Routine measurement and feedback can be used to improve outcomes for youths who receive typical home-based services in the community.

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The purpose of this descriptive study was to examine caregiver stress in grandparents who are raising grandchildren as well as the antecedents to the child's placement with grandparents. The sample was 41 grandparents, aged 40 to 78 years, with a mean of 55 years. Subjects reported increased psychological distress as measured by the Symptom Checklist-90-Revised inventory. Social isolation and restriction of role, as measured by the Parenting Stress Index, were found to be predictors of increased psychological distress. Child maltreatment, often involving parental substance abuse, was found to be the major antecedent to children being raised by grandparents.

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purpose. To examine parenting stress and coping behaviors in substance‐abusing and non‐substance‐abusing mothers. design. A comparative descriptive design. setting. Pediatric primary care clinic. participants. Low‐income, predominantly African‐American mothers (N = 60) of young children recruited from a pediatric primary care clinic. Thirty mothers were known substance abusers and 30 had no known history of substance abuse. main outcome measures. Parenting Stress Index/Short Form (PSI/SF) and Child Protective Service (CPS) validation of abuse or neglect. results. Substance‐abusing mothers scored significantly higher than comparison mothers on total stress and the three subscales of the PSI/SF: parent‐child dysfunctional interaction, difficult child, and parental distress. Forty‐seven percent of substance‐abusing mothers scored in the clinical range on total stress compared with only 3.3% of non‐substance‐abusing mothers. Proportionately more substance‐abusing mothers than comparisons demonstrated maladaptive parenting behaviors as evidenced by CPS‐confirmed abuse or neglect of their youngest child. conclusions. Substance‐abusing mothers of young children are at increased risk for increased levels of stress and maladaptive coping behaviors. Substance‐abusing mothers need support and monitoring in the parenting role and referrals to substance‐abuse and parenting programs.

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