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AN ATTACHMENT PERSPECTIVE ON GRANDPARENTS RAISING THEIR VERY YOUNG GRANDCHILDREN: IMPLICATIONS FOR INTERVENTION AND RESEARCH
JULIE POEHLMANN

University of Wisconsin Madison

ABSTRACT: The purpose of this article is to apply an attachment perspective to the growing number of families with grandparents raising grandchildren to increase our understanding of the complexity of intergenerational relationship processes in these families and to guide early intervention and research. It is proposed that, as grandparents take responsibility for their grandchildren, three relationship processes simultaneously occur: (1) disruptions in attachments potentially occur, especially in relationships involving parents, (2) attachment relationships between grandchildren and grandparents develop or are revised, and (3) family members internal working models of attachment and caregiving are challenged and shaped. To address these processes, attachment theory and research focusing on the formation, disruption, and intergenerational transmission of attachment relationships are reviewed. Conclusions suggest that when grandparents assume responsibility for grandchildren, families may need and be particularly open to a range of interventions. In addition, research focusing on attachment relationships in families of grandparents raising grandchildren is needed. RESUMEN: El proposito de este estudio es aplicar la perspectiva de la afectividad al creciente numero de familias en las que los abuelos cran a los nietos, para incrementar nuestra comprension de la complejidad de los procesos de relaciones intergeneracionales en estas familias, y para guiar la temprana intervencion e investigacion. Se propone que, a medida que los abuelos asumen las responsabilidades de criar a sus nietos, ocurren tres procesos de relaciones simultaneamente: (1) los trastornos en la afectividad posible mente ocurren, especialmente en aquellas relaciones que involucran a los padres, (2) las relaciones entre abuelos y nietos de desarrollan o se reconsideran, y (3) los modelos internos de afectividad y de prestar cuidado que poseen los miembros de la familia se enfrentan a un reto y adquieren forma. Con el proposito de tratar estos procesos, se revisan tanto la teora como la investigacion sobre la afectividad que se enfoca en la formacion, trastorno y transmision intergeneracional de la afectividad. Las conclusiones sugieren que cuando los abuelos asumen responsabilidad por la crianza de los nietos, las familias pudieran necesitar y estar especcamente dispuestas a una gama de intervenciones. Adicionalmente, se hace necesaria una

Special thanks to Inge Bretherton, Mary Brintnall-Peterson, and Kari Morgan for productive conversations regarding links between attachment theory and families with grandparents raising grandchildren, and to two anonymous reviewers for their insightful comments on earlier versions of this manuscript. Direct correspondence to: Julie Poehlmann, Ph.D., Human Development and Family Studies, University of Wisconsin, 1430 Linden Drive, Madison, WI 53706; e-mail: poehlmann@waisman.wisc.edu. INFANT MENTAL HEALTH JOURNAL, Vol. 24(2), 149 173 (2003) 2003 Michigan Association for Infant Mental Health Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/imhj.10047

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investigacion que se centre en las relaciones de afectividad en aquellas familias en las que los abuelos cran a los nietos.
RESUME: Le but de cet article est dappliquer une perspective dattachement au nombre croissant de grands-parents qui elevent leurs petits-enfants, de maniere a etendre notre comprehension de la complexite ` ` ` des processus de relation intergenerationnelles dans ces familles et de maniere a guider lintervention ` ` precoce et les recherches. Nous argumentons que, lorsque les grands-parents soccupent de leurs petits enfants, trois processus relationnels ont lieu simultanement: (1) des perturbations dans les attachements peuvent eventuellement se passer, surtout dans les relations qui incluent les parents, (2) des relations dattachement entre les petits-enfants et les grands-parents se developpent ou se trouvent revisees, et (3) les modeles internes de travail dattachement et de mode de soin des membres de la famille sont mis a ` ` lepreuve et remodeles. Pour aborder ces processus, la theorie dattachement et les recherches concentrees sur la formation, linterruption et la transmission intergenerationnelle des relations dattachement sont passees en revue. Les conclusions suggerent que lorsque les grands-parents commencent a soccuper de ` ` leurs petits-enfants, les familles peuvent avoir besoin de toute une gamme dinterventions, et y etre particulierement ouvertes. De plus, de plus amples recherches mettant laccent sur les relations ` dattachement dans les familles ou les grands-parents elevent leurs petits-enfants sont necessaires. ` ` ZUSAMMENFASSUNG: Der Zweck dieser Arbeit ist es eine Bindungsperspektive auf die zunehmende Zahl

von Familien in denen die Groeltern ihre Enkelkinder aufziehen, anzuwenden, um unser Verstandnis der Komplexitat des transgenerationalen Beziehungsprozesses in diesen Familien zu verbessern und An weisungen fur die Fruhforderung und die Forschung zu geben. Es wird vorgeschlagen drei Beziehungs typen gleichzeitig zu untersuchen, wenn die Groeltern die Verantwortung fur ihre Enkelkinder uberneh men: 1. Unterbrechungen in den Beziehungen tritt moglicherweise auf, besonders, wenn die Beziehung Eltern einbezieht; 2. Bindungen zwischen Enkelkindern und Groeltern entwickeln sich, oder gehen verloren; und 3. die internalisierten Arbeitsmodelle der Bindung und der Pege werden herausgefordert, oder beeinut. Um den Proze zu uberschauen, bezieht sich die Bindungstheorie und -forschung auf die Entstehung, Unterbrechung und die transgenerationale Ubertragung der Bindung. Die Schlufolgerungen zeigen, da, wenn die Groeltern Verantwortung fur die Kinder ubernehmen, die Familien Interventionen brauchen konnten und ihnen gegenuber auch offen sind. Zusatzliche Forschung, die sich mit den Bezie hungen in Familien in denen die Groeltern die Kinder aufziehen, befassen, sind erforderlich.

Families in which grandparents raise their grandchildren have become an increasingly prevalent family structure. In 1997, nearly 5.5 million children in the United States, or 7.7% of all children under 18 years of age, lived in homes with a grandparent (Bryson & Casper, 1999). Approximately three-fourths of these children live in grandparent-headed households,

