GrandFamilies: The Contemporary Journal of GrandFamilies: The Contemporary Journal of
Research, Practice and Policy Research, Practice and Policy
Volume 6 Issue 1 Article 6
September 2020
Parenting challenges of grandparents raising grandchildren: Parenting challenges of grandparents raising grandchildren:
Discipline, child education, technology use, and outdated health Discipline, child education, technology use, and outdated health
beliefs beliefs
Ludivine Brunissen
Emory University
, [email protected]
Eli Rapoport
Cohen Children's Medical Center of New York
, [email protected]
Kate Fruitman
Cornell University
, [email protected]
Andrew Adesman
Cohen Children's Medical Center of New York
, aadesman@northwell.edu
Follow this and additional works at: https://scholarworks.wmich.edu/grandfamilies
Part of the Child Psychology Commons
Recommended Citation Recommended Citation
Brunissen, L., Rapoport, E., Fruitman, K., Adesman, A. (2020). Parenting challenges of grandparents
raising grandchildren: Discipline, child education, technology use, and outdated health beliefs.
GrandFamilies: The Contemporary Journal of Research, Practice and Policy
, 6 (1).
Available at: https://scholarworks.wmich.edu/grandfamilies/vol6/iss1/6
This Research Article is brought to you for free and open
access by the National Research Center on Grandparents
Raising Grandchildren at ScholarWorks at WMU. It has
been accepted for inclusion in GrandFamilies: The
Contemporary Journal of Research, Practice and Policy
by an authorized editor of ScholarWorks at WMU. For
more information, please contact wmu-
[email protected].
GrandFamilies Vol. 6(1), 2020
16
Research Article
Parenting Challenges of Grandparents Raising Grandchildren:
Disciplines, Child Education, Technology Use, and Outdated Health Beliefs
Ludivine Brunissen
Emory University
Eli Rapoport
Cohen Children’s Medical Center of New York
Kate Fruitman
Cornell University
Andrew Adesman
Cohen Children’s Medical Center of New York
Correspondence can be directed to: Ludivine Brunissen; Emory University School of
Medicine; [email protected]
Abstract
BACKGROUND: As of 2015, approximately three million children in the United
States were being raised primarily by their grandparents. This study aims to examine, in a
large national sample, to what extent grandparents raising grandchildren (GRGs) have
difficulty with discipline and meeting their grandchild’s educational and social needs, find
computers/other technology challenging, and subscribe to outdated health beliefs.
METHODS: An anonymous online parenting questionnaire was administered to
GRGs recruited through state and local grandparent support groups and elderly service
agencies.
RESULTS: 733 grandparents that self-identified as the primary caregiver of one or
more grandchildren met inclusion criteria. 56.5% of GRGs reported difficulties with
discipline, and 19.1% believed corporal punishment to be an appropriate method of
discipline. Approximately a third of GRGs reported difficulties with their grandchild’s
education, social and recreational activities. Nearly a third of GRGs did not find using their
grandchild’s school website or portal to be easy; those who had difficulty were more likely to
experience difficulties registering their grandchild for school (τ = -.127, p = .007) and were
less likely to feel that teachers maintained adequate contact (τ = .242, p < .001). A large
percentage of GRGs subscribed to outdated health beliefs, such as scrapes healing better if
they are not covered with a bandage (64.0%) and ice baths being an appropriate treatment for
a fever (39.8%).
CONCLUSION: GRGs encounter significant parenting challenges, owing to
generational differences. Healthcare providers and other professionals should provide GRGs
with anticipatory guidance to ensure grandchildren’s needs are properly met.
Keywords: parenting, education, discipline, technology, health beliefs
GrandFamilies Vol. 6(1), 2020
17
In recent years, the number of children being raised by grandparents in the U.S. has
increased substantially, from 2.5 million children in 2005 to 2.9 million children in 2015
(Wiltz, 2016). Moreover, from 1970 to 2012, the number of children living in grandparent-
headed households nationwide has almost doubled (Ellis & Simmons, 2014), and, according
to the U.S. Census Bureau, 6.1% of American children under the age of 18 lived in the home
of their grandparents in 2019 (U.S. Census Bureau, 2019). The placement of children in non-
parental care has recently begun to increase, driven partly by the opioid epidemic (Young,
2016), forcing grandparents to assume the full-time care of their grandchildren. Indeed, it is
estimated that over a third of all children who were removed from their homes in 2014 due to
parental drug and alcohol use were placed with relatives (Generations United, 2016) and
recent increases in the number of grandfamilies and “skipped generation families” have been
largely attributed to parental substance use (National Abandoned Infants Assistance Resource
Center, 2004).
Challenges Facing Grandfamilies
Although grandparents raising grandchildren (GRG) often report an increased sense
of purpose from assuming the care of their grandchildren (Lent & Otto, 2018), parenting a
grandchild without adequate support can pose significant challenges to the well-being of
elderly primary caregivers such as GRGs, including psychological and emotional distress
(Caputo, 2000; Fuller-Thompson et al., 1997; Peterson, 2017), physical health problems
(Neely-Barnes et al., 2010; Peterson, 2017; Yoo & Russell, 2020), and added financial
burdens (Hayslip & Kaminski, 2008). In addition, children living in grandparent-headed
households with parents present are also twice as likely to be living in poverty than children
in parent-headed households with grandparents present (Fields, 2003). Researchers have also
reported higher incidences of behavioral and emotional problems among adolescent
grandchildren in custodial grandparent care relative to other low-income youths (Smith &
Palmieri, 2007).
Despite a growing body of literature documenting challenges specific to GRGs and
their grandchildren, few studies have focused on parenting challenges arising from
generational differences which uniquely affect GRGs. A notable concern regarding GRGs is
that some parenting practices, educational settings, and health beliefs may have changed
since the time when grandparents raised their own children decades earlier. Specifically,
GRGs may have difficulties with maintaining discipline, meeting their grandchildren’s
educational and social needs, adapting to the extensive use of computers and other
technology by schools, and safely caring for their grandchildren’s health.
Discipline and Limit-Setting
Although grandparents are traditionally allowed to “spoil” their grandchildren,
effective limit-setting and discipline techniques are essential for grandparents assuming a
primary parenting role. Based on qualitative reports, GRGs report showing greater leniency
towards their grandchildren than they did towards their own children (Sampson & Hertlein,
2015) and tend to experience problems with discipline at home (Robinson & Wilks, 2006).
