicapped and nonhandicapped siblings. Journal of Applied Behavior Analysis,19, 173–186.PubMedPubMedCentralCrossRefGoogle Scholar
  43. Kaminsky, L., & Dewey, D. (2002). Psychological adjustment in siblings of children with autism. Journal of Child Psychology and Psychiatry. Scholar
  44. Kazdin, A. E. (1982). Single-case research designs: Methods for clinical and applied settings. New York: Oxford University.Google Scholar
  45. Kim, T., & Horn, E. (2010). Sibling-implemented intervention for skill development with children with disabilities. Topics in Early Childhood Special Education. Scholar
  46. Knott, F., Lewis, C., & Williams, T. (1995). Sibling interaction of children with learning disabilities: A comparison of autism and Down’s syndrome. Journal of Child Psychology and Psychiatry and Allied Disciplines,36, 965–976.CrossRefGoogle Scholar
  47. Lavinguer, H. (1976). The use of siblings as an adjunct to the behavioral treatment of children in the home with parents as therapists. Behavior Therapy,7, 602–613.CrossRefGoogle Scholar
  48. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B., DiLavore, P. C., et al. (2000). The Autism Diagnostic Observation Schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders,30, 205–223.PubMedCrossRefPubMedCentralGoogle Scholar
  49. McGillicuddy-De Lisi, A. V. (1993). Sibling interactions and children’s communicative competency. Journal of Applied Developmental Psychology,14, 365–383.CrossRefGoogle Scholar
  50. McHale, S. M., Sloan, J., & Simeonsson, R. J. (1986). Sibling relationships of children with autistic, mentally retarded, and nonhandicapped brothers and sisters. Journal of Autism and Developmental Disorders,16, 399–413.PubMedCrossRefPubMedCentralGoogle Scholar
  51. McHale, S. M., Updegraff, K. A., & Feinberg, M. E. (2016). Siblings of youth with autism spectrum disorders: Theoretical perspectives on sibling relationships and individual adjustment. Journal of Autism and Developmental Disorders. Scholar
  52. Meadan, H., Stoner, J. B., & Angell, M. E. (2010). Review of literature related to social, emotional, and behavioral adjustment of siblings of individuals with autism spectrum disorders. Journal of Developmental and Physical Disabilities,22, 83–100.CrossRefGoogle Scholar
  53. Meyers, C., & Vipond, J. (2005). Play and social interactions between children with developmental disabilities and their siblings: A systematic literature review. Physical and Occupational Therapy in Pediatrics,25, 81–103.PubMedPubMedCentralGoogle Scholar
  54. Miller, N. B., & Cantwell, D. (1976). Siblings as therapists: A behavioral approach. American Journal of Psychiatry,133, 447–450.PubMedCrossRefPubMedCentralGoogle Scholar
  55. Minnett, A. M., Vandell, D. L., & Santrock, J. W. (1983). The effects of sibling status on sibling interaction: Influence of birth order, age spacing, sex of child, and sex of sibling. Child Development,54, 1064–1072.CrossRefGoogle Scholar
  56. Mullen, E. M. (1995). Mullen scales of early learning (AGS ed.). Circle Pines, MN: American Guidance Service Inc.Google Scholar
  57. Odom, S. L., & McConnell, S. R. (1997). Play time/social time: Organizing your classroom to build interaction skills. Minneapolis, MN: Institute on Community Integration (UIAP).Google Scholar
  58. Odom, S. L., & Strain, P. S. (1986). A comparison of peer-initiation and teacher-antecedent interventions for promoting reciprocal social interaction of autistic preschoolers. Journal of Applied Behavior Analysis,19, 57–72.CrossRefGoogle Scholar
  59. Oppenheim-Leaf, M. L., Leaf, J. B., Dozier, C., Sheldon, J. B., & Sherman, J. A. (2012). Teaching typically developing children to promote social play with their siblings with autism. Research in autism Spectrum Disorders. Scholar
  60. Parker, R. I., & Vannest, K. J. (2009). An improved effect size for single case research: nonoverlap of all pairs (NAP). Behavior Therapy,40, 357–367.PubMedCrossRefPubMedCentralGoogle Scholar
  61. Parker, R. I., Vannest, K. J., & Davis, J. L. (2011). Effect size in single-case research: A review of nine nonoverlap techniques. Behavior Modification,35, 303–322.PubMedCrossRefPubMedCentralGoogle Scholar
  62. Rakap, S. (2015). Effect sizes as result interpretation aids in single subject experimental research: Description and application of four nonoverlap methods. British Journal of Special Education. Scholar