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with the greatest growth occurring among grandchildren raised by grandparents without a parent present (Bryson & Casper, 1999). Scholars attribute this increase to a variety of problems experienced by the middle generation, such as drug abuse, teen pregnancy, incarceration, and other difculties (Bryson & Casper, 1999), in addition to growing reliance on kinship care arrangements within the child welfare system (Nisivoccia, 1996; Rosenfeld et al., 1997). For children age four years or younger who are living with neither parent, grandparents provide the majority of care (National Maternal and Child Health Clearinghouse, 2000). In the present article, I focus on this latter group, families with grandparents raising their very young grandchildren without the parents present due to parental difculties. Although a growing literature focuses on the well-being of grandparents functioning as surrogate parents for their grandchildren (e.g., Burton, 1992; Emick & Hayslip, 1999; Jendrek, 1993; Minkler & Roe, 1993, 1996), few studies address the well-being of infants, young children, and their parents in these circumstances. However, understanding the diverse and complex perspectives of each generation of family members is crucial for researchers and early intervention professionals. Because grandparents take on additional responsibilities when caring for their grandchildren and must transition into nontraditional or nonnormative roles, often in times of family crisis, studies typically examine the adjustment of grandparent caregivers from stresscoping, role theory, or functional/economic perspectives, although Bengtsons concept of intergenerational solidarity is an exception (Bengtson, 2001). Grandparents assumption of primary caregiving responsibility for their grandchildren transforms many areas of family life and individual development, including the nature of intergenerational family relationships or affectional bonds (Ainsworth, 1989). Attachment theory (Bowlby, 1969/1982, 1973,1980; Ainsworth & Bowlby, 1991) provides a conceptual lens from which to examine the interactional, affective, and cognitive dimensions of intergenerational relationship processes that propel and result from these changes. Although scholars have used an attachment perspective to understand the adjustment of infants in foster care (e.g., Stovall & Dozier, 1998), it has not been applied to families with grandparents raising grandchildren. An attachment perspective is uniquely suited to deepening our understanding of families with grandparents raising grandchildren for a number of reasons. First, attachment theory is a well-articulated and empirically investigated conceptual framework documenting the formation and disruption of dyadic relationships, rather than focusing solely on individual development. Second, its focus is both lifespan and intergenerational. Third, it addresses interactions among behavioral, cognitive, emotional, interpersonal, and social-contextual dynamics in relationships, rather than focusing on any one of these. Fourth, since its origin, effects of parental deprivation, separation, and loss on development have been of central importance. Finally, attachment theory seeks to understand processes associated with both adaptive and maladaptive relationship patterns, and it has successfully guided intervention and research with other high risk populations, such as children experiencing domestic violence, maltreatment, or parental depression (e.g., see Greenberg, 1999; Lieberman & Zeanah, 1999, for reviews). Because of these considerations, the purpose of this article is to apply an attachment perspective to families with grandparents raising their very young grandchildren to increase our understanding of the complexity of intergenerational relationship processes in these families and to guide early intervention and research. I propose that, as grandparents take responsibility for their grandchildren, three simultaneous processes occur (see Figure 1): (1) disruptions in attachments potentially occur, especially in relationships involving parents (although in some circumstances grandparents assumption of caregiving for grandchildren may not disrupt parent child relationships, the focus of this article is on processes resulting from parental problems, such as maltreatment, incarceration, drug abuse, illness, HIV infection, etc., in which disrupted relationships are likely); (2) attachment relationships between grandchildren and

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FIGURE 1.

Intergenerational relationship processes in families of grandparents raising grandchildren.

grandparents develop or undergo revision; and (3) family members internal working models of attachment and caregiving adapt to changes and challenges. To address these processes, I briey review attachment theory and research focusing on the formation, disruption, and intergenerational transmission of attachment relationships and working models of attachment and caregiving. I apply these constructs to families with grandparents raising grandchildren, including the perspectives of grandparents, parents, and grandchildren, and conclude with a case example and recommendations for intervention and research. Although I discuss specic suggestions for research and intervention throughout the paper, Tables 1 and 2 summarize the key points.
FORMATION OF ATTACHMENT RELATIONSHIPS AND WORKING MODELS OF ATTACHMENT

In his seminal work on attachment, Bowlby (1969/1982) proposed that individuals exhibit a number of behavioral systems that facilitate survival, including the feeding, caregiving, attachment, exploration, and sociability systems. The primary function of the attachment system is protection from danger by maintenance of proximity to and availability of the attachment gure (Ainsworth, 1990; Bowlby, 1973). According to Bowlby, attachment relationships develop starting in infancy and continuing through the childs rst several years of life. Moreover, most children select more than one attachment gure by 18 months of age, which may include the childs grandparents (Howes, 1999). Bowlby (1969/1982, 1973) also proposed that children develop internal working models, or cognitive and emotional expectations of self and others, in the context of attachment relationships. Building on experiences that occur within the family during infancy, initial working models emerge during the toddler years. During the preschool years, as their concepts of specic caregivers and attachment gures in general become more rened, childrens representations and understanding of self, others, and relationships gradually become more enduring. Bretherton (1990, 1991, 1993) contends that the preschool years are crucial for the growth and elaboration of internal working models, a claim that is supported

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TABLE 1. Potential Areas of Research with Families of Grandparents Raising Grandchildren Generation of Family Members Inter-Related Domains
Behavioral/ Interactional

Grandchildren
attachment behaviors toward caregivers processes related to relationship formation and disruption separation and reunion behaviors visitation (e.g., timing, frequency) atypical attachment behaviors behavior problems expectations about caregivers understanding of situation (information provided and own experience) relation of what child is told to childs mental health emotional reactions to situation childs age, developmental capacities age at and length of placement quality of other relationships services available stressful life events (cumulative effects of trauma, gestational exposures, etc.)

Parents
caregiving behaviors toward child (especially during visits) coparenting (compete with or enhance caregiving) communication with child and grandparent access to child

Grandparents
caregiving behaviors toward child (read childs signals, sensitive responsiveness, therapeutic responding) coparenting (compete with or enhance caregiving) communication with grandchild and parent (what child is told)

Cognitive/ Affective

appraisal of situation interpretation of childs behaviors (especially during visits) expectations about relationships identity as parent emotional reactions to separation reason for inability to care for child social stigma quality of other relationships supports and resources available stressful life events limitations, barriers to communication

interpretation of childs behaviors appraisal of situation, meaning of caregiving expectations about relationships knowledge of child development, separation/reunion reactions health, age social stigma quality of other relationships supports and resources available stressful life events economic and other challenges

Social/ Contextual

by research on event representations, autobiographical memory, and childrens growing psychological understanding of self and others (Thompson, 1998). These internal working models are thought to guide an individuals behavior, emotional reactions, and interpretations of interactions in future interpersonal relationships (Bowlby, 1969/1982). The quality of attachment relationships, which has implications for an individuals later social and emotional development (e.g., Bohlin, Hagekull, & Rydell, 2000; Thompson, 1999), is shaped, in part, by how sensitively and responsively caregivers interact with their infants (Ainsworth, Blehar, Waters, & Wall, 1978; Bowlby, 1980; DeWolff & van IJzendoorn, 1997). Whereas parental involvement, warmth, and responsiveness predict secure attachment, insensitive and inconsistent parenting predicts insecure attachment (e.g., Bates, Maslin, & Frankel, 1985; Crockenberg, 1981; NICHD Early Child Care Research Network, 1997). Specically, insecure/avoidant attachment is associated with maternal rejection of physical contact, and insecure/ambivalent attachment is associated with maternal inconsistency and lack of respon-

