Feeling of Neglect by Siblings

When a child has a chronic illness or a disability, a great deal of the parents’ time is devoted to that child: doctor’s appointments, medication, care, and worry. The healthy sibling stands on the sidelines and gets less of that attention. This imbalance can lead to a growing feeling of being less important. Specialized agencies and families refer to this as the “shadow child.”

This isn’t about a fight over toys. Over weeks and months, the child experiences that their concerns seem less important than their brother’s or sister’s illness. They often go about their business quietly, help out, and hold back. Inside, sadness or anger builds up. Experts view this as an understandable reaction to a stressful family situation. It is not a diagnosis in itself.

The signs are often subtle. A child who never causes trouble can be just as troubled as one who acts out.

• They withdraw, seem sad, or are quiet.
• They complain of stomachaches or headaches with no clear cause.
• Their grades slip, and their concentration wanes.
• They react with outbursts of anger or defiance, even when the cause is minor.
• They conform excessively and take on responsibilities that are too great for their age.
• They express feelings of guilt, such as the secret thought that they are partly to blame for the illness.

The change is striking: a child who used to speak openly now falls silent. Some children hide their distress precisely because they don’t want to burden their parents further. When this assumed responsibility becomes a permanent role, it is referred to as sibling parentification.

Parental leave is a limited time. A child with diabetes, epilepsy, or a disability has appointments, therapies, and supervision that fill the day. What takes up this child’s time is missing elsewhere. The healthy child is unintentionally left out.

This is not a sign of poor parenting. The professional literature describes it as a typical side effect of an exceptional situation in which parents are stretched beyond their limits. When their own exhaustion sets in, the remaining attention they can give shrinks even further. Often, parents also unconsciously place their hopes on the healthy child and expect them to do what the sick child cannot. This pressure can become overwhelming and manifest as problems at school or social withdrawal. At the same time, studies indicate that many of these children grow up to be particularly socially competent and independent. Both aspects can coexist.

Children can cope with the fact that a sick sibling needs more attention at times. At the same time, they need reliable moments when they have their parents all to themselves. Small, regular rituals are more effective in this regard than rare, big outings.

• Set aside specific times: ten minutes in the evening, a meal with undivided attention, one set time each week.
• Talk about the illness in an age-appropriate and honest way so that hidden fears and feelings of guilt can be addressed.
• Clearly define responsibilities: which ones the child can and wants to take on, and which ones are beyond their age.
• Protect the child’s own interests and friendships outside the family.
• Allow for normal friction; sibling rivalry under stress is part of it and is acceptable.

In practical terms, taking turns as a team helps: one parent stays with the sick child, while the other spends time with the sibling. It’s also important to keep an eye on your own stress levels, because exhausted parents have little to give.

Regional seminars for siblings and self-help groups provide children with a place where others are in the same situation. Nationwide, there are over a hundred organizations offering such services. For parents, there are guidebooks and counseling centers that help them manage their energy.

If the warning signs persist—such as prolonged withdrawal, sleep problems, a significant drop in performance, or recurring feelings of guilt—a professional evaluation is advisable. Rückenwind provides coaching to parents in their daily lives and helps them support their other children. This is not a substitute for a diagnosis or psychotherapy. Only a child and adolescent psychiatric practice (KJP) or a medical or psychotherapeutic specialist can determine whether there is more to the issue.