Considering siblings of children with a diagnosis of ADHD

When a child receives a diagnosis of ADHD a lot changes in the family dynamic. There is an increased focus on supporting the child with the diagnosis.

Everyday can be challenging for the family if the child has not yet been diagnosed or if the ADHD diagnosis is new and effective support has not been implemented just yet.

Inattention, Hyperactivity and Impulsivity can make the morning routine difficult, spare time after school may regularly turn into fights between siblings. Parents may find themselves trying to constantly mediate between siblings, and on top of that mediate the expectations society may put on parents and how to interact with their children. These are only some challenges that a daily routine brings for any family for that matter, not just for families in which a child may have a diagnosis of ADHD.

What about the sibling who does not have a diagnosis of ADHD?

They often receive much less attention and stand on the sidelines of what happens in the family. They shift into the background.

So what happens for the child without the diagnosis? What may be their thoughts and feeling and how do these affect their behaviour and development?

Family Of Four Walking At The Street
Photo by Emma Bauso from Pexels

Due to the increased attention given to the child with the diagnosis the sibling may begin to start feeling invisible, unimportant. This experience may turn into thoughts and feelings of low self-esteem. “Mum and Dad are constantly talking and thinking about my brother/sister. They never think about me. They never spend time with me. They do not love me as much.”

This may lead to the sibling without the diagnosis to be hyper-agreeable, hyper-conscientious in the hopes that the parents may notice their achievements and their “good behaviour” and to receive praise.

Another motivation driving such overly independent behaviour may be the wish to relieve the parent of some of the (dis-)stress they may be exhibiting. A process known as parentification.

Often siblings may feel frustrated or irritated because they think (which may not be too far from the truth), “Everyday my parents have arguments or fights with my sibling (with ADHD). Why can’t we have just one day when no one is fighting and we are all just happy and relaxed?”

Such processing of their experience may lead to the child without a diagnosis to exhibit externalising behaviours (disobeying rules, arguing and fighting etc.) in oder to be heard and seen by the parents.

The sibling of the child with the diagnosis may have many more negative thoughts and feelings about the situation. These are just a few examples.

So how can we support the sibling equally as much as the child with the ADHD diagnosis?

  1. Show compassion and understanding
    Allow the siblings to show their negative feelings. Encourage them to talk to you when they are frustrated and upset. Help the sibling to identify their feelings and name them. Show understanding for them and meet them with compassion. If possible re-assure them that you as parents are trying your best to support everyone in the family.
  2. Parent-Child Time
    Regularly (once a week or similar) one parent (or both) spend time only with the sibling. This ought to be roughly one hour. This parent-child-time should take place when the child with the ADHD diagnosis is either at school, doing extracurricular activities or similar. This way the sibling can learn that the parents like spending time with them and that this time is not dependent on the siblings behaviour. During this time the sibling may choose what they want to do with the parent (drawing, playing games, talking, baking…). The sibling will feel more seen and more heard.
  3. Sibling Zones
    As described above, sometimes siblings may feel very frustrated and stressed by daily arguments. As a parent try to create spaces of calm, peace and safety for the sibling where they are able to retreat to whenever they want to extract themselves. This space should be comfortable and safe and no one may enter or disturb the sibling without permission. This may be a small play-tent or their room, if possible. Create a sign together with the sibling that can signal to everyone that the sibling is relaxing and does not want to be disturbed.
    Additionally, enable the siblings to do activities alone such as meeting friends, hobbies etc.
  4. Avoid Comparisons
    Try to avoid comparing the siblings with one another. This applies to any family. It might be well-intentioned saying things like, “You are better at sports than Maths or English.” in order to boost their strengths and self-esteem. However, what often happens then is that the siblings start comparing themselves to one another too, which turns into rivalry and further fights. One child may feel inadequate or lash out. Instead focus on and highlight positive interactions between the siblings, e.g. “It was so nice to see you two play together.”; “It was great when you helped your brother/sister:”

I hope this is helpful.

Please feel free to contact me should you have any questions or wish to discuss some aspects further.

Lukas Dressler

Lukas Dressler (he/him)
Psychologist (MSc.)
Integrative Psychotherapist (MBACP)
for Children and Young People



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Lukas Dressler - Psychotherapy Plus

Counselling Psychologist (MSc.), HCPC Registered, Integrative Psychotherapist for Children and Young People.