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How does autism shape the bond between siblings over time? 

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

According to NHS guidance, autism or autism spectrum disorder (ASD) affects how individuals communicate, express emotions, and relate to others. When one child in a family is autistic, their siblings often experience a relationship that evolves uniquely over time, shaped by learning, patience, and deep mutual understanding. 

As NICE guidance (CG142) explains, autism doesn’t limit the sibling bond; rather, it can transform how that bond develops as both children grow and adapt to one another’s communication and emotional styles. 

Early childhood: curiosity and confusion 

In early childhood, non-autistic siblings may first notice differences in communication, play, or behaviour. An autistic child might prefer solitary or repetitive play, find certain noises distressing, or struggle with shared activities. Without clear explanation, these differences can cause confusion or frustration. 

2025 study in the Journal of Autism and Developmental Disorders found that young siblings who were given early, positive explanations of autism displayed greater empathy and emotional awareness later in life. According to the World Health Organization (WHO), early education helps reduce sibling anxiety and encourages natural acceptance. 

Adolescence: understanding through experience 

As siblings enter adolescence, their understanding of autism deepens. According to NHS advice on communication and interaction, this stage often brings greater awareness of social differences such as how the autistic sibling handles friendships or sensory overload. 

Some siblings may feel protective, while others may experience frustration if family life revolves around managing autism-related challenges. However, studies show that as families communicate more openly, these feelings often shift from strain to empathy and pride. 

BMJ Open review (2024) reported that siblings who participate in family education sessions are more likely to maintain close emotional bonds, describing their relationships as based on trust and understanding rather than obligation. 

Adulthood: lifelong connection and acceptance 

Over time, many siblings describe their bond as an unspoken understanding. According to NICE guidance (CG170), growing up alongside an autistic sibling can enhance emotional intelligence and shape lasting family cohesion. Adult siblings often take on supportive or advocacy roles, helping ensure their autistic brother or sister is included in social and community life. 

The WHO notes that families who embrace neurodiversity early, recognising that communication and connection look different, not lesser, tend to maintain stronger, lifelong sibling relationships. 

Takeaway:  

Autism can shape sibling bonds in powerful ways: from early curiosity and challenges to lifelong empathy and connection. With open communication, understanding, and shared support, these relationships often grow into some of the most authentic and enduring family connections. 

Beatrice Holloway, MSc
Beatrice Holloway, MSc
Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez
Dr. Rebecca Fernandez, MBBS
Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy. 

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