Moreover, a quarter of GRGs identify discipline and/or emotional problems of their
grandchildren as secondary stressors (Giarrusso et al., 2000). In addition, although corporal
punishment has become less common in recent years, it was tacitly accepted and more widely
practiced in the past (Zolotor et al., 2011), suggesting that older caregivers may be more
likely to use corporal punishment in the household since older caregivers were more likely to
have practiced corporal punishment when raising their own children. While custodial
grandparents have not been shown to differ from parents regarding their belief in the use and
value of corporal punishment (Hayslip & Kaminski, 2005), the extent to which endorsement
GrandFamilies Vol. 6(1), 2020
18
of corporal punishment and difficulties with discipline are associated with the ages of GRGs
has yet to be evaluated.
Academic and Social Challenges
Educational settings and expectations have changed substantially in the past several
decades, potentially precluding GRGs from meeting the complex educational and
extracurricular demands of their grandchildren. Research has shown that children raised by
custodial grandmothers lag behind their peers in the development of reading and quantitative
skills (Pittman & Boswell, 2007). According to Strom & Strom (2000), most GRGs are
unsure how to best support their grandchild’s learning and feel alienated when attending
parent-teacher association meetings with younger parents. Some GRGs may also encounter
challenges when registering their grandchildren for school due to lack of legal guardianship
status (Silverstein & Vehvilainen, 2000).
Multiple studies have suggested that GRGs may face unique social challenges. In
particular, the demands of the parenting role may isolate GRGs socially from peers who do
not have similar caregiving responsibilities (Ehrle & Day, 1994; Giarrusso et al., 2000).
Additionally, GRGs often report that they have little in common with the parents of their
grandchild’s friends (Erhle & Day, 1994), which may result in feelings of discomfort when
meeting social needs of grandchildren, such as attending birthday parties and extracurricular
activities. It remains unclear to what extent GRGs feel that they are meeting the educational
and social needs of their grandchildren, and which specific challenges are most commonly
encountered by GRGs. Additionally, even though the academic and social demands of
children increase in complexity as children advance from primary to secondary education, it
has yet to be evaluated whether the academic and social challenges of caregiving are different
for grandparents raising grandchildren in primary school relative to those raising children in
secondary school.
Computer and Other Technology Use
Although Internet use among older adults in America has steadily increased from
14% in the early 2000s to 67% in 2017 (Anderson & Perrin, 2017), lack of confidence in
learning new technology and lack of trust in the Internet among older individuals often leads
to apprehension of online activities (Gatto & Tak, 2008; Githens, 2007). Furthermore, older
adults are more likely to need additional time and to make more mistakes when performing
computer tasks (Lee at al., 2011). Additionally, the costs of owning a computer and
purchasing Internet access have been cited as the key constraints limiting computer use in
older adults (Carpenter & Buday, 2007; Lee et al. 2011), an issue which may
disproportionately affect grandfamilies living below the poverty line (Baker & Mutchler,
2010). Even though many schools have embraced the use of computers for school
registration, student learning, and teacher communication in recent years, it remains unclear
the extent to which barriers related to technology use make it difficult for GRGs to
effectively meet their grandchildren’s educational needs; it is also unclear how strongly
caregiver age is associated with barriers related to technology use which may preclude
meeting grandchildren’s education needs.
Health beliefs
Another parenting challenge subject to generational differences that GRGs may
encounter is outdated health beliefs. Many health guidelines have evolved since GRGs were
raising their own children several decades ago, such as proper sleeping positions for infants
(Engelberts et al., 1991), so it is possible that older caregivers are more likely to follow
outdated guidelines or practices. The extent to which GRGs subscribe to outdated health
GrandFamilies Vol. 6(1), 2020
19
beliefs, which may pose unnecessary risks to their grandchildren’s well-being, is presently
unknown.
In our study, using a national sample of GRGs in the U.S., we aimed to evaluate the
extent to which GRGs endorse corporal punishment and report challenges with discipline, as
well as difficulty meeting the educational and social needs of their grandchildren. We also
examined whether GRGs tend to encounter obstacles in using school-related technology and
whether they subscribe to outdated health beliefs. Based on previous research examining
GRGs and older adults, we expected to identify substantial parenting challenges relating to
each of these measures. Additionally, we aimed to assess the extent that some of these
measures were associated with the age of the caregiver and grandchild educational setting
(i.e., primary vs. secondary school). To the best of our knowledge, this study is the first to
report on these parenting challenges among GRGs using a large national sample, and the first
to assess whether parenting challenges among GRGs are more burdensome for older GRGs
or for grandparents raising older grandchildren.
Methods
Survey Instrument
The GRG questionnaire (GRG-Q) is an anonymous online parenting questionnaire
that was developed to assess attitudes towards discipline and limit setting, academic and
social concerns, challenges with computers and technology, and persistence of outdated
health beliefs in grandparents acting as the primary caregiver for their grandchildren. GRGs
were recruited electronically for the study from December 2016 to July 2017 through state
and local grandparent support groups and service agencies that support the elderly throughout
the U.S., such as those noted in national and state-level grandfamily fact sheets (GrandFacts
State Fact Sheets for Grandfamilies). For GRGs raising more than one grandchild, those with
children in grade school (ages 5-12 years) were asked to answer questions with respect to
their grade school-age child. GRGs raising multiple grade school-age grandchildren were
asked to answer the GRG-Q with respect to their eldest grade school-age grandchild, and
GRGs raising more than one grandchild where none were in grade school were instructed to
answer with respect to their oldest grandchild under the age of 18. This research protocol was
approved by the Institutional Review Board of Northwell Health.
GRG-Q items were divided into four subsections for analysis: 1) discipline and limit
setting, 2) academic and social challenges, 3) computer and other technology use, and 4)
health beliefs. In the discipline and limit-setting section, GRGs were asked if disciplining
their grandchild had been more difficult than expected, if they were less strict with their
grandchild before they began living in the same household, and if they viewed spanking (and
other forms of physical punishment) as an appropriate method of discipline. In the academic
and social challenges section, GRGs were asked the extent to which they agreed with a range
of parenting statements pertaining to their grandchild’s social life, such as if their grandchild
has friends or is teased by other children. Additionally, they were asked if their grandchild’s
social and recreational activities were more difficult for them to handle than expected. GRGs
were also asked about their grandchild’s education, including the adequacy of teacher
interactions (e.g., feeling welcomed and acknowledged by their grandchild’s teacher), their
ability to fulfill parenting responsibilities (e.g., attending Parent-Teacher conferences, school
performances, sport games, etc.) and to help with homework, and adequacy of meeting their
grandchild’s educational needs (including difficulties with schooling and school registration).
