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The typically developing siblings of children with disabilities are vulnerable to behavioral problems as they grow up in an environment of considerable stress. Yet, the needs and behavior problems of these siblings are often neglected especially in Pakistan. In this cross-sectional study, we assessed the behavior problems among siblings of children with developmental disabilities. The strength and difficulties questionnaire (SDQ) was administered on 250 siblings (aged 6–17 years) of children with a developmental disability (Autism, Intellectual disability (ID), Down Syndrome (DS), and Attention Deficit Hyperactive Disorder (ADHD)) attending special education institutions in Karachi, Pakistan. Multiple linear regression was applied to assess the relationship between SDQ scores and other demographic, parental, and disability-related factors. Adjusted beta coefficients were reported along with a 95% confidence interval. The average SDQ score was found to be 14 ± 6 among the siblings of children with developmental disabilities. Multivariable analysis showed that the estimated mean SDQ score was almost twice among siblings of children with ADHD (95% CI: 0.73–3.48) and ID (95% CI: 0.64–3.16) than siblings of children with Down syndrome. Also, the mean SDQ score was 8 units higher among siblings of children with a severe developmental disability compared to mild disability (95% CI: 6.79–9.47). The findings of the current study emphasize the need for appropriate mental health services, using a family-focused approach from therapeutic and counseling platforms to the siblings, parents, and disabled brother/sister for early identification and management of behavior issues. Abbreviations:  ADHD: Attention Deficit Hyperactive Disorder; AKU: Aga Khan University; β: Beta Coefficient (Slope); βo: Intercept; CHS: Community Health Sciences; DS: Down syndrom; ERC: Ethical Review Committee; ID: Intellectual Disability; MLR: Multiple Linear Regression; SDQ: Strengths and Difficulties Questionnaire; SES: Socioeconomic Status; TD: Typically Developing

Behavioral problems and its associated factors among siblings of children with developmental disabilities: analytical cross-sectional study