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TABLE 2. Suggested Roles for Infant Mental Health Professionals Working with Families of Grandparents Raising Grandchildren

Evaluate childrens current interactions with grandparents and parents and how these relate to childrens cognitive and emotional expectations about relationships Assess grandparents appraisals of the situation, such as whether they focus on the stressors, challenges, or potential emotional rewards of caregiving; assist them in nding meaning in parenting again Examine how the childs age and developmental capacities affect his/her understanding of the situation Evaluate current family risks relative to resources and work with the family to determine the level and type of needs Work with families to examine their caregiving behaviors and cognitive/emotional expectations about relationships Identify risks for intergenerational patterns of relationship dysfunction and foster experiences leading to alteration in maladaptive cycles Work with families to recognize and understand childrens behavioral expressions of their feelings about separation, including: (a) conditions under which childrens attachment behaviors become salient, and (b) that some children may glorify positive feelings or deny negative feelings about parents

Help grandparents and parents understand the importance of what they tell the child about the situation Educate family members about the emotional dynamics of disrupted attachment relationships Help families understand the need for increased sensitivity in reading and responding to childrens signals Foster grandparents knowledge of strategies for responding therapeutically to grandchildren with disrupted attachments Work with the family to facilitate open communication between generations, including: (a) recognition of who controls contact between parent and child, and (b) identication of what level and type of contact would benet the child Suggest resources for preventing and coping with childrens behavioral and learning difculties Facilitate the familys ties to formal and informal community networks and professional resources Reect on the situation from the perspectives of grandparents, parents, and grandchildren

siveness to infant distress (Ainsworth et al., 1978; Belsky, Rovine, & Taylor, 1984; Isabella, Belsky, and von Eye, 1989; Lewis & Fiering, 1989; Smith & Pederson, 1988; Vondra, Shaw, & Kevinides, 1995). Disturbed parent child interactions, such as those involving maltreatment or frightening behavior, predict insecure/disorganized attachment (Barnett, Ganiban, & Cicchetti, 1999; Main & Hesse, 1990; van IJzendoorn, Schuengel, & Bakermans-Kranenburg, 1999). Moreover, a growing number of studies document interactions between parental and child characteristics in the development of attachment relationships (e.g., Belsky, 1997, 1999; Crockenberg, 1981; van den Boom, 1994; Poehlmann & Fiese, 2001). Although few studies address childrens attachment relationships with or representations of relationships with grandparents, adults often mention grandparents in their narratives of signicant people in their lives (Howes, 1999; Wiscott & Kopera-Frye, 2000). Werner (2000) indicated that in her Kauai Longitudinal Study, grandparents often functioned as caregivers and sources of emotional support for children whose parents experienced mental illness or alcoholism. In addition, Myers, Jarvis, and Creasey (1987) examined attachment behaviors of young children toward their mothers and nonsurrogate-parent grandmothers during a playseparation situation, and concluded that grandmothers can function as attachment gures who play important roles in childrens social development (Myers et al., 1987). Moreover, most grandparents raising grandchildren meet criteria proposed to identify attachment gures other than the childs parents because they provide physical and emotional care for the child and are consistent gures in the childs life, in addition to having an emotional investment in the child (Howes, 1999). In short, grandparents often serve as a secure base for their grandchildren.

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DISRUPTIONS IN ATTACHMENT RELATIONSHIPS

Disruptions in attachment relationships occur when the attachment gure is not accessible (i.e., available and responsive) to the child, such as during a separation or when discontinuity in care occurs (Bowlby, 1973). Disruptions in attachments may be temporary (e.g., a separation) or permanent (e.g., parental death or abandonment of a child). When grandparents begin raising their grandchild, a disruption may occur in the parent child attachment relationship because of the physical separation that is initiated (see Figure 1). In addition, the child may have experienced insecurity in attachment relationships prior to the separation because of parental problems that precipitated the change in care. Conditions that predate a change in care tend to have cumulative negative effects on development, in addition to effects associated with disruptions in care. Based on observations of toddlers and young children during prolonged separation from their parents, Bowlby (1973) and colleagues found that children experienced stages of protest, despair and detachment in their reactions to separation. In the rst several hours and for a week or more following separation, children expressed distress, fear, angry protests, desperate efforts to nd the missing parent, and hope that the parent would return. As the separation continued, children experienced despair, increasing hopelessness about the parents return, and withdrawal from the environment. Other researchers have found that maltreated children who are separated from their familiar, abusive caregiver, may glorify their feelings and deny or defensively exclude negative information about the abusive caregiver during the separation (Milan & Pinderhughes, 2000). Detachment, the nal stage suggested by Bowlby, involved a return to interest in the environment and increased acceptance of substitute caregivers. However, if reunited with their attachment gures at this point, children often walked away, alternated between treating parents like strangers and clinging to them, or alternated between crying, showing expressionless faces, or exhibiting fear that parents might leave again. In brief separations that occur as part of the Strange Situation, which is used to assess the quality of infants attachments to parents and other caregivers, it is normal for infants classied as secure to cry when the parent leaves and even continue fussing for a time when the parent returns. However, secure infants calm down quickly and resume their exploratory behaviors following the parents return, whereas insecure infants exhibit a range of less adaptive reunion behaviors, such as avoidance of parents, inability to calm, pushing parents away, blank staring, etc. Contradictory reunion behaviors may be confusing to parents and caregivers. That is, if a child treats a parent as a stranger or seems distressed when reunited after a prolonged separation, the parent may feel rejected and the caregiver may be reluctant to facilitate parental visitation in the future. In a study of incarcerated women and their families, for example, foster parents indicated that childrens visits with mothers were disruptive and the children often misbehaved following a prison visit (Baunach, 1985). However, Bowlby (1973) noted that eventually the heightened attachment behaviors that children show during reunion subside or are expressed in more subtle ways as children reestablish relationships with their parents. In addition, beyond infancy and early childhood, illness, distress, or reunion with an attachment gure after a prolonged separation may magnify an individuals attachment behaviors, emotional reactions and cognitions (Ainsworth, 1989). Recognizing and understanding childrens behavioral expressions of their complex feelings about separation and reunion are important for professionals working with grandparents, especially because behavioral issues are salient in these families (Emick & Hayslip, 1999; Sands & Goldberg-Glen, 2000; Hayslip, Shore, Henderson, & Lambert, 1998). Intervention might involve discovering parents and grandparents interpretations of these behaviors and clarifying the function and meaning when children defensively exclude negative information or express