In the use of computers and other technology section, GRGs were asked about their own use
of technology (including Internet, email, Facebook), if they had difficulty using their
grandchild’s school website or portal, if they were unable to help their grandchild with
computers and other technology for school when needed, and if they felt less capable of
GrandFamilies Vol. 6(1), 2020
20
providing assistance with computer and other technology use relative to other parents. Lastly,
in the health beliefs section, GRGs were asked to evaluate the validity of several health-
related statements about which there are popular misconceptions (e.g., chocolate causes acne,
ice baths may be used to bring down a high fever, and infants should be put to sleep on their
back).
Inclusion Criteria
GRGs were included in the final sample for analysis if they consented to participate in
the study and if they reported being a grandparent who is the primary caregiver of one or
more of their grandchildren younger than 18 years of age.
Sample Characteristics
The GRG-Q was completed by 752 grandparents, of whom 733 met inclusion criteria.
Of the 733 grandparents in the sample, 685 (93.5%) were grandmothers; 418 (57.0%)
reference grandchildren were primary school-age (5-12 years old) and 153 (20.9%) were
secondary school-age (13-17 years old); 162 (22.1%) reference grandchildren were under the
age of 5.
Table 1
Sample Demographics of Grandparents and Grandchildren in Grandparent-
Headed Households (n = 733)
n
(%)
57.2
(7.9)
685
(93.5)
625
(85.3)
71
(9.7)
50
(6.9)
391
(53.3)
233
(31.8)
73
(10.0)
65
(8.9)
167
(22.8)
186
(25.4)
314
(42.9)
n
(%)
8.5
(4.3)
357
(48.7)
464
(63.3)
104
(14.2)
95
(16.1)
a Missing response from 14 participants; b Participants could select more than one
response option; c Eleven participants chose not to respond. d Missing response from one
participant. e One participant chose not to respond. Missing response from 132
participants.
GrandFamilies Vol. 6(1), 2020
21
The final sample had a mean age of 57.2 (SD = 7.9), and the majority identified as
white (n = 625, 85.3%). The highest level of educational attainment for approximately half of
GRGs was a high school diploma (n = 391, 53.3%), while 31.8% (n = 233) had a college
diploma, and 10.0% (n = 73) had a graduate degree. Almost half of GRGs had been raising
their grandchild for more than five years (n = 314, 42.9%); a quarter (n = 186, 25.4%) had
been raising their grandchild for three to five years, 22.8% (n = 167) for one to two years, and
8.9% (n = 65) had been raising their grandchild for less than one year. The average age of the
reference grandchild was 8.5 years (SD = 4.3) and 57.0% of sampled children were between
the ages of 5 and 12 years. Gender was evenly distributed (48.7% girls) and grandchildren
were predominantly identified as white (n = 464, 63.3%). Additional demographic
information of the sample is displayed in Table 1.
Statistical Analysis
An alpha of .05 was used for all statistical analyses in this study. All statistical
analyses were performed using R, version 4.0.0.
Discipline and Limit Setting
For each parenting statement concerning discipline and limit setting, Kendall rank
correlation coefficients were calculated to evaluate associations with grandparent age.
Additionally, descriptive statistics were calculated for rates of grandparent agreement with
discipline and limit setting statements, stratified by grandparent age.
Academic and Social Challenges
Chi-square tests of independence were performed to compare responses from
grandparents of grandchildren in primary school (ages 5 – 12) and secondary school (ages 13
– 17) across questions in the academic and social challenges section of the GRG-Q to
determine if the academic and social parenting challenges faced by grandfamilies differ as the
educational and social demands of grandchildren change. Additionally, a composite measure
for academic challenges was derived from individual items in the GRG-Q (Cronbach’s alpha
= 0.63); a t-test was used to compare this measure between grandfamilies with a reference
child in primary school and those with a reference child in secondary school to evaluate
overall differences in academic challenges. A composite measure for social challenges could
not be derived due to poor internal consistency of the component measures (Cronbach’s alpha
= 0.48). For these analyses, children with Autism Spectrum Disorder and/or an intellectual
disability were excluded from the sample. Additionally, children whose grandparents were
not sure if their grandchild had an Autism Spectrum Disorder or intellectual disability were
also excluded if they currently had an Individualized Education Program or were in a special
education class in school. Similarly, children whose grandparents reported they were a slow
learner or were unsure if they were a slow learner were excluded if they currently had an
Individualized Education Program or were in a special education class in school. These
exclusion criteria were intended to reduce the impact of including students with atypical
academic challenges in our analyses.
Computer and Other Technology Use
Analyses of measures in the computer and other technology use section of the GRG-Q
were restricted to grandparents of children ages 5 to 17 since many of the measures relate to
school and education. Kendall rank correlation coefficients were calculated to evaluate
associations between frequency of technology use and grandparent age. Additionally, a
composite score was derived for the frequency of Internet-based technology use (Cronbach’s
alpha = 0.61); the association between this score and grandparent age was evaluated using
Kendall rank correlation. Kendall rank correlation coefficients were also used to test
associations between grandparents’ ability to use their grandchildren’s school website or
portal and both adequacy of teacher contact and difficulties registering grandchildren for
GrandFamilies Vol. 6(1), 2020
22
school. Chi-square tests of independence were performed to compare responses to measures
evaluating grandparent ability to assist with technology between grandparents of
grandchildren in primary school (ages 5 – 12) and secondary school (ages 13 – 17) since the
technological needs of children in primary school and secondary school are likely to differ in
complexity.
Health Beliefs
Associations between correctness of responses to questions in the health beliefs
section of the GRG-Q and grandparent age were evaluated using Kendall rank correlation
coefficients.
Results
Discipline and Limit Setting
Approximately half of GRGs indicated that disciplining their grandchild was more
difficult than expected, but no association was noted with grandparent age (τ = .025, p = .36)
(Table 2). Additionally, almost two-thirds of GRGs stated they were less strict with their
grandchild prior to their grandchild living in their household and one-fifth of GRGs indicated
that they believe corporal punishment to be an appropriate method of discipline. Endorsing
physical punishment was negatively associated with grandparent age (τ = -.100, p < .001).
Table 2
Grandparent Agreement by Age of Grandchild with Statements about Discipline and Limit-Setting (n
= 733)
Grandparents in Agreement with Statement, n (%)
Kendall Rank
Correlation τ
(p-value)
Grandparent Age in Yearsa
32-40
(n=11)
41-50
(n=129)
51-65
(n=475)
66-81
(n=105)
All
(n=733)
“I think spanking
(and other forms of
physical
punishment) is an
appropriate method
of discipline.”
5
(45.5)
28
(21.7)
88
(18.5)
18
(17.1)
140
(19.1)
-.100
(<.001)
“Disciplining my
grandchild has been
more difficult than I
expected.”