  63. Recchia, H. E., & Howe, N. (2009). Sibling relationship quality moderates, the associations between parental interventions and siblings independent conflict strategies and outcomes. Journal of Family Psychology, Scholar
  64. Recchia, H. E., Howe, N., & Alexander, S. (2009). You didn’t teach me, you showed me: Variations in sibling teaching strategies in early and middle childhood. Merrill-Palmer Quarterly,55(1), 55–78.CrossRefGoogle Scholar
  65. Rispoli, M., Lang, R., Neely, L., Hutchins, N., Camargo, S., Davenport, K., et al. (2013). A comparison of within- and across-activity choices for reducing challenging behavior in children with autism spectrum disorders. Journal of Behavioral Education,22, 66–83.CrossRefGoogle Scholar
  66. Scruggs, T. E., & Mastropieri, M. A. (1998). Synthesizing single subject studies: Issues and applications. Behavior Modification,22, 221–242.PubMedCrossRefPubMedCentralGoogle Scholar
  67. Shivers, C. M. & Plavnick, J. B. (2015). Sibling involvement in interventions for individuals with autism spectrum disorders: A systematic review. Journal of Autism & Developmental Disorders, Scholar
  68. Smith, A. L., Romski, M., & Sevcik, R. A. (2013). Examining the role of communication on sibling relationship quality and interaction for sibling pairs with and without a developmental disability. American Journal of Intellectual and Developmental Disabilities,118(5), 394–409.CrossRefGoogle Scholar
  69. Stewart, R. B., & Marvin, R. S. (1984). Sibling relations: The role of conceptual perspective-taking in the ontogeny of sibling caregiving. Child Development,55, 1322–1332.CrossRefGoogle Scholar
  70. Stoneman, Z. (2001). Supporting positive sibling relationships during childhood. Mental Relation and Developmental Disabilities Reviews,7, 134–142.CrossRefGoogle Scholar
  71. Stoneman, Z., Brody, G. H., Davis, C. H., & Crapps, J. M. (1987). Mentally retarded children and their same-sex siblings: Naturalistic in-home observations. American Journal on Mental Retardation,92, 290–298.PubMedPubMedCentralGoogle Scholar
  72. Tankersley, M., Harjusola-Webb, S., & Landrum, T. J. (2008). Using single subject research to establish the evidence base of special education. Intervention in School and Clinic,44(2), 83–90.CrossRefGoogle Scholar
  73. Trent, J. A., Kaiser, A. P., & Wolery, M. (2005). The use of responsive interaction strategies by siblings. Topics in Early Childhood Special Education,25(2), 107–118.CrossRefGoogle Scholar
  74. Tsao, L., & Odom, S. L. (2006). Sibling-mediated social intervention for children with autism. Topics in Early Childhood Special Education,26, 106–123.CrossRefGoogle Scholar
  75. Walton, K. M., & Ingersoll, B. R. (2012). Evaluation of a sibling mediated imitation intervention for young children with autism. Journal of Positive Behavior Intervention. Scholar
  76. Wetherby, A., Prizant, M., & Barry, M. (2002). Communication and symbolic behavior scales: Developmental profile (CSBS DP) manual. Baltimore, MD: Paul H. Brookes Pub.Google Scholar
  77. White, O. R., & Haring, N. G. (1980). Exceptional teaching (2nd ed.). Columbus, OH: Charles Merrill.Google Scholar
  78. Whiteman, S. D., McHale, S. M., & Crouter, A. C. (2007). Competing processes of sibling influence: Observational learning and sibling de-identification. Social Development. Scholar
  79. Wolf, M. M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis,11, 203–214.PubMedPubMedCentralCrossRefGoogle Scholar
  80. Wright, B. M., & Benigno, J. P. (2019). Autism spectrum disorder and sibling relationships: Exploring implication for intervention using a family systems framework. American Journal of Speech-Language Pathology,28, 759–767.PubMedCrossRefPubMedCentralGoogle Scholar
  81. Youngblade, L. M., & Dunn, J. (1995). Individual differences in young children’s pretend play with mother and sibling: Links to relationships and understanding of other people’s feelings and belief. Child Development,66, 1472–1492.PubMedCrossRefPubMedCentralGoogle Scholar

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Authors and Affiliations

  1. 1.School of Family and Consumer SciencesUniversity of IdahoMoscowUSA

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