Millions of children are being raised solely by their grandparents, with numbers continuing to climb as the opioid crisis and other factors disrupt families. New research being presented at the American Academy of Pediatrics (AAP) 2018 National Conference & Exhibition shows that caregivers who step up to raise their grandchildren are overcoming unique challenges to manage just as well as biological and adoptive parent caregivers.The study abstract, "Grandparents Raising Grandchildren: Are They Up to the Job?" will be presented on Monday, Nov. 5, at the Orange County Convention Center in Orlando, Fla. The study is the first to examine a nationally representative sample of children and directly compare households where children are being raised by their grandparents with those being raised by their parents.

"A large and increasing number of mothers and fathers aren't able to meet the responsibilities of parenthood, prompting their own parents to take on the primary caregiver role for their grandchildren," said senior author Andrew Adesman, MD, FAAP, Chief of Developmental and Behavioral Pediatrics for Cohen Children's Medical Center of New York. "Although these children are more likely to have endured one or more adverse childhood experiences and the grandparents themselves often face extra health and socioeconomic hurdles, our findings suggest they appear to be coping well."

The researchers analyzed and compared 2016 National Survey of Children's Health data from 44,807 parent-led households and 1,250 grandparent households. They determined that caregivers raising their grandchildren were more likely to have a greater number of physical and mental health problems, have household incomes at or below the federal poverty line, have lower levels of education, and be single.

In addition, the grandchildren they were raising were more likely to become angry/anxious with transitions, lose their temper and have other behavioral issues.

"This was not surprising, since we know that children in non-parental care are likely to have experienced more adverse childhood experiences and have an increased risk of behavioral problems as a result," said abstract co-author Sarah Keim, PhD, Principal Investigator at Nationwide Children's Hospital.

However, Keim said, grandparents and parents showed no difference when asked if the child "does things that really bother" them, is "harder to care for" than peers, or if they "felt angry with this child." In fact, grandparents and parents did not differ on most measures of parent coping, parenting stress, or caregiver-child interactions when stratified by child health and child age.

The study also found that a substantial proportion of both grandparent caregivers (31 percent) and parent caregivers (24 percent), reported that they did not have anyone "to turn to for day-to-day emotional support with parenting."

"Given that children being raised by their grandparents may pose greater behavioral challenges, and that nearly a third of the parenting grandparents reported they had no one to turn to for day-to-day emotional support with parenting, pediatricians and other health professionals caring for 'grandfamilies' must be mindful of these issues and be ready to refer families to counseling when needed, as well as refer them to supports groups locally and online," Dr. Adesman said.