5
(45.5)
68
(52.7)
276
(58.1)
58
(55.2)
414
(56.5)
.025
(.36)
“I was less strict
with my grandchild
before we began
living in same
household.” b
5
(62.5)
62
(62.0)
214
(59.4)
58
(67.4)
344
(61.1)
-.011
(.73)
a Fourteen participants did not provide their age.
b “Not applicable” response selected by 170 grandparents for this item.
Academic Challenges
Overall, GRGs expressed generally positive beliefs regarding the educational needs of
their school-age child (e.g., “my grandchild’s educational needs are well met;” “I am able to
help my grandchild with homework when he or she needs it.”). GRGs raising children in
primary school expressed positive beliefs for a significantly larger percent of the 10
statements concerning education needs of their child (80% vs. 70%, t = 4.39, p < .001).
Grandparents raising grandchildren in primary school were more likely to feel that their
GrandFamilies Vol. 6(1), 2020
23
grandchild’s education needs are well met than those raising grandchildren in secondary
school (92.7% vs. 84.8%, 𝜒² = 5.85, p = .02). Significantly more grandparents of secondary
school students reported that their grandchild’s education (e.g., schooling, special education
needs, etc.) had proven to be more difficult to handle than expected relative to grandparents
of primary school students (49.1% vs. 33.0%, 𝜒² = 9.00, p = .003). Of note, assisting
grandchildren with homework was shown to be an area of particular difficulty for
Table 3a
Grandparent Agreement with Parenting Statements Regarding Education Needs of School-Age
Children (n = 493)
Grandparents in Agreement with Statement,
n (%)
Chi Square
(p-value)
All
Children
(n=493)
Grandchild Age in Years
Primary
School
(Ages 5 to
12)
(n=368)
Secondary
School
(Ages 13 to 17)
(n=125)
Education
My grandchild’s educational needs are
well met.
435
(90.6)
329
(92.7)
106
(84.8)
5.85
(.02)
My grandchild’s education (schooling,
special education needs, etc.) has
proven to be more difficult to handle
than I expected.a,b
173
(37.0)
116
(33.0)
57
(49.1)
9.00
(.003)
I am able to help my grandchild with
homework when he or she needs it b
381
(80.7)
305
(86.4)
76
(63.9)
27.62
(<.001)
Helping my grandchild with his/ her
homework is easier than helping my
own child/ children was.b
121
(26.1)
101
(29.1)
20
(17.1)
5.94
(.02)
As a grandparent, I am equally or more
capable of attending my grandchild’s
school performances, sports games, and
recitals compared to the parents of his
or her classmates.b
406
(85.7)
303
(85.6)
103
(85.8)
<0.001
(1.00)
As a grandparent, I am equally or more
capable of attending my grandchild’s
Parent-Teacher conferences compared
to the parents of his or her classmates.b
455
(93.8)
345
(94.3)
110
(92.4)
0.25
(.62)
As a grandparent, I feel welcomed and
acknowledged by my grandchild’s
teachers.
452
(91.7)
346
(94.0)
106
(84.8)
9.23
(.002)
My grandchild’s teacher understands
the special circumstances of our
family.b
379
(79.5)
304
(85.4)
75
(62.0)
28.90
(<.001)
My grandchild’s teacher maintains
enough contact with me.
428
(86.8)
330
(89.7)
98
(78.4)
9.40
(.002)
As a grandparent, I have had
difficulties registering my grandchild
for school.a,b
66
(15.5)
48
(15.0)
18
(17.0)
0.11
(.74)
a These items reflect difficulties, whereas all other items reflect positive statements.
b Individuals who responded “not applicable” were excluded from these analyses.
GrandFamilies Vol. 6(1), 2020
24
grandparent raising older children. Whereas 86.4% of GRGs of primary school students
indicated they were able to help their grandchild with homework, only 63.9% of grandparents
raising secondary school students agreed with this statement (𝜒² = 27.62, p < .001). Few
GRGs (26.1%) felt that helping their grandchild with homework was easier than it had been
with their own child/children; this was especially true for grandparents with grandchildren in
secondary school (17.1% vs. 29.1%, 𝜒² = 5.94, p = .02).
The overwhelming majority of GRGs felt equally or more capable of attending their
grandchild’s school performances/sports/games/recitals and of attending Parent-Teacher
conferences, respectively, relative to the parents of their grandchild’s classmates. Most
grandparents reported feeling welcomed and acknowledged by their grandchild’s teacher;
however, this was less likely of grandparents with secondary school grandchildren compared
to primary school grandchildren (84.8% vs. 94.0%, 𝜒² = 9.23, p = .002). A similar disparity
was noted with respect to grandparents feeling that their grandchild’s teacher understands the
special circumstances of their family (62.0% for secondary school-age children vs. 85.4% for
primary school-age children, 𝜒² = 28.90, p < .001). A significant disparity was also noted
with respect to grandparents’ belief that their grandchild’s teacher maintains enough contact
with them (78.4% for secondary school-age children vs. 89.7% for primary school-age
children, 𝜒² = 9.40, p = .002). Notably, 15.5% of all grandparents raising school-age children
reported having difficulties registering their grandchild for school. Additional information
regarding grandparent agreement with statements about their grandchildren’s education is
displayed in Table 3a.
Social Challenges
In terms of their grandchild’s social and emotional needs, most GRGs reported that
their grandchild has friends (86.4%) and is not teased by other children (79.8%). However,
only 70.2% of GRGs reported feeling comfortable socializing with other parents at events
like birthday parties or sporting events, and 38.3% of GRGs indicated that their grandchild’s
“social and recreational activities have been more difficult to handle than expected.” No
associations between type of school (primary vs. secondary) and measures evaluating the
social and emotional needs of grandchildren were noted (Table 3b).
Table 3b
Grandparent Agreement with Parenting Statements Regarding Social Needs of School-Age
Children (n = 493)
Grandparents in Agreement with Statement,
n (%)
Chi
Square
(p-value)
All
Children
(n=493)
Grandchild Age in Years
Primary
School
(Ages 5 to 12)
(n=368)
Secondary
School
(Ages 13 to 17)
(n=125)
Social
My grandchild has friends.
425
(86.4)
319
(86.9)
106
(84.8)
0.20
(.66)
My grandchild is teased by other
children because of our family
situation.a
87
(20.2)
69
(21.4)
18
(16.7)
0.84
(.36)
GrandFamilies Vol. 6(1), 2020
25
When I attend events for my
grandchild (such as birthday parties,
sporting events, school meetings or
events), I am comfortable socializing
with the parents who are there.b
344
(70.2)
263
(71.7)
81
(65.9)
1.22
(.27)
My grandchild’s social and
recreational activities have been
more difficult to handle than I
expected.a,b
182
(38.3)
136
(38.0)
46
(39.3)
0.02
(.88)
a These items reflect difficulties, whereas all other items reflect positive statements.
b Individuals who responded “not applicable” were excluded from these analyses.
