中華心理衛生協會

 Purpose: Existing research on sibling relationships involving individuals with autism often focuses on individual perspectives, viewing siblings as stimuli to explore the interactions among various stimulus variables. Autism is frequently conceived as a risk factor in the relationships of these siblings. However, there was a lack of consistency and a sense of ambiguity in the results. Besides, in the context of Taiwanese families, interpersonal interactions follow specific social norms, such as Chinese familism, which defines a system of family interaction for maintaining harmony. It is challenging to exclude parental influence when discussing sibling relationships in families with autism. Factors such as sibling gender and birth order also deserve consideration. This study aims to explore the relational experience of being an adult elder sister to an autistic brother within the context of Chinese familism in Taiwan. Methods: 3 females aged 25-35 participated in the study, and they were the elder sisters of autistic brothers. Each interview lasted between 90 and 120 minutes, during which discussed their sibling relationship and interactions with their autistic brother. Afterward, a phenomenological analysis of the transcripts was conducted. Results: The general structure revealed from the analysis is composed of 4 themes. (1) sibling interaction in a natural state, which indicates siblings of autism initially interact similarly to typical siblings and continue to engage naturally by providing necessary guidance and support when they recognize the unique behaviors of autistic brothers. (2) sibling as an assigned helper, which shows that the sibling carrying out various care activities for the autistic brother on behalf of the parents and beyond a mere sibling relationship, shaping the care triangle within the family dynamic. Despite this being a manifestation of filial piety, feelings of reluctance or unfairness may compromise the natural sibling relationship. (3) facing the diagnosis of autism, which highlights the phenomena that siblings perceive unique behaviors through personal experiences, while professional diagnosis offers a different perspective that does not aid in understanding their daily interactions. however, diagnosis allows for access to professional care and resources, incorporates professional elements into the sibling relationship, and offers siblings a future-oriented, actionable direction. (4) developmental path in the transition from assigned helper to professional caregiver, which illustrates a dilemma that occurred while a sibling became a professional caregiver, believing that it not only benefits personal development but also equips them with the knowledge to take care of their autistic siblings, but they experienced rejection from family members. In addition, what appears to be rejected is not a specific caregiving model, but rather professional caregiving provided by siblings. Conclusions: according to these findings, 3 patterns of experiential structure of sibling caregiving were identified: natural caregiving, assigned caregiving, and professional caregiving, and the corresponding displacement within the caregiving structure was defined. The results of this study imply that sibling relationships with autistic individuals cannot be understood without referring to the familistic framework, especially in Taiwanese families.