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distress at reunion. In addition, future research could examine childrens emotional and behavioral reactions to separation from parents when they transition into their grandparents care, childrens behaviors before, during and after visits with parents, and the meaning that parents and grandparents attribute to childrens reactions. The timing, frequency, and context of visitation that is optimal for children in different circumstances would be important to investigate as well. Additional research focusing on children adopted after difcult early experiences or environmental deprivation has found reduced rates of attachment security and a tendency for children to engage in indiscriminate friendliness toward others, behaviors that may confuse caregivers (Chisholm, Carter, Ames, & Morison, 1995; Marcovitch et al., 1997; see Stovall and Dozier, 1998, for a review). For example, Howe (1995) found that later-adopted children who had a history of neglect, abuse, or multiple placements experienced difculty forming relationships, poor developmental outcomes, and displayed indiscriminate behavior toward others. Indiscriminate friendliness and terror of strangers has also been documented in young children placed in foster care (Albus & Dozier, 1999). These atypical behaviors have implications for how caregivers respond to children. In summarizing several studies examining attachment relationships between children with prior difcult life experiences and their nonparental caregivers, Howes (1999) concludes that in order to construct a secure attachment relationship with such a child, an adult may need to be much more sensitive than is the case in typical child adult attachment (p. 680). This conclusion is important because it highlights the need for caregivers to read childrens signals accurately and provide a high level of support for grandchildren with negative early attachment experiences. Similarly, based on observations of infants in foster care, Stovall and Dozier (1998, 2000) concluded that sensitive responding to the childs signals by foster parents may be insufcient for children with disrupted attachment histories, and that therapeutic responses may be needed to facilitate secure relationships with these children. Because of these issues, grandparents may benet from working with early intervention professionals, such as infant mental health specialists, to foster secure attachments to their custodial grandchildren with disrupted relationship histories through discovering and implementing ways of therapeutically responding to grandchildren. In addition, possibilities for future research include: (1) examining whether children raised by their grandparents, like children in adoption and foster care studies, exhibit unusual attachment behaviors such as indiscriminate friendliness, (2) documenting how custodial grandparents read, interpret, and react to their grandchildrens behavioral signals, especially during times of stress, and (3) whether the childs early experiences or family characteristics predict or interact with these issues.
CHILD AND FAMILY FACTORS AS SOURCES OF VULNERABILITY AND STRENGTH

When examining disruptions in attachment relationships that occur when children are separated from their parents, the childs age, cognitive and emotional expectations about caregivers, as well as the balance of risks and resources in the family, are important variables to consider.
Childrens Age

Bowlby (1969/1982) indicated that a child remains open to becoming quickly attached at least through his or her rst year of life. Although most research regarding the formation of attachments has been conducted with infants (e.g., Ainsworth et al., 1978; Isabella et al., 1989), a small literature focusing on toddlers and older children suggests that, because children construct

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relationships based on repeated interactions with caregivers, this process may parallel the development of attachments in infancy (Howes, 1999). However, the likelihood of developing a secure relationship with a new attachment gure beyond infancy depends on multiple factors, including the childs earlier caregiving experiences, the childs age, the caregivers attachment state of mind, and the quality of interactions with the new attachment gure (Dozier, Stovall, Albus, & Bates, 2001; Stovall & Dozier, 1998). For example, Stovall and Dozier (2000) examined the development of attachment over two months in young maltreated children placed in foster care. The authors found that infants placed before 12 months of age with foster parents judged secure developed secure attachments, whereas children placed later developed insecure attachments. Although a more recent report indicated that childrens age at placement was not related to their attachment quality with foster mothers, all children were placed early within their rst year and a half of life (Dozier et al., 2001). Children raised by grandparents due to parental problems such as maltreatment, substance abuse, or incarceration may be at increased risk for developing insecure attachment relationships with their caregivers, depending on their age of placement and other variables (e.g., Barnett et al., 1999; Milan & Pinderhughes, 2000; Poehlmann & Kinderman, 2001; van IJzendoorn et al., 1999). However, this issue needs to be investigated empirically in families with grandparents raising grandchildren. Variables that may predict risk for developing insecure attachments with grandparents include: (1) whether the child grandparent attachment was already established prior to grandparents assuming caregiving responsibilities, (2) the quality of the childs relationship with parents, (3) how old the child is at placement, (4) how sensitively grandparents respond to the child, (5) the quality of the grandparents marital relationships, and (6) interactions among these variables (see Figure 1). Future research could explore how these and other factors combine with parent, grandparent, and contextual factors to predict relationship quality in families with grandparents raising grandchildren. In the latter part of infancy, even short-term physical separations from an attachment gure can be disruptive although, on the positive side, infants are open to forming new attachments quickly. With advances in cognitive development, older children can engage in symbolic means of communicating with their attachment gures and maintaining felt security. Thus, an older child may tolerate brief separations but experience a prolonged separation as disruptive. Although adults are more likely to tolerate longer separations because they can engage in distal forms of communication, adult relationships may be disrupted when a barrier to reunion exists or is believed to exist, or when communication is not open (Kobak, 1999), which may occur when parents experience problems that precipitate grandparents assuming responsibility for their grandchildren. Consistent with attachment theory, grandparents raising grandchildren report that relationships with their adult children are a signicant source of stress (MorrowKodos, Weber, Cooper, & Hesser, 1997). Early intervention professionals can assist families in understanding the complex dynamics of adult relationships, in addition to how the childs age, developmental capacities, and caregiving history affect their comprehension of and reactions to family transitions, such as when grandparents begin raising their grandchildren. Moreover, future research could examine the quality of adult relationships and level of open communication that exist between parents and grandparents in these families.
Childrens Cognitive and Emotional Expectations

When a separation occurs, a child may experience less distress if he or she believes that the parent is available, which includes perceptions that channels of communication are open, physical access to the attachment gure is possible, and the attachment gure will respond if called upon (Ainsworth, 1990; Bowlby, 1973; Kobak, 1999; Solomon & George, 1999). The childs