Computer and Other Technology Use
The frequency of technology use by grandparent age is shown in Table 4. Overall,
frequency of using Internet-related technology was found to be negatively associated with
grandparent age (τ = -.085, p = .008). Most (92.4%) GRGs reported that their grandchild’s
school has a website or portal, a characteristic which was more common among grandparents
of secondary school-age children (𝜒² = 6.38, p = .01) (Table 5). However, 10.7% of these
GRGs reported being unable to use this website or portal and 37.1% reported difficulty using
it.
Table 4
Technology Use by Grandparents of School-Age Children (n = 571)
Grandparent Age in Yearsa
Kendall Rank
Correlation τ
(p-value)
32-40
(n=5)
41-50
(n=72)
51-65
(n=392)
66-81
(n= 94)
All
(n=563)
Mean Score (SD)
Frequency of
Internet Useb
4.0
(0.00)
3.88
(0.37)
3.78
(0.59)
3.67
(0.71)
3.78
(0.59)
-.096
(.005)
Frequency of
Email Useb
4.0
(0.00)
3.58
(0.83)
3.69
(0.69)
3.61
(0.85)
3.66
(0.75)
-.004
(.92)
Frequency of
Facebook Useb
3.2
(1.30)
3.36
(1.17)
3.21
(1.27)
2.81
(1.53)
3.16
(1.31)
-.121
(<.001)
Composite Scorec
11.20
(1.30)
10.82
(1.72)
10.68
(2.05)
10.09
(2.54)
10.60
(2.11)
-.085
(.008)
a Age was not known for eight grandparent caregivers of school-age children.
b Rated on a 5-point Likert item, ranging from (0) = Never to (4) = Several times a day.
c Composite scale ranges from 0 (minimal technology use) to 12 (maximal technology use).
Ability to help grandchildren with computers or other technology for school purposes
was significantly more common among grandparents raising primary school-age children
than those raising secondary school-age children (² = 19.24, p = <.001). Feeling less able to
assist grandchildren with technology than other parents was associated with raising a
secondary school-age child (² = 5.86, p = .02). Lastly, ease of using the school’s website or
portal was directly correlated with adequacy of teacher contact (τ = .242, p < .001) and
inversely correlated with difficulty in registering their grandchild for school (τ = -.127, p =
.007).
GrandFamilies Vol. 6(1), 2020
26
Health Beliefs
When asked whether health statements relating to outdated medical beliefs were true
or false, GRGs, on average, were able to correctly identify 3.36 (SD = 1.36) of the seven
statements as true or false (Table 6). The majority of GRGs correctly identified that butter is
not a good first-aid remedy for minor burns and that “infants should be put to sleep on their
back, not their stomach or side,” and two-thirds knew that chocolate does not cause acne.
However, over half of GRGs mistakenly believed that “putting ice on a minor burn is a good
first-aid remedy,” two-thirds did not correctly identify that “scrapes and cuts heal better if
they remain covered with a bandage,” and most GRGs incorrectly believed that it is not
acceptable to “give children milk and other dairy products if they have diarrhea.” Older
grandparents were less likely to know that butter is not a good first-aid remedy for minor
burns (τ = -.067, p = .030) or that it is acceptable to give dairy products to a child with
diarrhea (τ = -.107, p < .001).
Table 6
Grandparent Response to Parenting Health Beliefs (n = 733)
Responses, n (%)
Kendall Rank
Correlationa τb
(p-value)
Correct
Incorrect
Don’t
Know
“Chocolate causes acne” [False]
491
(67.0)
88
(12.0)
154
(21.0)
-.012
(.694)
“Putting ice on a minor burn is a good
first-aid remedy”. [False]
213
(29.1)
416
(56.8)
104
(14.2)
-.005
(.869)
“Butter is a good first-aid remedy for
minor burns.” [False]
587
(80.1)
98
(13.4)
48
(6.5)
-.067
(.030)
Table 5
School-Related Technology Use by Grandparents of School-Age Children (n = 571)
Grandparents in Agreement with Statement,
n (%)
Chi
Square
(p-value)
All
(n=571)
Grandchild Age in Years
Primary
School
(Ages 5-12)
(n=418)
Secondary
School
(Ages 13-17)
(n=153)
Child’s school has a website or portal.a
488
(92.4)
341
(90.5)
147
(97.4)
6.38
(.01)
School website or portal is easy to use.b
324
(67.6)
233
(70.0)
91
(62.3)
2.37
(.12)
I can help grandchild with computers
or other technology for school when
needed.
429
(77.9)
331
(82.8)
98
(64.9)
19.24
(<.001)
I am equally or more capable of
assisting my grandchild with technology
relative to other parents.
402
(73.0)
305
(75.9)
97
(65.1)
5.86
(.02)
a Thirty-one grandparents were unsure if such a website/portal exists.
b Limited to children whose school have an online portal.
GrandFamilies Vol. 6(1), 2020
27
“Scrapes and cuts heal better if they
remain covered with a bandage.” [True]
219
(29.9)
469
(64.0)
45
(6.1)
-.023
(.465)
“Ice baths can be used to bring down a
very high fever.” [False]
323
(44.1)
292
(39.8)
118
(16.1)
-.059
(.057)
“It is OK to give children milk and other
dairy products if they have diarrhea.”
[True]
56
(7.6)
601
(82.0)
76
(10.4)
-.107
(<.001)
“Infants should be put to sleep on their
back, not their stomach or side.” [True]
571
(77.9)
101
(13.8)
61
(8.3)
-.027
(.381)
a Correlations were assessed between grandparent age and correctness regarding the health belief.
b Positive τ corresponds with higher likelihood to answer question correctly with increasing age.
Discussion
Given the substantial increase in grandfamilies in recent years, it is increasingly
important to identify the unique parenting challenges of GRGs such that childcare
professionals can provide effective anticipatory guidance and resources, not only for
grandparents providing full-time care for their grandchildren, but also for the millions of
grandparents providing daytime or after-school care for grandchildren. This is the first study
of its kind to report GRGs’ difficulties with discipline, education, technology use, and health
beliefs in a large national cohort.
Discipline and Limit-Setting
The majority of GRGs reported difficulties with discipline, in line with previous
studies (Giarrusso et al., 2000; Robinson & Wilks, 2006). Interestingly, older GRGs in our
sample were less likely to view corporal punishment as appropriate than younger GRGs,
which is seemingly contrary to generational trends (Zolotor et al., 2011). It is possible that
this finding can be explained by differences in the ages of grandchildren being raised by
younger and older GRGs. The prevalence of corporal punishment is lower for older children
(Straus & Stewart, 1999); since older grandparents are more likely to be raising older
grandchildren, it is not surprising that they are less likely to endorse corporal punishment.
