Siblings' Lived Realities of Autism Spectrum Disorder

Introduction: Autism spectrum disorder (ASD) affects 1 in 54 children globally. South African estimates suggest that approximately 2% of the population has the condition. The persistent nature of ASD characteristics requires an enduring commitment of care from the entire family. Despite the positive experiences equated with raising a child with ASD, families experience stress and reduced mental and emotional well-being. Both the positive and less favourable aspects of ASD influence typically developing siblings within the family unit. This study explored the perspectives of typically developing siblings who live in the same household as their sibling with ASD. Methods: The qualitative design allowed for the collection of in-depth data via semi-structured interviews. Participants aged seven years and older were recruited to participate in the study. The necessary permissions, consent and assents were obtained. Thematic analysis using an inductive approach was used to analyse the data. Findings: The findings revealed that siblings coped with challenging behaviours from the child with ASD, communication difficulties, limited time with parents, and resource limitations regarding support and skill acquisition. However, they adapted to these challenges by developing coping strategies and being self-driven to understand ASD. Conclusion: Siblings are integral to the family unit. Further research into their lived experiences and needs is prudent.  Implications for practiceFamily-centred occupational therapy should address the unique needs of siblings in families with a child with ASD, which imposes significant challenges on family dynamics. This study provides the following insights for research and intervention:•    Insights into sibling experiences and coping strategies can inform targeted interventions for siblings.•    Siblings, alongside parents, may reinforce therapeutic strategies at home, enhancing intervention outcomes.•    Further research is needed in culturally diverse contexts, particularly in South Africa, to optimise occupational therapy for families with autistic children.