Caregiving Students Need More Support

By Emma Armstrong-Carter, PhD, Assistant Professor at Tufts University in the Eliot-Pearson School of Child Study and Human Development

Adolescence is a key developmental period when youth can learn to contribute to the lives of others in meaningful ways. Our ability to consider the needs, concerns, and perspectives of others increases throughout our teenage years. We become better able to provide emotional and practical support to our friends, family, schools, and broader communities in deeper, more impactful ways than when we were younger.

Contributing to others has been shown to support positive development for youth, helping to cultivate meaning and purpose, enhancing autonomy and agency, and promoting positive identity development. And families are typically the first context where youth have the opportunity to contribute to others, through common household chores such as cooking or taking care of animals.

But many middle and high school students are doing more than a few household chores. In an article for the Hechinger report, developmental psychologist Emma Armstrong-Carter highlights a form of contributing that many youth provide for their families, in addition to completing chores around the house—caregiving.

“Caregiving youth are young people below age 18 who provide ongoing, time-intensive care at home to family members who have aging-related needs or are chronically ill, such as grandparents, parents, and disabled siblings,” Emma explains.

While caregiving can have benefits for youth (young people can gain self-confidence, resilience, and close relationships), being responsible for someone’s physical or mental well-being can also be taxing in ways that negatively impact mental health and academic achievement. The experience of providing care can be stressful for youth as they are trying to go to school, develop friendships, or participate in afterschool activities, while also caregiving for their loved one by doing tasks such as administering medicine, washing, feeding, or helping with other activities of daily living. Because the responsibilities can be taxing, caregiving adolescents often report missing class, struggling to study and complete homework and feeling worried, fatigued, and isolated.

Caregiving youth need support from adults to ensure they meet their key developmental needs, and the first step is to identify caregiving youth. “Currently, caregiving students are ‘hidden’ from educational systems in the U.S. because they are not formally counted or supported,” Emma explains.

One way to identify caregiving students is by including a survey item in the mandated statewide, school-based behavioral studies which are already conducted in public schools in the U.S. As an example, Emma partnered with the Rhode Island Department of Education to survey 48,500 public middle and high school students across the state about their experiences providing care to their families. The survey helped bring national attention to caregiving youth, and revealed that 29 percent of middle and high school students reported caring for family part of the day, and 7 percent said they were doing so most of the day.

Once schools have identified caregiving adolescents, they can find ways to help youth feel less likely to have to choose between caregiving and school activities. For example, after recognizing that one in three students in Rhode Island take care of a family member for part or most of the day, the Rhode Island Department of Education is beginning to develop solutions for supporting caregiving youth in schools across the state. Currently, the department requires every public middle and high school in the state to develop flexibility and supports for caregiving students.

Together, Emma Armstrong-Carter and the Rhode Island Department of Education suggest five ways that schools can provide additional support for caregiving youth:

Offer flexible course schedules.
Explore the idea of awarding students with community service hours for their caregiving work.
Train teachers and social workers to understand caregiving youth and their experiences.
Embrace and celebrate diversity (in identity or family structure, for example), and recognize that not every young person’s experience is the same.
Create and facilitate support and skill-building groups for caregiving youth to ensure they feel less alone.

Although contributing can be good for youth, too much responsibility for others can interfere with young caregivers’ health and wellbeing. Adults must ensure that all youth are able to meet their key developmental needs. By having targeted support systems in place, adults can promote positive development for all students, including caregiving youth, so they have what they need to thrive.

Additional Resources

The Connecting Adolescent Brain

Fact Sheet

This fact sheet gives an overview of adolescent brain development and explains how access to resources, opportunities, and meaningful relationships during adolescence can build connections within our brains and with the world around us that support us into adulthood.

Brain development during adolescence is fundamentally a story of connections.

Around age 9 or 10, hormonal changes kick off a period of intense learning and development, when brain cells form, strengthen, and streamline connections in response to our experiences more rapidly than in any period of life after early childhood.

Activity increases especially in the brain networks that propel us to explore the world, learn from our mistakes, and connect with others in new ways. In turn, these new experiences prompt our brain cells to connect with other neurons in ways that help us adapt to new events and new information. These neural connections become stronger the more we use them, while unused connections are pruned away, helping the brain become more efficient at acquiring and mastering new skills and new ways of thinking.

This brain-building learning happens through direct experiences in our environments and interactive, responsive relationships—with our families and peers, in our classrooms and neighborhoods, in community activities, and even online. The resources, opportunities, and experiences we as adults provide in and out of school can help young people’s brains build the extensive networks of connections that will manage the complex knowledge and behaviors needed to navigate adulthood.

