Grandparents Raising Grandchildren in the United States: New Research Into Characteristics and Challenges

Largest study to date examines custodial grandparents from more than 80,000 households; shows children more likely to have social and behavioral problems

Dr. Andrew Adesman (Credit: Adam Cooper/Northwell Health)

MANHASSET, N.Y.--()--Approximately 2.7 million grandparents in the United States are raising their grandchildren, and yet little is known about the characteristics and challenges many of these households face. New research from the Division of Developmental and Behavioral Pediatrics at Northwell Health’s Cohen Children's Medical Center and the Feinstein Institutes for Medical Research sheds new insight into those households in the most extensive study to date, which examined 80,646 households, including 2,407 with grandparents raising their grandchildren.

A team of investigators, led by Andrew Adesman, MD, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center, published their findings today in the American Academy of Pediatrics journal, Pediatrics. The team examined the National Survey of Children’s Health (NSCH) from 2016 to 2018 in an effort to characterize and compare grandparent- and parent-headed households with respect to childhood adversity, child temperament, ADHD and caregiver aggravation and coping.

The paper shows that children in grandparent households were much more likely to have a history of Adverse Childhood Experience (ACEs), such as having lived with someone with drug or alcohol problems, psychiatric issues or exposure to violence. The study found children raised by their grandparents were six times more likely -- 35.6 percent for grandparents (compared to 5.8 percent for parents) -- to have had a parent or guardian serve time in jail and four times (29.7 percent) more likely to have lived with someone with a drug or alcohol problem.

School-age children (ages 6 to 17) raised by grandparents were almost twice as likely (18.0 percent) to have a medical diagnosis of attention-deficit/hyperactivity disorder (ADHD). The differences for preschool-age children (ages 3 to 5) were even greater. Those raised by grandparents were more than five times (7.8 percent) as likely to have a medical diagnosis of ADHD.

The results found poorer child temperament and an increase in parental aggravation in grandparent-headed household for school aged children, but when the children with an ADHD diagnosis were excluded from the analysis, those differences disappeared. This signifies that ADHD itself may be responsible for many differences seen between the households.

“For households across the nation, grandparents have stepped up to become caregivers, for a variety of reasons, and with that responsibility often comes difficulties,” said Dr. Adesman, senior author on the paper. “Through our research, we hope to identify some of the most common characteristics and challenges these grandparents may face to help provide insight, and potential tools to help these unique families.”

One major challenge revealed through the analysis showed that both parent-head of households (24 percent) and grandparent-head of households (30 percent) felt that they did not have someone to turn to for day-to-day emotional support. This conclusion echoes similar, past research findings and suggests that grandparent households may be particularly in need of social support services to cope with the difficulties associated with raising grandchildren. Despite the challenge of raising children with more difficult temperament, no differences were noted by grandparents with respect to their ability to handle the day-to-day demands of parenting.

“Dr. Adesman and his team’s research is a valuable look into the lives of the many children raised by grandparents,” said Charles Schleien, MD, MBA, senior vice president and chair of pediatric services at Northwell Health, and the Philip Lanzkowsky Chair and Professor of Pediatrics at the Zucker School of Medicine at Hofstra/Northwell. “Research like this is a step to help highlight and address the challenges American parents and grandparents may face in child rearing.”

About the Steven and Alexandra Cohen Children’s Medical Center of New York

Founded in 1983, Cohen Children’s Medical Center is a 202-bed hospital dedicated exclusively to the care of children. The specialists in the hospital’s national and international programs cover an entire range of specialties. State-of-the-art care for children’s medical, surgical, and dental needs are provided in both inpatient and outpatient settings. The facility is the largest provider of pediatric health services in New York State, serving 1.8 million children in Brooklyn, Queens, and Nassau and Suffolk Counties. For the 12th consecutive year in 2018, Cohen’s was ranked among the nation’s best children’s hospitals in U.S. News & World Report's 2018-19 “America’s Best Children’s Hospitals” survey, achieving top-50 rankings in eight of 10 pediatric specialties.

About the Feinstein Institutes

The Feinstein Institutes for Medical Research is the research arm of Northwell Health, the largest health care provider and private employer in New York State. Home to 50 research labs, 3,000 clinical research studies and 5,000 researchers and staff, the Feinstein Institutes raises the standard of medical innovation through its five institutes of behavioral science, bioelectronic medicine, cancer, health innovations and outcomes, and molecular medicine. We make breakthroughs in genetics, oncology, brain research, mental health, autoimmunity, and are the global scientific leader in bioelectronic medicine – a new field of science that has the potential to revolutionize medicine. For more information about how we produce knowledge to cure disease, visit and follow us on LinkedIn.


Matthew Libassi


Matthew Libassi