Interventions to Improve Outcomes of Grandchildren Raised By Grandparents: A Systematic Review

Background and Purpose: The socio-emotional, mental, behavioral, and educational challenges facing grandchildren have adverse effects on short- and long-term child development, which calls for evidence-based interventions to address these issues. Thus, this systematic review aims to examine the effectiveness of interventions that seek to improve grandchildren’s socio-emotional, mental, and behavioral and educational outcomes. More specifically, this review aims to answer two research questions: (1) what interventions targeting custodial grandchildren’s socio-emotional, mental, and behavioral and educational outcomes have been implemented and evaluated?; and (2) what are these interventions’ effects on grandchildren’s outcomes?

Method: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken. We searched in ERIC, Family Studies Abstracts, PubMed, PsycINFO, Social Work Abstracts, Sociological Abstracts, Web of Science, and Google Scholar in July 2021. Our search yielded scholarly articles (n=17,863) from seven databases, and we further identified two additional relevant articles from Google Scholar. COVIDENCE software was used to manage and screen all articles. Quality assessment was conducted for these included studies. Findings on the effect of interventions on these outcomes from quantitative, qualitative, and mixed-methods studies were extracted for a narrative synthesis.

Results: Among these eight studies, these interventions had different focuses and targets. The focus of these interventions included custodial grandparents only (e.g., Campbell et al., 2012; N’zi et al., 2016; Smith et al., 2018), custodial grandchildren only (e.g., Dare et al., 2020; Leder & Jensen, 2003), and custodial grandparent-grandchild dyads (e.g., Dannison & Smith, 2003; Littlewood et al., 2010; Smith & Dannison, 2003). For interventions targeting custodial grandchildren and custodial grandparent-grandchild dyads, the interventions primarily focused on custodial grandchildren from infancy to middle childhood. The length of the interventions varied, ranging from four days to 14 weeks, and most of the interventions occurred weekly or biweekly. Two randomized control trials (RCTs) examined the short- (i.e., post-test) and long-term (i.e., follow-up test) effects of these interventions on grandchildren’s socio-emotional, mental, and behavioral outcomes, and results indicated grandchildren had improvement in their socio-emotional, mental, and behavioral outcomes. All pre-experimental design studies (Campbell et al., 2012; Leder & Jensen, 2003; Littlewood et al., 2010; Smith & Dannison, 2003) showed the same results regardless of evaluation methods. In addition, four intervention studies (Campbell et al., 2012; Leder & Jensen, 2003; Littlewood et al., 2010; Smith & Dannison, 2003) examined the effect of these interventions on grandchildren’s educational outcomes, and results were mixed across these four studies.

Conclusions and Implications: Findings of the review suggest that there is a lack of rigorous empirical research on interventions for this population, and that existing interventions lack grounding in a clear theory of change. Researchers and practitioners invested in improving the socio-emotional, mental, behavioral, and educational outcomes of custodial grandchildren should invest time in developing and testing interventions that are grounded in a solid theoretical framework, such as positive youth development, attachment, and family systems theories. These interventions should be evaluated using rigorous experimental or quasi-experimental designs with advanced statistical methods and in-depth qualitative methods.