. 2021 Apr 7;26(3):734–749. doi: 10.1177/13591045211007921

Table 1.

Summary of included studies (N = 15).

First Author, (Year), Country	Purpose	Sample	Method	Analysis	Results	CASP Quality Score
Pavlopoulou (2020)	To investigate TD sisters’ experiences in a co-established research process.	11 TD sisters, 13–14 years old, 9 older, 1 younger, 1 twin of ASD siblings (10–14 years old, 9 male)	Photovoice methodology	Thematic analysis	• 8 themes: difficulties with routines; acceptance of ASD is more important than awareness; positive feelings; strengths and resources; finding out what works as a family; witnessing parental struggles; advocacy; support needs	10
Greece			Interviews
Greece			Focus groups
Pavlopoulou (2019)	To investigate the experience of TD sisters who have an ASD sibling.	9 TD sisters, 12–14 years old, 6 older than ASD siblings (10–14 years old, 7 male)	Interviews	Interpretative Phenomenological Analysis	• 4 themes: interactions with ASD sibling; interactions with parents; practical struggles of caring; TD sibling’s needs	10
UK			Interviews	Interpretative Phenomenological Analysis		10
Costa (2019)	To understand and analyse the perceptions of TD siblings who have an ASD sibling.	6 TD siblings, 10–12 years old, 4 female, 3 younger than ASD sibling (5–13 years old, 5 male)	Interviews	Content analysis and a category system used for inductive and deductive analysis	• Greater knowledge and understanding of ASD leads to less embarrassment and increased ability to cope. • Discrepancy with level of parental availability and attention between TD and ASD sibling. • Attitudes of others can be difficult.	8
Portugal			Interviews			8
Tsai (2018)	To describe experiences of mothers and TD siblings of children with Autism in two cultural contexts.	14 TD siblings	Interviews	Interpretative phenomenological analysis	• 4 themes: influence of ASD; family resilience; what we do as a family; the support needed. • Marked differences in experiences between countries.	10
Taiwan/UK		• UK: 7 TD siblings 9–13 years old, 3 female, 5 older than ASD siblings (5–15 years old, all male) • Taiwan: 7 TD siblings 9–17 years old, 5 female, 2 older than ASD siblings (5–18 years old, 5 male)
Taiwan/UK		14 mothers (7 from each country)
Gorjy (2017)	To explore how TD siblings who have an ASD sibling view their lives.	11 TD adolescent siblings, 12–17 years old, 3 female, one twin and all others were older than ASD sibling (6–15 years old, 9 male)	Interviews	Nvivo 10: thematic analysis	• 6 themes: ‘it’s hard’; ‘it’s different’; ‘it affects my life’; ‘adaption’; ‘it’s worth it’; “but it’s normal for us’.	10
Australia			Interviews	Nvivo 10: thematic analysis		10
Corsano (2017)	To explore the experiences of TD siblings who have a brother with ASD.	• 14 TD siblings, 12–20 years old, 9 male, 11 older than ASD sibling (12–20 years old, all male)	Interviews	Content analysis	• 6 themes: attitudes towards ASD sibling; perceptions; precocious sense of responsibility; concern about the future; friendship difficulties; the need to talk.	10
Italy		14 Mothers	Interviews	Content analysis		10
Ward (2016)	To gain TD sibling’s perspectives of living with an ASD sibling and to examine differences in age, birth order and gender.	16 families	Interviews	Open coding and development of themes	• 2 themes: positive and negative experiences • Multiple differences in perceptions according to age, birth order and gender of the TD sibling.	9
USA		• 22 TD siblings (7 came from 3 families), 7–18 years old, 11 female, 12 older, 2 twins.	Interviews	Open coding and development of themes		9
Cridland (2016)	To investigate the experiences of TD siblings of younger brothers with ASD and how best to support them.	3 families	Interviews	Nvivo: coding and development of themes	• 4 themes: roles at school; roles at home; tension with family system; adjustment to having an ASD sibling.	10
Australia		• 3 TD adolescent sisters, 16–17 years old, all older than their brother with ASD (13-15 years old) • 3 mothers • 2 fathers	Interviews	Nvivo: coding and development of themes		10
Chan (2014)	To explore the coping ability of TD siblings who have an ASD sibling and how they contribute to the dynamics of familial relationships.	5 families	Interviews	Nvivo 10: coding and development of themes	• 3 themes: double-standard parenting; strategies and responses to this; mother’s relationship with TD child.	9
Singapore		• 5 mothers • 5 TD siblings, 9–13 years old, 3 male, 3 younger than ASD sibling (9–13 years old, all male)	Interviews	Nvivo 10: coding and development of themes		9
Petalas (2012)	To explore how TD siblings of brothers who have ASD make sense of their unique circumstances and experiences.	12 TD siblings, 14–17 years old, 6 male, 3 younger than sibling with ASD (4–18 years old, all male)	Interviews	Interpretative phenomenological analysis	• 6 themes: negative impact of siling’s ASD; impact of other’s reactions; influence of past experiences; acceptance and tolerance towards ASD sibling; positive experiences; future concerns.	9
UK			Interviews	Interpretative phenomenological analysis		9
Angell (2012)	To investigate experiences of TD siblings who had an ASD and identify their self-reported support needs.	12 TD siblings, 7–15 years old, 6 male, two twins, 5 younger than sibling with ASD (6–15 years old, 11 male)	Interviews	Cross-case analysis with a constant comparative method	• 3 themes: descriptions of the sibling subsystem; cohesion between siblings; adaptability of the TD sibling. • Some differences in experiences based on age and birt order of TD siblings.	9
USA			Interviews	Cross-case analysis with a constant comparative method		9
Hwang (2010)	To explore TD children’s experiences and perspectives of living with an ASD sibling.	9 TD siblings, 7–15 years old, 5 male, 4 younger than sibling with ASD (6–18 years old, 8 male)	Video diaries	Unclear	• Stigmatising attitudes of others caused TD siblings to feel shame. • TD siblings have the ability to reframe negative experiences, are resilient and can cope.	8
Korea			Home movies
Korea			Interviews
Petalas (2009)	To investigate perceptions and experiences of TD siblings, who had a brother with ASD.	8 TD siblings, 9–12 years old, 3 male, one twin, 3 younger than ASD sibling (8–17 years old, all male)	Interviews	Interpretative phenomenological analysis	• 5 themes: impact of their brother’s ASD on their lives; attitudes of others; tolerance and acceptance of ASD sibling; positive attitudes and experiences; support needs	9
UK			Interviews	Interpretative phenomenological analysis		9
Benderix (2007)	To describe TD siblings’ experiences of having a sibling with ASD and LD.	5 families	Interviews	Content analysis	• 7 content categories: precocious responsibility; feeling sorry; exposed to frightening behaviour; impact on friendships; empathetic feelings; hope a group home would cause relief; physical violence made TD siblings feel unsafe and anxious.	10
Sweden		• 14 TD siblings, 5–29 years old, 8 male, 10 older than ASD sibling	Interviews	Content analysis		10
Mascha (2006)	To pilot a method encouraging TD siblings to talk about their experience of having an ASD sibling.	11 families	Interviews	Content analysis	• Method used is appropriate for future research. • TD siblings reported both positive and negative experiences. • Attitudes of others towards the sibling with ASD were also a concern.	8
UK		• 14 TD siblings, 11–18 years old, 10 female, 12 older than ASD sibling (7–20 years)	Interviews	Content analysis		8

Note. ASD = autism spectrum disorder; TD = typically developing; DS = downs syndrome; DAMP = deficits in attention, motor control and perception; LD = learning disability.