Parenthood Take Two: The Mental Health of Custodial Grandparents and the Academic Preparedness of the Preschoolers they Raise

Principal Needs & Problems: 58% of preschool-aged US children do not have the optimal physical cognitive and social-emotional preparedness to enter kindergarten Healthy and Ready to Learn (new HRSA MCH National Outcome Measure for school readiness). Without early intervention poor school readiness sets up children for poor academic performance throughout their education and widens disparities in educational and employment outcomes. Household stability and caregiver mental health are important to school readiness. However the number of children in foster care is increasing: by 12% between 2012-2017 alone. Major drivers likely include the epidemics of parent substance abuse (opioids methamphetamine) and incarceration. Foster care agencies now place more children in kinship care meaning that nearly 2.7 million grandparents are now primary caregivers for children. Caring for a child in these circumstances may affect the mental health of grandparents and the care they provide with downstream effects on children's readiness for school; however the current knowledge base about these associations is no longer generalizable to today's children because of the recent major shifts in substance abuse criminal justice and foster care policies that have changed the context under which 'grand families' form and live . Thus current services and school readiness programs may be a mismatch for the needs of today's grand families and further undermine children's ability to enter school healthy and ready to learn. There is therefore an urgent need to provide an updated understanding of the mental health status of the growing grandparent caregiver population and the school readiness of their grandchildren in order to better support their needs. Design and Methods: With a nationally-representative sample of 24 000 children ages 1-5 years from the National Survey of Children's Health (2016-18) our objective is to gain a contemporary understanding of the mental well-being of today's grandparents raising grandchildren and to examine how early cognitive development (as measured by early language acquisition) and school readiness differs between young children being raised by grandparents compared to parents. This aligns with MCHB Strategic Research Issue IV: Promoting the healthy development of MCH populations as school readiness is a leading indicator of early child development. Importantly this project will use propensity score matching methods to balance confounders that drive selection into grandparent-only multigenerational or parent-led homes. This research is innovative in that it represents a substantive departure from past studies that had limited generalizability narrow assessment of school readiness and incomplete consideration of key covariates. The knowledge gained is expected to be significant because it can be applied to tailor early childhood programs to better meet the needs of this vulnerable population.

Keim SA, Parrott A, Mason RE. Mental health and parenting demands among grandparent caregivers of young U.S. children [published online ahead of print, 2022 Jul 12]. J Women Aging. 2022;1-12. doi:10.1080/08952841.2022.2094153 DOI:10.1080/08952841.2022.2094153 July 2022 35820049

Yisahak SF, Khalsa AS, Keim SA. Caregiver Concern About Child Overweight/Obesity in Grandparent Versus Parent-Headed Households in the United States [published online ahead of print, 2022 Jul 31]. Acad Pediatr. 2022;S1876-2859(22)00370-9. doi:10.1016/j.acap.2022.07.019 DOI:10.1016/j.acap.2022.07.019 July 2022 35921996