Corporal punishment has been shown to be associated with a range of behavioral and
emotional problems in children, adolescents, and adults (Eron et al, 1991; Farrington &
Hawkins, 1991), and children who experienced corporal punishment have been shown to be
at an increased risk of physical abuse (Crouch & Behl, 2001; Fréchette et al., 2015; Straus,
2000), underscoring the need for anticipatory guidance regarding discipline tailored to GRGs.
The majority of GRGs in our sample reported being stricter with their grandchild
when he/she entered their custodial care. GRGs may struggle to strike the right balance in
their parenting style when transitioning from their role as a grandparent, which is typically
marked by greater permissiveness, to a less permissive caregiving role. The stress of
parenting may be especially magnified in GRGs caring for grandchildren with behavioral and
emotional problems arising from prior dysfunctional family environments (Billing et al.,
2002; Leder et al., 2007), and they would greatly benefit from parenting guidance by mental
health professionals.
Educational and Social Challenges
In addition, even though almost all GRGs felt that they are meeting their grandchild’s
educational needs, a third of GRGs reported that their grandchild’s education and
social/recreational activities had proven more difficult than expected, with more grandparents
of secondary school students struggling to meet their grandchild’s educational needs, to
successfully help with homework, and to maintain adequate contact with their grandchild’s
GrandFamilies Vol. 6(1), 2020
28
teacher. Secondary school grandchildren’s increasingly complex school routines and
extracurricular demands may prevent GRGs from effectively supporting their grandchildren’s
educational and social needs, in turn leading to greater academic struggles. This may, in part,
explain the findings of the Welfare, Children and Families study, which noted that children
raised by custodial grandmothers lagged behind their peers in the development of reading
skills and quantitative skills (Pittman & Boswell, 2007), stressing the need for individualized
attention from teachers and school counselors. Teachers of secondary school students in
particular should pay special attention to the unique family circumstances of children being
raised by their grandparents and strive to maintain regular contact with GRGs through
appropriate means.
Computer and Other Technology Use
As expected, GRGs in our sample encountered significant challenges with computer
and other technology use, and older GRGs were less likely to use Internet-related technology
than younger GRGs. In line with previous reports of declining Internet use (Madden &
Savage, 2000) and level of Internet skill (Teo, 2001) with user age, almost half of GRGs in
our sample were either unable to use or had difficulty using their grandchild’s school website
or portal, potentially precluding them from maintaining adequate teacher contact and
registering their grandchild for school. Grandparent difficulties with use of school-related
technology may once again disproportionately affect secondary school-age grandchildren,
who are more likely to have an online school portal. These findings point to an elevated need
for support in using computers and other technology for grandparents raising secondary
school-age grandchildren, especially among older GRGs.
Health Beliefs
Lastly, a large percentage of GRGs subscribed to outdated and potentially harmful
health beliefs, and older GRGs were more likely to endorse incorrect health beliefs. Of
particular importance, putting infants to sleep on their stomach, or the prone position, has
been identified as the most significant risk factor for Sudden Infant Death Syndrome
(Sperhake et al., 2018). However, the prone position was still widely endorsed when some
GRGs were raising their own children several decades ago (Gilbert et al., 2005). Today,
most, if not all, parents know to place infants to sleep on their back, or the supine position.
Comparatively, 14% of GRGs still believed that infants should be put to sleep on their
stomach or side, highlighting a need for anticipatory health guidance. Similarly, whereas ice
baths were previously recommended to treat a high fever, they are now contraindicated as
they introduce heat-producing mechanisms such as shivering, which can ultimately worsen a
child’s fever (Fruthaler, 1985). The strikingly high rate of incorrect health beliefs among
grandparents in this study highlights that even though grandparents have already raised
children in the past, they may need as much, if not greater, anticipatory guidance regarding
current childcare approaches that may have evolved over the years. Even though GRGs as a
whole are in need of anticipatory guidance, it appears that older GRGs are particularly likely
to subscribe to inaccurate health beliefs, suggesting that greater support and educational
outreach may be needed for these individuals.
Implications for GRGs
Our study has identified additional key parenting issues where GRGs may experience
difficulties: discipline, meeting educational and social needs, comfort with technology, and
outdated health beliefs. It is undoubtedly true that grandparent caregivers can provide strong
emotional, social and academic support for their grandchildren if given access to adequate
resources. Compared to children in foster care with non-relatives, children living with
GrandFamilies Vol. 6(1), 2020
29
relatives have better behavioral and mental health outcomes, experience fewer school
changes, are more likely to have a permanent home, and maintain a deeper connection to
their family and community (Lent & Otto, 2018). However, for grandparents to optimally
care for their grandchildren in the future, it is imperative that social support be provided
through accessible and affordable resources.
It is crucial for GRGs to be aware of changes in caregiver demands and parenting
practices since they raised their own children. Many GRGs would likely benefit from
counseling regarding behavior management strategies in order to promote alternative forms
of discipline to corporal punishment. Behavioral parent training (BPT) and cognitive-
behavioral therapy (CBT) have been shown to be more effective than information-only
control conditions at lessening distress and improving parenting practices for custodial
grandmothers (Smith et al., 2018). Instead of relying solely on support groups, researchers
recommend interventions that combine support and education about contemporary parenting
practices (Hayslip & Kaminski, 2005; Strom and Strom, 2000; Kirby, 2015), such as the
Parental Skills/Psychosocial Skills Training Program (Hayslip & Patrick, 2003) and the
Grandparent Triple P (Kirby & Sanders, 2014), which have been shown to decrease child
behavior problems.
Tutoring or homework support for grandchildren being raised by older guardians
would also likely be of value, especially for secondary school-age grandchildren. These
recommendations are consistent with findings from the Healthy Grandfamilies Project, where
42.6% of GRGs identified “help with homework” as a service they would like to receive for
their grandchild (Dunn & Wamsley, 2018). GRGs would also likely benefit from adult
education programs focused on technology use (e.g., Center on Research and Education for
Aging and Technology Enhancement, CREATE) (Czaja et al., 2001). Indeed, Kautzmann
(1990) showed that a one-time instructional session on computer use led by students
increased feelings of self-esteem and mastery among elderly persons. Lastly, pediatricians
and health care providers should be especially mindful of potential outdated health beliefs
when evaluating children raised by grandparents and advising GRGs. Organizations such as
Generations United (www.gu.org) and the American Association of Retired Persons
(www.AARP.org) provide considerable resources tailored to GRGs to help them embrace up-
to-date parenting practices.