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cognitive and emotional expectations about whether the parent is available or not are inuenced by past experiences with the parent and what the child is told about the parent and the separation, as well as how extended family members support parent child communication during the separation. If a parent showed diminished responsivity and sensitivity in the past, even when the parent was physically accessible, the child is likely to have developed negative expectations about the parent availability, which tend to persist later in life (Bowlby, 1973). For example, substance abuse often prevents a caregiver from responding to a child needs because the primary focus is on drugs (C.S. Brooks, Zuckerman, Bamforth, Cole, & Kaplan-Sanoff, 1994) and because of associated risks such as psychiatric disorders, homelessness, poverty, social isolation, violence, and maltreatment (Espinosa, Beckwith, Howard, Tyler, & Swanson, 2001; Mayes, 1995; Osofsky and Thompson, 2000). In addition, drug-exposed infants may engage in less optimal interactions with their caregivers (Osofsky & Thompson, 2000). As expected, Rodning, Beckwith, and Howard (1991) reported that most drug-exposed 13 month olds developed insecure attachment relationships with their caregivers, and Epinosa et al. (2001) found elevated rates of disorganized infant mother attachment in toddlers of heavy cocaine-using mothers. In Espinosa et al.s (2001) study, 31% of toddlers experienced a change in caregiver during their rst 18 months of life usually from the mother to the maternal grandmother or from the maternal grandmother to the mother. However, the authors did not report infant grandmother attachment data for these children. Based on formulations derived from attachment theory, researchers could explore whether childrens cognitive and emotional expectations derived from past experiences with attachment gures inuence their interaction patterns with custodial grandparents. Specically, longitudinal research could detail how childrens internal working models of attachment develop and change in these families, including the consequences of working models for childrens behavioral and emotional adaptation and family functioning. Moreover, early interventionists can help grandparents understand the origins and consequences of childrens and adults expectations about relationships. Because family transitions may lead to reexamination and alteration of earlier internal working models and existing behavior patterns (Bowlby, 1969/1982, 1973), family members may be particularly open to intervention strategies when grandparents assume a custodial caregiving role. For children who have begun to understand and use language, information provided about the reasons for childrens living arrangements may affect childrens current beliefs about parental availability. Information may range from little to excessive detail or from factually accurate to distorted. For example, in their study of preschoolers whose mothers were incarcerated, Poehlmann and Kinderman (2001) found that, although most caregivers simply told the child that the mother was in jail, some children were told that their mothers were sick and in a hospital, or away at school, at work, or at the park even children who visited the prison. Bowlby (1980) hypothesized that young children experience increased risk for mental health problems when their caregivers distort the facts in a way that contradicts the childs experiences. Future research could test this hypothesis by describing how family members portray the circumstances (e.g., how temporary or permanent the separation is, its positive or negative facets, whether the parent is referred to as available or not, distortions in facts) and whether the accuracy or tone of this portrayal predicts childrens mental health and their expectations about parental availability. Furthermore, family members may facilitate open parent child communication to varying degrees. In some situations, depending in part on who has legal rights to the child, grandparents control the amount of parent child contact. When the parent is incarcerated, for example, the grandparent may choose whether to bring the child to visit at the prison and whether to allow

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phone calls or written correspondence. In other cases, the parent may decide when to visit or call, or family members may negotiate and mutually decide upon the frequency and timing of parent child communication. Regardless of who controls communication, how grandparents portray the circumstances and facilitate parent child contact during the separation partially depend upon their relationships with the childs parents and their appraisal of the situation, or the meaning they attribute to their role (Hayslip et al., 1998). Whereas some grandparents focus on stressors and challenges inherent in raising their grandchildren (Emick & Hayslip, 1996), others emphasize the potential emotional rewards of parenting again (Burton & DeVries, 1992). These appraisals provide important insights into grandparents experiences and open the door for infant mental health professionals to assist grandparents in nding meaning in their custodial caregiving roles, despite numerous challenges. Future research could document how grandparents appraisals inuence their interactions and relationships with children and parents, and whether these appraisals inuence childrens internal working models of attachment. Research could also explore how these families communicate across generations and negotiate coparenting. George and Solomon (1999) suggest that coparenting can enhance or compete with an individuals ability or desire to engage in caregiving. It would be interesting to examine this proposition in families with grandparents raising grandchildren, including delineating predictors of various coparenting styles and their impact on child and family well-being.
Balance of Risks and Resources

Finally, the balance of cumulative risks relative to supports and resources in the family context is an important consideration (Belsky, 1996, 1999). In addition to attachment theory, several family and contextual models may assist our understanding of these processes, such as transactional developmental theory (Sameroff & Fiese, 2000), ecological theory (Bronfenbrenner, 1986, 1992), or McCubbins (1979; McCubbin & Patterson, 1982) revision of Hills (1949) ABC-X model of family stress and coping. When grandparents raise their grandchildren, the extended family may function as a protective factor (Werner, 2000) or as an additional risk (Crittenden, 1996), depending on the circumstances and the quality of relationships in the family. For example, Farber and Egeland (1987) and Herrenkohl, Herrenkohl, and Egolf (1994) observed that resilient children from maltreating homes often developed secure attachments with grandparents who became substitute caregivers. However, other children experience insecurity in multiple relationships, which may have cumulative negative effects on their social and emotional development. Although the phenomenon of grandparents raising grandchildren cuts across gender, ethnicity, and socio-economic status, family markers of risk tend to be overrepresented in households with grandparent caregivers (Fuller-Thompson, Minkler, & Driver, 1997). These grandparents are more likely to be single, African American, and female, with lower income and educational attainment than traditional grandparents (Fuller-Thompson et al., 1997). Although ethnicity itself is not a source of risk (Garca Coll & Magnuson, 2000), it is a marker for discrimination, racism, and decreased opportunities associated with the segregation of ethnic minorities in the United States (McAdoo, 1981). In addition, although scholars have recognized that intergenerational kinship networks, and grandmothers in particular, are resources for African American families, these resources have limitations (McDonald & Armstrong, 2001). For example, many grandparent caregivers lack support in their roles as nontraditional grandparents. In a qualitative study of African American grandparents raising grandchildren, only 3% of the respondents indicated that they received reliable, consistent family support for their roles (Burton, 1992). Lack of social support may be particularly salient when the reasons for caregiving are socially stigmatizing, such as parental incarceration, substance abuse, or HIV infec-

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tion. Moreover, Burnette (1999) found that, for Latino grandparents raising their grandchildren, poverty and depression rates were particularly high. Strawbridge, Wallhagen, Shema, and Kaplan (1997) reported that most grandparent caregivers suffered from poor health and other stressful life conditions well before they became surrogate parents. Thus, when grandparents assume responsibility for their grandchildren, a challenging opportunity arises for early interventionists and other professionals to assess the balance of risks and resources in the family, to work with families to determine the level and type of the familys needs, and to foster ties to a range of extended family, community, and professional support networks. Moreover, researchers could use a combination of attachment theory and other family/contextual models to understand the processes of stress and coping and relationship development in these families. For example, researchers could discern whether the balance of cumulative environmental risks relative to supports and resources predicts the well-being of each generation of family members, in addition to the quality of intergenerational relationships.
INTERGENERATIONAL TRANSMISSION OF ATTACHMENT

