Keim Sarah A, Mason Rachel E, Yisahak Samrawit F
Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA.
Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Paediatr Perinat Epidemiol. 2025 Jan;39(1):56-67. doi: 10.1111/ppe.13118. Epub 2024 Sep 3.
One in ten U.S. children lives with a grandparent, and more foster children are being placed in kinship care.
Our objective was to compare early language and communication development and school readiness among children raised by grandparents (alone or in multigenerational households) to children raised by parents.
We included in this cross-sectional study children ages 1-5 years from the 2016-2020 National Survey of Children's Health to examine healthy and ready to learn school readiness outcomes and binary language and communication development (2018-2020 data only) by caregiver type (parent, multigenerational, and grandparent-only) with survey-weighted log-binomial regression adjusted for confounders. We stratified by survey years pre-COVID-19 pandemic versus during.
Among 33,342 children, 86.0% (SE = 0.51) of children were 'On-Track' for language and communication development; only 37.2% (SE = 0.68) were 'On-Track' overall for school readiness. Children raised by grandparents or in multigenerational households were more often 'On-Track' for school readiness than children raised by parents, but only upon adjustment for covariates (adjusted prevalence ratio (aPR) for grandparent-only 1.13, 95% confidence interval (CI) 1.11, 1.15; aPR for multigenerational 1.13, CI 1.12, 1.15). Smaller and less consistent differences in prevalence were observed for the other outcomes (language and communication development, school readiness domains of early learning skills, social-emotional development, self-regulation development and physical well-being and motor development). A disparity in school readiness may have emerged during the COVID-19 pandemic; children in grandparent-only households had a lower prevalence of being 'On-Track' for school readiness (aPR 0.71, 95% CI 0.69, 0.73) compared to children in parent households, whereas children in multigenerational households continued to be more often school-ready than children in parent households.
Large proportions of children across caregiver types were not fully prepared for school. Consideration of key covariates is important because socio-economic disadvantage may mask other advantages grandparent-led and multigenerational households offer children's early development.
美国每十名儿童中就有一名与祖父母生活在一起，越来越多的寄养儿童被安置在亲属照料家庭中。
我们的目的是比较由祖父母抚养（单独或在多代同堂家庭中）的儿童与由父母抚养的儿童在早期语言和沟通发展以及入学准备方面的情况。
我们将2016 - 2020年全国儿童健康调查中1 - 5岁的儿童纳入这项横断面研究，以按照料者类型（父母、多代同堂、仅由祖父母照料）检查健康及准备好学习的入学准备结果以及二元语言和沟通发展情况（仅使用2018 - 2020年数据），并通过调查加权对数二项回归对混杂因素进行调整。我们按新冠疫情前和疫情期间的调查年份进行分层。
在33342名儿童中，86.0%（标准误 = 0.51）的儿童在语言和沟通发展方面“进展正常”；总体而言，只有37.2%（标准误 = 0.68）的儿童在入学准备方面“进展正常”。由祖父母抚养或在多代同堂家庭中抚养的儿童在入学准备方面比由父母抚养的儿童更常“进展正常”，但仅在对协变量进行调整后才是如此（仅由祖父母照料的调整患病率比（aPR）为1.13，95%置信区间（CI）为1.11，1.15；多代同堂的aPR为1.13，CI为1.12，1.15）。对于其他结果（语言和沟通发展、早期学习技能的入学准备领域、社会情感发展、自我调节发展以及身体健康和运动发展），患病率的差异较小且不太一致。在新冠疫情期间可能出现了入学准备方面的差距；与父母家庭中的儿童相比，仅由祖父母照料家庭中的儿童在入学准备方面“进展正常”的患病率较低（aPR为0.71，95%CI为0.69，0.73），而多代同堂家庭中的儿童仍然比父母家庭中的儿童更常做好入学准备。
不同照料者类型的儿童中很大一部分没有为上学做好充分准备。考虑关键协变量很重要 because socio-economic disadvantage may mask other advantages grandparent-led and multigenerational households offer children's early development.（原文此处表述有误，正确的英文应该是“because socio-economic disadvantage may mask other advantages that grandparent-led and multigenerational households offer to children's early development”，翻译为“因为社会经济劣势可能掩盖了祖父母主导的家庭和多代同堂家庭为儿童早期发展带来的其他优势”） 因为社会经济劣势可能掩盖了祖父母主导的家庭和多代同堂家庭为儿童早期发展带来的其他优势。