Limitations
Methodologically, this study has several strengths and weaknesses. Since recruitment
of GRGs was conducted electronically, GRGs who do not use email could not have been
recruited, thus limiting our sample to participants with at least some proficiency with
computers. As such, our sample of GRGs is likely to be disproportionately younger and more
likely to be able to assist their grandchildren with technology than the national population of
GRGs. Thus, our findings may underestimate the scope and severity of problems GRGs face
regarding the use of computers and other technology. Furthermore, since the GRG-Q is a
self-report questionnaire, response bias with respect to social desirability is also possible.
Additionally, the measures examined in this study were subjective and could not be
externally validated due to the structure of the study. Further research is essential regarding
associations between these measures and objective measures, such as caregiver stress and
child well-being, academic performance, and behavioral difficulties. Moreover, additional
studies concerning parent caregiver perspectives regarding discipline, academic and social
challenges of parenting, technology use, and outdated health beliefs would provide valuable
normative baselines for identifying disparities in the challenges faced by parent and
grandparent caregivers.
GrandFamilies Vol. 6(1), 2020
30
Despite these limitations, this is the first study to investigate approach to discipline
and corporal punishment, ability to meet grandchild educational and social needs, facility
with computers and other technology, as well as endorsement of outdated health beliefs in a
single cohort of GRGs. Moreover, whereas most prior studies have relied on small or
regional samples, GRG recruitment in this study was nationwide, resulting in one of the
largest and most diverse samples to date. However, although our national sample of GRGs is
relatively diverse, it is important to note that it is not a nationally representative sample.
Thus, our findings may not be generalizable to the entire population of GRGs in the United
States.
Conclusion
Our findings from a large, national sample of GRGs provide evidence of GRGs’
struggles with discipline, difficulty managing their grandchildren’s educational and social
needs (including helping with school-related technology), and endorsement of outdated,
potentially harmful health beliefs. The unique parenting challenges of GRGs call for
resources to help grandparents embrace up-to-date parenting practices, as well as special
attention from educators and healthcare providers. Academic support for children raised by
their grandparents should also be considered, especially for secondary school-age students.
Future research examining the burdens and challenges encountered by GRGs would be
greatly enhanced by nationally representative data. Additionally, investigation of the
association between the challenges faced by grandchildren being raised by grandparents and
their grandparents’ parenting practices would shed light on the potential developmental
consequences of being raised in a skipped-generation household. It is our hope that findings
from this study will be utilized to develop evidence-based parenting programs for GRGs
tailored to their unique challenges and needs.
References
Anderson, M., & Perrin A. (2017). Tech Adoption Climbs Among Older Adults. Pew
Research Center. https://www.pewresearch.org/internet/2017/05/1 7/technology-use-
among-seniors/.
Baker, L. A., & Mutchler, J. E. (2010). Poverty and material hardship in grandparent‐headed
households. Journal of Marriage and Family, 72(4), 947-962.
Billing, A., Ehrle, J., & Kortenkamp, K. (2002). Children cared for by relatives: What do we
know about their well-being? Washington, DC: Urban Institute.
Caputo, R. K. (2000). Second-generation parenthood: A panel study of grandmother and
grandchild coresidency among low-income families, 1967-1992. The Journal of
Sociology & Social Welfare, 27(3), 3-20.
Carpenter, B. D., & Buday, S. (2007). Computer use among older adults in a naturally
occurring retirement community. Computers in Human Behavior, 23(6), 3012-3024.
Crouch, J. L., & Behl, L. E. (2001). Relationships among parental beliefs in corporal
punishment, reported stress, and physical child abuse potential. Child Abuse &
Neglect, 25(3), 413-419. doi:10.1016/s0145-2134(00)00256-8.
Czaja, S. J., Sharit, J., Charness, N., Fisk, A., D, & Rogers, W. (2001). The Center for
Research and Education on Aging and Technology Enhancement (CREATE): A
program to enhance technology for older adults. Gerontechnology, 1(1), 50-59.
Dunn, B., & Wamsley, B. (2018). Grandfamilies: Characteristics and Needs of Grandparents
Raising Grandchildren. Journal of Extension, 56(5), v56-5rb2,
https://joe.org/joe/2018september/rb2.php.
GrandFamilies Vol. 6(1), 2020
31
Ehrle, G. M., & Day, H. D. (1994). Adjustment and family functioning of grandmothers
rearing their grandchildren. Contemporary Family Therapy, 16(1), 67-82.
Ellis, R .R., & Simmons T. (2014). Coresident grandparents and their grandchildren: 2012.
United States Census Bureau,
https://census.gov/content/dam/Census/library/publications/2014/demo/p20-576.pdf.
Engelberts, A. C., De Jonge, G. A., & Kostense, P. J. (1991). An analysis of trends in the
incidence of sudden infant death in The Netherlands 1969–89. Journal of Paediatrics
and Child Health, 27(6), 329-333.
Eron, L., Huesmann, L., & Zelli, A. (1991). The role of parental variables in the learning of
aggression. In D. Pepler & K. Rubin (Eds.), The Development and Treatment of
Childhood Aggression (pp. 169–188). Erlbaum.
Farrington, D., & Hawkins, J. (1991). Predicting participation, early onset and later
persistence in officially recorded offending. Criminal Behavior and Mental Health,
1(1), 1-33.
Fields, J. (2003). Children's Living Arrangements and Characteristics: March 2002. Current
Population Reports.
Fréchette, S., Zoratti, M., & Romano, E. (2015). What is the link between corporal
punishment and child physical abuse? Journal of Family Violence, 30(2),135-148.
Fruthaler, G. J. (1985). Fever in children: phobia vs facts. Hospital Practice (Office Ed.),
20(11A), 49-53.
Fuller-Thomson, E., Minkler, M., & Driver, D. (1997). A profile of grandparents raising
grandchildren in the United States. The Gerontologist, 37(3), 406-411.
Gatto, S. L., & Tak, S. H. (2008). Computer, Internet, and e-mail use among older adults:
Benefits and barriers. Educational Gerontology, 34(9), 800-811.
Generations United (2016). State of Grandfamilies 2016. Raising the Children of the Opioid
Epidemic: Solutions and Support for Grandfamilies.
https://www.gu.org/app/uploads/2018/09/Grandfamilies-Report-SOGF-Updated.pdf
Giarrusso, R., Feng, D., Silverstein, M., & Marenco, A. (2000). Primary and secondary
stressors of grandparents raising grandchildren: Evidence from a national
survey. Journal of Mental Health and Aging, 6(4), 291-310.