Learning by Exploring the World Around Us

One of the networks that changes significantly with the increase in hormones and dopamine at the beginning of puberty is the “reward system” in our brain. Heightened activity in this system increases the feeling of reward we get from exploring the world, taking risks, and learning from the results.

Meanwhile, the network of brain regions that make up the “social brain” also changes during adolescence. These changes help us tune into social and emotional cues, like facial expressions or social rejection and approval, and increase our desire to earn respect and contribute to others. It also enables us to learn the nuances of changing social contexts in ways that help prepare us for adult relationships.

The prefrontal cortex (the region of the brain that orchestrates critical thinking and behavioral control) undergoes its most rapid period of development during adolescence. It builds on many other systems within the brain to manage our responses to the flood of new information and intensifying emotions. Engaging with other people and our environment and learning from our successes and our mistakes, known as “action-based learning,” helps shape the prefrontal cortex by strengthening the connections within it and between it and other brain networks. We learn through repeated practice—which includes trying and sometimes failing—what is adaptive and appropriate in different situations and how to guide our behavior accordingly, in ways that equip us to pursue new forward-looking goals.

When adults provide youth with opportunities to try new things, to practice navigating emotions, and to learn from failures along the way, it helps build the brain connections that we all need to grow into healthy, thriving adults.

Policies, Experiences, and Mindsets Shape the Connecting Brain

Although we can continue to learn new skills and behaviors as adults, the adaptability of the brain during adolescence means that these connections are much more likely to form quickly in response to experiences. The extent of these changes make the adolescent years a critical window when investments in the right policies and programs for youth can shape long-term positive development.

Likewise, this makes the adolescent years a time when negative experiences including racism, other forms of discrimination, poverty, or abuse can create steeper hills for young people to climb toward a healthy adulthood. When adults ensure that all young people, especially those who have experienced earlier adversity, have what they need along their journey, they can build the skills and capacities they need to thrive as adults. This includes opportunities to explore and take healthy risks, to connect with and contribute to those around us, to make decisions and learn from the outcomes, to develop a healthy sense of identity, and to rely on support from parents or other caring adults.

Understanding how and why the brain develops during adolescence lets us provide the support young people need to build healthy connections—in their world and within their brains—that will help our youth and our communities thrive.

Thumbnail Image for March 2024 Research Roundup

Spring 2024 Research Roundup

This issue provides an overview of research showcasing the protective role of positive lifestyle factors for mental health, the benefits of continuing contribution, an effective intervention to support positive racial-ethnic identity exploration, synchronized brain activity between parents and youth, and the importance of timing in parental support.

In this issue of our quarterly Research Roundup, we provide an overview of some recent research showcasing the protective role of positive lifestyle factors for mental health, the benefits of continuing contribution, an effective intervention to support positive racial-ethnic identity exploration, synchronized brain activity between parents and youth, and the importance of timing in parental support.

You can suggest research articles for future roundups by emailing meghanforder@ucla.edu or sign up to receive the quarterly research roundup in your inbox.

Lifestyle factors counteract the neurodevelopmental impact of genetic risk for accelerated brain aging in adolescence (March 2024)
The contribution of community service during the transition to adulthood to health in adulthood (February 2024)
Parental involvement affects parent-adolescents brain-to-brain synchrony when experiencing different emotions together: An EEG-based hyperscanning study (February 2024)
Teachers’ implementation of the Identity Project is associated with increases in U.S. high school students’ ethnic-racial identity exploration (February 2024)
Responsive parental support buffers the link between chronic stress and cardiometabolic risk among adolescents (February 2024)

Lifestyle factors counteract the neurodevelopmental impact of genetic risk for accelerated brain aging in adolescence

A recent study led by Raluca Petrican and colleagues investigated the interplay between positive lifestyle factors (friendships, parental warmth, school engagement, physical exercise, and healthy nutrition) and genetic risk for major depressive disorder, Alzheimer’s disease, anxiety disorders, bipolar disorder, and schizophrenia.

Analyzing data from the Adolescent Brain Cognitive Development (ABCD) Study (a long-term study of brain development and youth health), the researchers found that genetic risk for disorders such as anxiety and depression increased the risk for mental health problems, while positive lifestyle factors decreased the risk for mental health problems later in adolescence. Both genetic vulnerability and positive lifestyle factors were associated with altered development of brain regions involved in cognitive control, emotion regulation, and attention later in adolescence. Importantly, the changes in brain development linked to positive lifestyle factors reduced the risk for psychiatric disorders—especially among adolescents who had experienced high levels of adversity (Biological Psychiatry, March 2024).

Why this is important: This study highlights the protective role of positive experiences on brain and emotional development in adolescence. It suggests that programs that enhance positive lifestyle factors (such as by improving school connectedness) could help protect against stressors and promote mental health, even among young people who have a genetic risk for psychiatric disorders.

