What is Glass Child Syndrome?

What is glass child syndrome?

Glass child syndrome isn’t a medical condition or diagnosis. It’s a colloquial term often used to describe the challenges and unique strengths of the siblings of children with chronic illnesses or disabilities.

In a 2010 TEDx talk, speaker Alicia Arena drew attention to a phenomenon that resonated with so many viewers who grew up with siblings who had special needs: glass children.

“Glass children take on these caretaker responsibilities and naturally we are conditioned not to have any problems,” she said. “We are supposed to be perfect. When someone asked us how we were doing, the answer is always: I'm doing fine.”

Who are glass children? Is there really such a thing as glass child syndrome? And what can you do to ensure glass children feel seen, heard, valued, and cared for? We’re diving deep into the topic below.

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“We are called glass children,” Arena explained, “because our parents are so consumed with the needs of our brothers and sisters that when they look at us they look right through us as though we're made of glass.”

Arena continued: “You cannot take for granted the emotional health of your children. Every emotion that you feel—whether it's pain, whether it's anger, frustration, fear, concern, crises of faith that you are experiencing because of your special-needs child—your healthy child feels all of it too, but with the coping skills of a child. So, when you ask your healthy child are you okay and they say yes, mommy, I'm fine, do not believe them. They are not fine. How can they be fine if they are experiencing what you are experiencing as a child?”

How many young people are “glass children”?

Understanding the prevalence of this experience is difficult, but as much as 8% of young people in the Global North grow up with a family member who is chronically ill. About 17% of children in the U.S. have one or more developmental disabilities.

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Although challenging to obtain data on prevalence accurately, it seems that a significant portion of young people likely has a sibling with a chronic illness or disability.

How might having a sibling with a chronic illness or disability impact a young person?

“Glass children take on these caretaker responsibilities and naturally we are conditioned not to have any problems. We are supposed to be perfect. When someone asked us how we were doing, the answer was always: I'm doing fine,” Arena said. “When my brother David died, I was almost 11. It was at that point in my life that I first started to plan how to kill myself. But here's the thing: No one knew … No one had a clue about how much I wanted to die because, again, that was my job.”

Arena’s claim that the siblings of children with chronic illnesses or disabilities transform themselves to be what their families need them to be is supported by research. Those transformations may be viewed as positive and as examples that someone’s doing well—even if they aren’t.

Some siblings may not feel like they can share negative feelings or experiences because their parents are busy caring for the child with a chronic illness or physical or developmental disability. They may feel that meeting their own needs comes second to the needs of their family. They may also distance themselves so they can better cope, which can intensify any negative effects.

There may, however, also be positive traits. The siblings of children with chronic illnesses or disabilities may develop more cognitive empathy—the ability to understand others’ emotions—than those without siblings who have chronic illnesses or disabilities.

How might having a sibling with a chronic illness or disability impact mental health?

As with any situation in life, not all young people who have siblings with chronic illnesses or disabilities have the same experiences. That said, we can look to a 2012 meta-analysis of 52 studies examining psychological functioning in the siblings of people with chronic illnesses or disabilities published in Pediatrics to understand the potential impact better.

According to the paper, which was published in the Journal of Pediatric Psychology, the researchers identified a small but significant negative effect on siblings. The studies showed that siblings could be especially vulnerable to internalizing issues rather than seeking help from their parents. The results varied by age of the family member, with older siblings demonstrating more of a negative effect than younger siblings. They also varied by how serious the illnesses were, with a heightened risk of psychological challenges among the siblings of children with highly intrusive and life-threatening illnesses.

‍Another study, published in 2013 in Pediatrics, broke down the psychological impact among 245 sibling participants. In the study, parents reported an increased rate of challenges in the following areas among their children who didn’t have chronic illnesses or disabilities:

• Interpersonal relationships
• Overall functioning
• Functioning at school
• Use of leisure time

A 2022 systematic review and meta-analysis published in the Journal of Pediatrics found that siblings of children with chronic illnesses or disabilities were more likely to have symptoms of depression.

What are the signs if the sibling of a child with a chronic illness or disability is having trouble coping?

The American Academy of Pediatrics writes that the following conditions or situations may be signs that the sibling of a child with a chronic illness or disability needs extra support:

• Your child is experiencing anxiety.
• Your child is experiencing depression.
• Your child is acting withdrawn.
• Your child appears to be angry.
• Your child is losing interest in their friends or activities they used to enjoy.
• Your child isn’t doing well in school.
• Your child is pushing themself too hard to do well.
• Your child is behaving rebelliously.
• Your child is “acting out” to get attention.

Your child’s healthcare provider can help you find resources for support—and you can turn to youth-oriented mental healthcare programs like Charlie Health for individual therapy, supported groups, and family therapy personalized for your family and situation.

How can you support the sibling of a child with a chronic illness or disability?

Research shows that the siblings of children with chronic illnesses or disabilities often develop and use their own coping strategies to manage, including learning more about the illness or disability to increase understanding and empathy—as well as tolerate and decrease feelings around the imbalance in parental attention.

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The siblings of children with chronic illnesses or disabilities may benefit from:

• Supportive relationships with people in similar circumstances. (The Sibling Leadership Network can be a great resource.)
• Family involvement in care and support.
• Open discussion with the healthcare providers of their siblings to reduce anxieties and uncertainties.
• Age-appropriate educational materials about the illness.
• Open family discussion about the illness and its impact.
• Space to find personal interests, achieve goals, and develop a positive self-identity outside of illness and sibling support.
• Going to a supportive camp.

In the TEDx talk, Arena also made three very strong recommendations for the parent or parents of siblings:

1. Help your child find the care and support they need.
2. Show them that you love them unconditionally—not just because they’re able to help you care for the child with a chronic illness or disability.
3. Spend time with them alone.

Mental health treatment for the siblings of children with chronic illnesses or disabilities

Mental healthcare and support are thought to be very helpful for the siblings of children with chronic illnesses or disabilities. However, the research exploring the best mental healthcare options is limited and inconclusive.

The important thing, said Arena, is to get them some kind of emotional support. “You send them to counseling, you find a support group for them,” she recommended. “Find a safe place where they can go and talk about their feelings and get some tools so they know how to cope and they know what to do because otherwise the patterns that they learn are going to repeat themselves through adulthood.”

Care and support at Charlie Health

Anyone and everyone can benefit from the dedicated support of mental health clinicians. For those of us whose children may be deeply struggling, a structured program can help the people we love to get the comprehensive support they need.

Charlie Health offers a fully virtual Intensive Outpatient Program (IOP) for children, teens, and young adults ages 12 to 28. IOPs are a great option for young people whose challenges may be better supported by more extensive care than once-a-week therapy. Charlie Health’s IOP incorporates individual therapy, supported groups based on shared history and experiences, and family therapy that centers on familial relationships and dynamics.

We know that traditional mental healthcare is far from accessible for all—especially for parents and guardians who care for multiple children with varying levels of need. Charlie Health accepts major insurance plans and Medicaid to bring access to quality care to as many people as possible.

If your child, teen, or young adult needs support, Charlie Health can help. Reach out to us today to see if our program is right for your family.