According to attachment theory, the actions of the attachment gure are guided by the caregiving behavioral system (Bowlby, 1969/1982), which develops in parallel with the attachment system (George & Solomon, 1999; Solomon & George, 1996). Because caregiving involves a transition from being protected to providing protection, caregiving has been conceptualized as the culmination and transformation of earlier attachment experiences that allows multiple inuences, including contemporaneous ones, to exert effects (George & Solomon, 1999). Caregiving also involves striking a balance between protecting the child and pursuing other personal goals (Solomon & George, 1996). The quality of attachment-caregiving relationships is thought to be transmitted from one generation to the next, although this is not a certainty (Bowlby, 1969/1982; Main & Goldwyn, 1984). Bretherton (1990) contends that communication strategies used by parents during interactions with their children may facilitate intergenerational links in internal working models of attachment and caregiving. Several two-generation empirical studies have attempted to address the issue of intergenerational continuity in attachment. Main and Goldwyn (1984) found that a mothers experience of her own mother as rejecting related to rejection of her own infant. Ricks (1985) reported that anxiously attached one year olds who fared poorly as preschoolers were likely to have mothers who reported that their own mothers were currently unhappy. In addition, several studies have examined intergenerational continuity in attachment across three generations in families in which grandparents function in traditional, or nonsurrogate-parent, roles. For example, Jacobvitz, Morgan, Kretchmar, and Morgan (1991) examined concordance between mothers and grandmothers perceptions of the care they received from their own mothers during childhood, and found 70% agreement for reports of acceptance. In Benoit and Parkers (1994) study, 65% of the grandmother mother infant triads had corresponding attachment classications. Additional studies have examined intergenerational transmission of both harsh and constructive parenting (e.g., Chen & Kaplan, 2001; Simons, Whitbeck, Conger, & Wu, 1991; van IJzendoorn, 1992), although not necessarily from an attachment perspective. Despite this high level of intergenerational correspondence in attachment patterns, careful examination of data reveals that concordance is highest for mothers judged secure, and that more variability or intergenerational discontinuity may exist for insecure relationships (George & Solomon, 1999). This is a positive nding because it indicates that security tends to replicate itself across generations, whereas insecurity is not automatically transmitted. Although it is

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widely known that risks such as substance abuse, maltreatment, and psychopathology tend to run in families (e.g., Brook, Whiteman, & Brook, 1999; Crittenden, 1996; Main & Goldwyn, 1984; Osofsky & Thompson, 2000), family members may follow diverse developmental trajectories and experience opportunities that may enhance resilience or increase risk (Egeland, Jacobvitz, & Sroufe, 1988; Werner, 2000). For example, Egeland and colleagues (1988) examined families in which mothers perpetuated or broke intergenerational cycles of maltreatment. They found that abused mothers who did not abuse their own children were likely to have a stable, supportive relationship with a partner, participated in therapy, or received emotional support from a nonabusive adult during childhood. Consistent with this nding, attachment theory claims that a persons degree of vulnerability to stressors during the life course is inuenced by both past and present relationships (Bowlby, 1988). It is important for infant mental health professionals to note that a history of insecure attachment relationships does not necessitate repeating this pattern with subsequent generations, although it indicates a heightened risk for intergenerational patterns of maladaptive relationships. Professionals working with vulnerable grandparents raising grandchildren can recommend and facilitate experiences that break intergenerational patterns of relationship dysfunction, such as fostering supportive relationships in the family and community. Likewise, researchers could examine the incidence of intergenerational transmission of attachment in families of grandparents raising grandchildren and what experiences (e.g., intimate support, participation in therapy) predict continuity and discontinuity in quality of relationships. Researchers could determine whether, as grandparents assume responsibility for grandchildren, parents and grandparents reect on and evaluate their successes and failures as caregivers. According to attachment theory, this type of reection would challenge internal working models of caregiving (see Figure 1). Future research might include: (1) what cognitive and emotional reactions grandparents and parents have when parental problems render him or her unable to function in this role, (2) how focused family members become on the parents needs and problems, (3) how grandparent grandchild relationships change during this process, and (4) whether grandparents attempt to compensate for their past mistakes in the caregiving role or whether they unknowingly repeat maladaptive patterns due to lack of support or knowledge. Given these considerations, grandparents assumption of care for grandchildren may be an opportune time for infant mental health professionals to facilitate family support and provide educational and therapeutic interventions designed to alter caregiving behaviors, internal working models of attachment and caregiving, and intergenerational patterns of relationship dysfunction.
RESEARCH ON PERSPECTIVES OF GRANDPARENTS, PARENTS, AND GRANDCHILDREN

Although early interventionists may work most directly with young children and grandparents, it is important to consider perspectives of each generation of family members. In the following section, I selectively review the limited research focusing on perspectives of family members and then provide a case example illustrating applications of these perspectives to intervention with families of grandparents raising grandchildren, within at attachment theory framework.
Grandparents Perspectives

A growing number of studies focus on the well-being of grandparents raising grandchildren. Most studies report declines in well-being, changes in roles, deterioration in health, or increases in depressive symptoms associated with the onset of caregiving responsibilities (e.g., Jendrek,

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1993; Minkler, Fuller-Thompson, Miller, & Driver, 1997; Minkler & Roe, 1993, 1996). However, several studies discuss possible benets of caregiving (Burton, 1992; Burton & DeVries, 1992), or nd minimal impact of raising grandchildren on grandparents roles or well-being (Pruchno, 1999; Sands & Goldberg-Glen, 1998; Szinovacz, DeViney, & Atkinson, 1999). In general, ndings regarding grandparents perspectives may depend on multiple family variables and the circumstances that propelled grandparents into their nontraditional roles. However, it is unclear if parenting stress experienced by grandparents is different from stress experienced by the middle generation. Whereas many reports focus on surrogate parenting under difcult conditions such as parental drug abuse or incarceration (e.g., Dressel & Barnhill, 1994; Hirshorn, 1998; Minkler, Roe, & Price, 1992), other studies do not report the reason for caregiving (Szinovacz et al., 1999) and include families with a range of experiences, including parental death, divorce, teen pregnancy, economic crisis, illness, and maltreatment. Moreover, grandparent well-being may depend, in part, on the familys relationship context, affective climate, social supports available, and grandparent perceptions of childrens behaviors. For example, Sands and Goldberg-Glen (2000) found that among African American and Caucasian custodial grandparents, caring for a grandchild with psychological and/or physical problems, experiencing low family cohesion, and being younger were associated with elevated grandparent stress. However, additional longitudinal studies are needed to document grandparents adjustment to caregiving and how their adjustment relates to and interacts with the well-being of other generations. Despite the growing number of studies representing grandparents perspectives on surrogate parenting, most of this literature has not addressed the emotional dynamics of disrupted attachment relationships and issues related to intergenerational continuity or discontinuity in relationship quality, an important component of family life (Bengtson, 2001). Future research examining grandparents perspectives needs to include a focus on their emotional well-being, including processes of intergenerational relationship development and maintenance. Researchers also should consider the extensive literature describing the stress and disequilibration in family structure and relationships that accompany the transition to parenting (e.g., Cowan & Cowan, 1988, 1997; Cox, Paley, Payne, & Burchinal, 1999; Heinicke, 1995). In a sense, custodial grandparents experience the transition to parenting again, but in a nonnormative, unplanned way.
Parents Perspectives

