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PACEs in Pediatrics

Family Well-being in Grandparent- Versus Parent-Headed Households [pediatrics.aappublications.org]

 

By Eli Rappaport, Nallammai Muthiah, Sarah A. Keim, and Andrew Adesman, Pediatrics, August 2020

Abstract

BACKGROUND AND OBJECTIVES: Little is known about the 2% of US children being raised by their grandparents. We sought to characterize and compare grandparent- and parent-headed households with respect to adverse childhood experiences (ACEs), child temperament, attention-deficit/hyperactivity disorder (ADHD), and caregiver aggravation and coping.

METHODS: Using a combined data set of children ages 3 to 17 from the 2016, 2017, and 2018 National Survey of Children’s Health, we applied survey regression procedures, adjusted for sociodemographic confounders, to compare grandparent- and parent-headed households on composite and single-item outcome measures of ACEs; ADHD; preschool inattention and restlessness; child temperament; and caregiver aggravation, coping, support, and interactions with children.

RESULTS: Among 80 646 households (2407 grandparent-headed, 78 239 parent-headed), children in grandparent-headed households experienced more ACEs (β = 1.22, 95% confidence interval [CI]: 1.07 to 1.38). Preschool-aged and school-aged children in grandparent-headed households were more likely to have ADHD (adjusted odds ratio = 4.29, 95% CI: 2.22 to 8.28; adjusted odds ratio = 1.72, 95% CI: 1.34 to 2.20). School-aged children in these households had poorer temperament (βadj = .25, 95% CI: −0.63 to 1.14), and their caregivers experienced greater aggravation (βadj = .29, 95% CI: 0.08 to 0.49). However, these differences were not detected after excluding children with ADHD from the sample. No differences were noted between grandparent- and parent-headed households for caregiver coping, emotional support, or interactions with children.

CONCLUSIONS: Despite caring for children with greater developmental problems and poorer temperaments, grandparent caregivers seem to cope with parenting about as well as parents.

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