What is Glass Child Syndrome?

What is glass child syndrome?

Despite what its name may suggest, “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.

Alicia Maples, who herself is a sibling of special needs children, drew attention to the phenomenon in a 2010 TEDx talk. The term glass child, she said, comes from the idea that parents caring for children with special needs “look right through” their healthy siblings. 

However, children without chronic illnesses or disabilities also need support, she goes on to add. “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,” she says. So what can parents and caretakers do to ensure glass children feel seen, valued, and cared for? We dive into this and more below. 

How many young people are glass children?

Understanding the prevalence of being a glass child is difficult, but according to one study as many as 8% of young people in “advanced industrialized societies” grow up with a family member who is chronically ill. Also, about 17% of children in the U.S. have one or more developmental disabilities, suggesting that a portion of young people likely have a sibling with a chronic illness or disability.

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

Having a sibling with a chronic illness or disability can have a profound impact on a person’s life experiences, emotions, and relationships, both in the short and long term. In Maples’ case, being a glass child significantly impacted her family dynamics and took an emotional toll — in fact, as a child she hid her thoughts of ending her life from family members who were focused on her brother’s well-being. “Glass children 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,” she said. 

Maples’ 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. One study found that children living with a sibling with a chronic illness may communicate less and ignore their own needs. Also, as their needs are deprioritized, they may find new ways to meet their needs themselves, like by learning new skills, the study found. All those transformations may be viewed as positive and as examples that the healthy sibling is doing well — even if they aren’t.

As Maples said, 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 impacts of being a glass child. 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 a person’s mental health?

As with any situation in life, not all people who have siblings with chronic illnesses or disabilities have the same experiences. That said, the mental health of so-called glass children is the subject of research — much of which shows that glass children suffer negative mental health effects from having a sibling with a chronic illness or disability. 

A 2012 meta-analysis of 52 studies examining psychological functioning in the siblings of people with chronic illnesses or disabilities found that so-called glass children faced some negative mental health effects. 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 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

Most recently, a 2022 systematic review and meta-analysis found that siblings of children with chronic illnesses or disabilities were more likely to have symptoms of depression.

What are the signs that a glass child 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

How can you support glass children?

By offering understanding, support, and resources, you can help glass children navigate the challenges of growing up in a family impacted by chronic illness or disability while promoting their well-being and resilience. Here are some ideas and resources to support glass children: 

• 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 her TEDx talk, Maples also recommended that parents or caregivers do the following to support glass children:

• Help your child find the care and support they need
• 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
• Spend time with them alone

Mental health treatment for glass children

Mental healthcare and support are thought to be very helpful for the siblings of children with chronic illnesses or disabilities. The research exploring the best mental healthcare options for glass children is limited and inconclusive. However, the important thing, says Maple, is to find some kind of support. “Find a safe place where they can go and talk about their feelings and get some tools, so they know how to cope,” she suggests. 

One idea is to consider seeking professional help from therapists or counselors who specialize in supporting children and families dealing with chronic illness or disability. 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 Charlie Health can help 

If a person in your life or family has a sibling with a chronic illness or disability and could use some extra support themselves, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides more than once-weekly mental health treatment for people and families dealing with serious mental health conditions. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With this kind of holistic treatment, managing your family’s mental health is possible. Fill out the form below or give us a call to start healing today.