Although there is a paucity of research on parents whose children are raised by grandparents, several studies focus on mothers separated from their children due to incarceration. Because most children of imprisoned mothers live with their grandparents during the incarceration period (Enos, 1997; Young & Smith, 2000), this line of research provides some insight into the experiences of the middle generation. Research with imprisoned mothers has found that enforced separation from their children is a primary concern of incarcerated mothers (Covington, 1998; Garca Coll, Surrey, Buccio-Notaro, & Molla, 1998; Phillips & Harm, 1997). For example, Garca Coll, Miller, Fields, and Mathews (1997) found that incarcerated mothers worried about the well-being of their children and the example they were setting for them, and regaining custody of their children was a primary motivational factor in their rehabilitation. However, during the incarceration period, few mothers receive regular visits from their children, often due to the distance lived from the prison or to the reluctance of the childs caregiver (Bloom & Steinhart, 1993; Gabel & Johnston, 1995; Mumola, 2000; Snell, 1994). Despite this nding, research suggests that maintenance of family relationships during incarceration predicts fewer disciplinary infractions, improved mental health, and decreased recidivism rates for in-

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mates, and increased probability of reunication with family members following release (e.g., Hairston, 1988, 1991). Moreover, several surveys of incarcerated women have found that family of origin dysfunction is highly prevalent in this population (e.g., U.S. General Accounting Ofce, 1999). For example, more than half of women in state prisons report a history of physical or sexual abuse, usually perpetrated by a relative, and many have family members who have been incarcerated (Greenfeld & Snell, 1999; U.S. General Accounting Ofce, 1999). In addition, a majority of incarcerated women report witnessing verbally or physically aggressive interactions between their own parents during childhood (Martin, Cotten, Browne, Kurz, & Robertson, 1995), and over one-third were abused by an intimate partner in the past (Greenfeld & Snell, 1999). These ndings may not generalize to the population of nonincarcerated parents whose children are cared for by grandparents; in particular, this research may overemphasize disrupted relationships, in contrast to more benign circumstances. Clearly, additional research focusing on the middle generation is needed, including studies addressing the quality of parent child and parent grandparent relationships during times when parents are unable to function in their parental role, and studies focusing on continuity and discontinuity in attachment relationships across generations, including a focus on internal working models of attachment and caregiving.
Childrens Perspectives

Although few studies focus on the well-being of children raised by grandparents, research has suggested that previously maltreated children living in kinship care arrangements are less likely to exhibit clinically signicant behavior problems compared to children in foster homes or group placements (D. Brooks & Barth, 1998; Heinger, Simpkins, & Combs-Orme, 2000). However, children in kinship care may be less likely to receive the health services they need and have longer placements than children in foster care who are not placed with relatives (Rosenfeld et al., 1997; U.S. General Accounting Ofce, 1995). In addition, families with informal kinship arrangements tend to have fewer resources and rely on public assistance more than families involved in formal kinship care arrangements (McLean & Thomas, 1996). Despite these challenges, as adults, children who lived in kinship care may not differ from children who lived in foster care on variables such as education, employment, physical and mental health, stresses or supports (Benedict, Zuravin & Stallings, 1996). However, compared to their nonmaltreated peers, previously maltreated children living in kinship care arrangements are more likely to exhibit poor study habits, diminished concentration, aggressive behavior, grade retention, problems with academic achievement, cognitive, and language decits, and increased participation in special and remedial education (Dubowitz & Sawyer, 1994; Dubowitz, Zuravin, Starr, Feigelman, & Harrington, 1993; Sawyer & Dubowitz, 1994). These problems may prove challenging for children and their caregivers. Early interventionists can play a crucial role in helping educate family members about the emotional dynamics of disrupted attachment relationships that may increase childrens risk for behavioral and learning difculties, in addition to working with families to locate resources for preventing and coping with these problems. Although ndings regarding the development of children in kinship care are interesting, additional studies focusing on infants and young children who are raised by their grandparents are needed, particularly with children who were not maltreated prior to placement with grandparents. In addition, studies focusing on the development of grandparent grandchild attachment relationships and how these relationships may function as protective or risk factors for children are important for understanding the development and family life experiences of children raised by their grandparents. Finally, additional research is needed that examines disruptions in parent child attachment relationships, how parent child relationships are maintained

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(or not) during the separation, and what implications these complex family relationships have for the childs long-term social and emotional development.
CHALLENGES IN CONDUCTING RESEARCH

Overall, three generations of family members have proved difcult to assemble for research purposes, with refusal rates ranging from 40% to over 80% (Poehlmann, 2001; Tomlin & Passman, 1989). In addition, studies have found that families in which one generation will not participate in the research process are less connected to other family members (King & Elder, 1997), report less supportive relationships (Poehlmann, 2001), and are more likely to have experienced disrupted family relationships (Wakschlag, Chase-Lansdale, & Brooks-Gunn, 1996). Because of these issues, research that includes the perspectives of children, parents, and grandparents is difcult to conduct, and may overrepresent higher functioning families. In addition, this type of research may require creative methods of recruiting and retaining research participants, including conducting home visits, scheduling exible appointments, combining research with intervention, and working to establish a high level of rapport with each generation of family members. Despite these challenges, multigenerational research can make signicant contributions to theory, understanding family processes and individual development in high risk families, and intervention. Because there is a paucity of research focusing on relationship processes in families of grandparents raising grandchildren, several different levels of research are needed, including descriptive research, examination of predictors of relationship quality and developmental outcomes, and identication of moderators and mediators of relations among individual, family, and social-contextual characteristics and relationship processes. Table 1 summarizes potential areas that investigators might explore for each generation of family members.
CASE EXAMPLE

The following case example illustrates perspectives of each generation, including salient issues and possible approaches to intervention.
Background1

Grandmothers perspective. Estelle is a 45-year-old, single African American woman who obtained her GED and indicates that her health is poor she has asthma, obesity, and diabetes. She has three adult children and nine grandchildren. Currently, Estelle is the primary caregiver for the six children of her eldest daughter, including four boys (ages 15, 11, 7, and 5 years) and two girls (ages 3 years and 6 months). She has cared for the two oldest children for the past six years, and she assumed care for her four younger grandchildren six months ago. Estelle does not work outside the home and her only income is kinship care funds that total $15,500 per year. Estelle indicated that her adult daughter used alcohol, cigarettes, and crack cocaine during her last pregnancy, so I called the police because I was worried about the baby. (Estelles seven-year-old grandchild has developmental delays related to prenatal substance exposures.) Estelle indicated that notication of the police helped her daughter get treatment in a residential
1

Names and demographic data have been altered to protect the familys identity.