Gilbert, R., Salanti, G., Harden, M., & See, S. (2005). Infant sleeping position and the sudden
infant death syndrome: systematic review of observational studies and historical
review of recommendations from 1940 to 2002. International Journal of
Epidemiology, 34(4), 874-887. https://doi.org/10.1093/ije/dyi088
Githens, R. P. (2007). Older adults and e-learning: Opportunities and barriers. Quarterly
Review of Distance Education, 8(4), 329.
GrandFacts State Fact Sheets for Grandfamilies. Retrieved December 2016 from
https://www.grandfactsheets.org.
Hayslip, B., & Patrick, J. H. (2003). Working with custodial grandparents. Springer.
Hayslip Jr, B., & Kaminski, P. (Eds.). (2008). Parenting the custodial grandchild:
Implications for clinical practice. Springer.
Hayslip Jr, B., & Kaminski, P. L. (2005). Grandparents raising their grandchildren: A review
of the literature and suggestions for practice. The Gerontologist, 45(2), 262-269.
Kautzmann, L. (1990). Introducing computers to the elderly. Physical & Occupational
Therapy in Geriatrics, 9(1), 27-36.
Kirby, J. N., & Sanders, M. R. (2014). A randomized controlled trial evaluating a parenting
program designed specifically for grandparents. Behaviour Research and
Therapy, 52C(1), 35-44.
https://www.researchgate.net/publication/259205052_A_randomized_controlled_trial
_evaluating_a_parenting_program_designed_specifically_for_grandparents
GrandFamilies Vol. 6(1), 2020
32
Kirby, J. N. (2015). The potential benefits of parenting programs for grandparents:
Recommendations and clinical implications. Journal of Child and Family
Studies, 24(11), 3200-3212.
Leder, S., Grinstead, L. N., & Torres, E. (2007). Grandparents raising grandchildren:
Stressors, social support, and health outcomes. Journal of Family Nursing, 13(3),
333-352.
Lee, B., Chen, Y., & Hewitt, L. (2011). Age differences in constraints encountered by seniors
in their use of computers and the internet. Computers in Human Behavior, 27(3),
1231-1237.
Lent, J. P., & Otto, A. (2018). Grandparents, Grandchildren, and Caregiving: The Impacts of
America's Substance Use Crisis. Generations, 42(3), 15-22.
Madden, G., & Savage, S. (2000). Some economic and social aspects of residential Internet
use in Australia. Journal of Media Economics, 13(3), 171-185.
National Abandoned Infants Assistance Resource Center. (2004). Kinship care fact sheet.
Berkeley: University of California, Berkeley. Retrieved July 20, 2016, from
http://aia.berkeley.edu/media/pdf/kinship_care_factsheet_2004.pdf.
Neely-Barnes, S. L., Carolyn Graff, J., & Washington, G. (2010). The health-related quality
of life of custodial grandparents. Health & Social Work, 35(2), 87-97.
Peterson, T. L. (2017). Changes in health perceptions among older grandparents raising
adolescent grandchildren. Social Work in Public Health, 32(6), 394-406.
Pittman, L., & Boswell, M. (2007). The Role of Grandmothers in the Lives of Preschoolers
Growing Up in Urban Poverty. Applied Developmental Science, 11(1), 20-42.
Robinson, M. M., & Wilks, S. E. (2006). "Older But Not Wiser": What Custodial
Grandparents Want to Tell Social Workers About Raising Grandchildren. Social
Work & Christianity, 33(3), 164-177.
Sampson, D., & Hertlein, K. (2015). The experience of grandparents raising
grandchildren. Grandfamilies: The Contemporary Journal of Research, Practice and
Policy, 2(1), 4.
Silverstein, N. M., & Vehvilainen, L. (2000). Grandparents and schools: Issues and potential.
In Cox, C.B. (Ed.) To Grandmother's House We Go and Stay: Perspectives on
Custodial Grandparents (pp. 268-282).
Smith, G. C., & Palmieri, P. A. (2007). Risk of psychological difficulties among children
raised by custodial grandparents. Psychiatric Services, 58(10), 1303-1310.
https://doi.org/10.1176/ps.2007.58.10.1303
Smith, G. C., Hayslip, B., Hancock, G. R., Strieder, F. H., & Montoro-Rodriguez, J. (2018).
A randomized clinical trial of interventions for improving well-being in custodial
grandfamilies. Journal of Family Psychology, 32(6), 816-827.
https://doi.org/10.1037/fam0000457.
Sperhake, J., Jorch, G., & Bajanowski, T. (2018). The prone sleeping position and SIDS.
Historical aspects and possible pathomechanisms. International Journal of Legal
Medicine, 132(1), 181-185. https://doi.org/10.1007/s00414-017-1749-5
Straus, M. A. (2000). Corporal punishment and primary prevention of physical abuse. Child
Abuse & Neglect, 24(9), 1109-1114. https://doi.org/10.1016/S0145-2134(00)00180-0
Straus, M. A., & Stewart, J. H. (1999). Corporal punishment by American parents: national
data on prevalence, chronicity, severity, and duration, in relation to child and family
characteristics. Clinical Child & Family Psychology Review, 2(2), 55-70.
https://doi.org/10.1023/A:1021891529770
Strom, R. D., & Strom, S. K. (2000). Meeting the challenge of raising grandchildren. The
International Journal of Aging and Human Development, 51(3), 183-198.
GrandFamilies Vol. 6(1), 2020
33
Teo, T. S. (2001). Demographic and motivation variables associated with Internet usage
activities. Internet Research-Electronic Networking Applications and Policy, 11(2),
125-137.
U.S. Census Bureau. (2019). Current Population Survey, 2019 Annual Social and Economic
Supplement Internet. Table C4. Children with Grandparents by Presence of Parents,
Sex, and Selected Characteristics: 2019. Retrieved from:
https://www.census.gov/data/tables/2019/demo/families/cps-2019.html.
Wiltz, T. (2016, November 2). Why more grandparents are raising children. The Pew
Charitable Trusts. https://www.pewtrusts.org/en/research-and-
analysis/blogs/stateline/2016/11/02/why-more-grandparents-are-raising-children.
Yoo, J., & Russell, D. W. (2020). Caring for Grandchildren and Grandparents’ Physical and
Mental Health Changes. Journal of Child and Family Studies, 29(3), 845-854.
Young, N. K. (2016, February 23). Examining the Opioid Epidemic: Challenges and
Opportunities: Hearing Before the United States Senate Committee on Finance. US
Government Publishing Office.
Zolotor, A. J., Theodore, A. D., Runyan, D. K., Chang, J. J., & Laskey, A. L. (2011).
Corporal punishment and physical abuse: population‐based trends for three‐to‐11‐
year‐old children in the United States. Child Abuse Review, 20(1), 57-66.