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drug rehabilitation facility, although this also led to an increase in her own custodial caregiving responsibilities. Estelle looks forward to her grandchildrens reunion with their mother. She indicates, with a sigh, that watching the kids supposed to be for six months, now its six years. Ill be so glad when their mama gets home. When she get the kids back, Im goin away for awhile, just to have time for me. Maybe Ill go to school or get a job. Estelle takes the children to visit their mother occasionally, and she has told the children that their mother is getting help because she took drugs. The children act crazy-like before and after the visits. Because their behaviors are growing worse, she is not sure whether the visits will continue. Mothers perspective. Sherry is a 32-year-old, single African American woman who nished high school even though she had her rst child at age 16. She has used crack cocaine off and on for the past 12 years. Sherry has been in a treatment facility for the past six months, following the birth of her youngest child. In addition, she was arrested six years ago, which led to her own mother obtaining custody of the two oldest children. Sherry indicated that her mother gave birth to her when she was 13 years old, so she lived with her maternal grandparents until age eight years. When she moved in with her mother at age eight, she experienced neglect from her mother and was sexually abused by her mothers boyfriends. In addition, Sherry experienced sexual assault as a young person and has been involved in several verbally abusive relationships with men. She has a history of Post-traumatic Stress Disorder and is currently depressed. She began seeing a therapist at the drug treatment center several months ago. Sherry reported that when she rst went to the drug treatment center, she was very distraught, really depressed, full of shame, guilt, anger, and in pain because I was still breastfeeding . . . but now I dont get caught up in self pity. I always wanted a daughter to show her all the love that I didnt have when growing up. I know its gonna take lot of work on my part to work at getting to know my kids again, a gradual process. But I have hope that Ill get to know them and theyll get to know me. Childs perspective. Sherrys three-year-old daughter, Precious, was extremely distraught when she rst came to live with her grandmother. She cried frequently for more than a week and stood at the window, saying mama, mama. Estelle indicated that now Precious has frequent temper tantrums, trouble sleeping, and wets the bed. She carries her mothers photograph around with her and sleeps with it next to her. When Precious does not like something that her grandmother does, she states Im gonna tell my mama on you. Her grandmother reports that Precious frequently hits the other children and the grandmother. When Precious engages in aggressive behavior, Estelle takes the picture of her mother away and says that, if her behavior continues, she will not allow her to visit her mother anymore. Although Precious becomes very excited when anticipating a visit with her mother, during visits she either ignores or hits her mother. Course of intervention. Estelle indicates that she receives regular home visits from a birth-tothree program to monitor the development of her six-month-old grandchild who experienced prenatal drug exposures. Because Estelle raised concerns about Precious behaviors, she was referred to an early childhood mental health clinic. During the initial assessment phase, Jean, an infant mental health specialist, conducted two home visits and observed one of the familys visits with the mother. Jean assessed Precious

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developmental abilities, which fell in the average range, and conducted a doll play assessment; both aggressive and nurturing themes were apparent in her play. When Jean asked about her mother, Precious repeatedly stated, My mamas gone. Gramma made her go. In addition, Jean spent a signicant amount of time listening to Estelle and learning about the familys background and current strengths and challenges. Estelle indicates that she is socially isolated and not involved in neighborhood or church activities, and she does not visit with friends. However, she receives a limited amount of help from her other children, who live nearby. In addition, Estelle indicates that she does not understand why Precious acts mean. Estelle also worries that the children will follow in their mothers footsteps, but she hopes that she is raising them better than she raised Sherry. She feels that Sherry does not appreciate everything she is doing for the children. Moreover, Estelle tends to focus on her negative feelings about caregiving: I got my grandchildren cause someone else dont have patience with them. They are terrible. Jean spoke to Sherry on the telephone about her perceptions of the children and her relationship with her own mother. Having her children live with their grandmother was Sherrys choice, although she has ambivalent feelings about the situation. Sherry reports that my mom is good to them, loving, different than she was to me when I was young. I appreciate what shes doing. But I feel resentment about what she did to me shes unhealthy. When asked about how they communicate with each other, she indicated that when they talk, they usually experience conict about the children. Theres only so much parenting I can do from afar. Me and my mom have agreed to be co-parents, but we have so many differences in the ways we deal with the kids. Sherry feels that Precious behavior problems reect her own mothers lack of structure and inconsistency. Sherry wishes that she could have regular visits with the children. Based on this assessment, it became clear that Precious behaviors were a source of confusion and frustration for her mother and grandmother. In her work with the family, Jean gradually offered interpretations for the childs anger, aggressive behaviors, and confusing behaviors before, after, and during visits with her mother. These interpretations included seeing Precious behaviors as communication of her feelings about separation from her mother, including missing her mother and viewing her grandmother as a cause of this loss. Carrying around the picture of her mother is a way that Precious tries to maintain a connection with her mother. When misbehavior occurs, Precious may need an adult to recognize these attempts at communicating her feelings, in addition to providing extra support and reassurance. During the course of treatment, Estelle became increasingly open to these ideas and no longer used threats of removing visits or taking away the mothers picture as discipline techniques. Sherry grew in her understanding of how difcult the separation was for her children. Jean also worked with Estelle to decrease her social isolation by connecting her to resources available in her community and at her church, as well as resources to assist with the other children, such as an after school program. Jean encouraged the family to discuss their visitation patterns with the mother and suggested a regular, consistent visitation schedule. Jean also recommended strategies to manage Precious behaviors before, during, and after the visits. Although the family responded positively to these interventions, and Precious behaviors gradually improved, Estelle continued to focus on stressors associated with caregiving and to resist discussion of her past caregiving behaviors. As Sherry neared her discharge date, the familys discussions centered on plans for reunication with the children. Estelle continued to focus on the negative aspects of caregiving and was eager for Sherry to resume care. Sherry felt that she needed some time to get on her feet again, including nding employment and housing.

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SUMMARY

When grandparents begin raising their very young grandchildren, the well-being of family members depends on a complex set of circumstances, including reasons for the childs placement, the childs age, the history of relationships and quality of current relationships in the family, patterns of communication, the balance of risks and resources, and supports available in the social context. Because it focuses on intergenerational, lifespan aspects of relationships, includes issues related to parental separation and loss, and has implications for intervention with high risk families, an attachment perspective is a useful framework for conceptualizing the emotional dynamics, cognitive expectations of relationships, and transitions in family structure and process for grandparents raising grandchildren. When grandparents assume responsibility for their grandchildren, a window of opportunity may open for these families, enabling them to respond to a range of educational and therapeutic interventions, including affective, cognitive, and interactionally based therapies as well as provision of information about childrens behaviors. Table 2 provides a summary of suggestions for early intervention professionals working with families of grandparents raising grandchildren. Implementing strategies designed to improve intergenerational family relationships, including interactions, affect, communication patterns, and support, may enhance the quality of life for family members and serve as additional protective factors at a time when infants and young children are particularly vulnerable. Early interventionists and researchers who work with families with grandparents raising grandchildren should remain mindful of the complexities involved in intergenerational relationship processes and work to foster positive connections within the family and with social networks and resources outside the family. Finally, a review of the limited research focusing on families of grandparents raising grandchildren highlights the need for additional scholarship focusing on the formation, disruption, and representations of relationships from the perspectives of grandchildren, parents, and grandparents. Moreover, information pertaining to long-term implications of grandparents raising grandchildren for individual and family development is needed.

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