The contribution of community service during the transition to adulthood to health in adulthood

In this study, Laura Wray-Lake and colleagues examined changes in community service engagement from adolescence into adulthood (ages 18 to 30) and the impact on adult health outcomes. The researchers analyzed data from over 10,000 participants from a range of high school graduation years (from 1976 to 2000). They tracked changes in participants’ levels of community service from ages 18 to 30, then looked at behavioral, physical, and psychological health outcomes at ages 35 and 40. The results revealed significant associations between community service involvement and adult health outcomes such that adolescents who continued engaging in community service in the transition from adolescence to adulthood reported lower substance use, healthier behaviors, and higher psychological well-being later in life (Journal of Research on Adolescence, February 2024).

Why this is important: This study shows the importance to health and well-being of promoting and supporting civic engagement opportunities as young people transition into adulthood.

Parental involvement affects parent-adolescents brain-to-brain synchrony when experiencing different emotions together: An EEG-based hyperscanning study

In this study, Xinmei Deng and colleagues used a technique called electroencephalograph (EEG) hyperscanning to examine the brain functions underlying shared parent-adolescent experiences by simultaneously recording brain activity in 26 parent-adolescent pairs as they rated their feelings about several 10-second film clips.

They found that in pairs of parents and youth with high parental involvement (where parents show interest, caring, and warmth) there was greater synchronization in brain activity–that is, their brains were responding in similar ways at the same time–when they shared positive emotions. This kind of synchronization between parents and youth is believed to support adolescent social-emotional development, and is based on the strong emotional bonding and connection between the family members. In this context, it suggests that strong bonds with parents can enhance the way parents and adolescents connect emotionally—even on a brain level (Behavioral Brain Research, February 2024).

Why this is important: This study shows one way that parental involvement impacts the dynamics between parents and young people, highlighting the importance of fostering supportive, caring parent-adolescent relationships over the teenage years.

Teachers’ implementation of the Identity Project is associated with increases in U.S. high school students’ ethnic-racial identity exploration

The Identity Project is an eight-session, school-based intervention that provides high school students with strategies and tools to learn about, explore, and reflect on ethnic-racial identity (ERI). The program has been shown to increase in ethnic-racial identity exploration and resolution in ways that support higher self-esteem, lower depressive symptoms, and better grades, among other positive outcomes, when delivered by researchers. In this study, Adriana Umaña-Taylor and her team sought to evaluate the effectiveness of the Identity Project when delivered by teachers themselves. In a group of 180 high school students from diverse backgrounds, the teacher-led Identity Project intervention increased ERI exploration over the course of the program. Further, the positive effects remained when accounting for factors such as ethnic-racial socialization within the family, student and teacher ethnic-racial identity, gender, immigrant status, and ethno-racial background, suggesting that this intervention is effective across diverse adolescent populations (Journal of Youth and Adolescence, February 2024)

Why this is important: These findings demonstrate that teachers, who are uniquely positioned to impact students, can be trained to effectively implement the Identity Project to help youth develop a positive ethnic-racial identity, which is essential to healthy social and emotional development during the adolescent years.

Responsive parental support buffers the link between chronic stress and cardiometabolic risk among adolescents

Exposure to chronic stress from experiences including poverty, bullying, and family turmoil during adolescence can impact mental and physical health–particularly in cardiometabolic issues such type 2 diabetes, heart disease, and stroke in adulthood. In a new study, Phoebe Lam and colleagues investigated a potential protective factor in the association between stress and health in adolescence: the nature and timing of parental support. Using data from 242 adolescents, the researchers found that youth who experienced higher levels of psychological stress over the past 6 months also showed higher levels of cardiometabolic risk (inflammation). Timely parental support—that is, an increase in support such as advice, comfort, and listening received on stressful days—acted as a buffer against the detrimental effects of stress on heart-related health. When adolescents received support from their parents on days when they experienced stress, the link between chronic stress and cardiovascular risk was weakened. Chronic stress was only linked with cardiovascular risk when youth did not receive support in response to days when they experienced stress. (Brain, Behavior, and Immunity, February 2024)

Why this is important: These findings highlight the importance of parental support provided at the time of stressful experiences to prevent the negative physical effects of stress during adolescence. This makes it clear that youth need support from their parents that is attuned to their experiences.

A Developmental Path to Policy and Programs

This spotlight offers examples of policies and programs that take a research-informed, developmental approach to supporting adolescents.

Adolescence is a time of remarkable opportunity, both for young people, who are learning and growing rapidly during these years, and for our broader society as we choose how to support young people on their path to adulthood. By aligning policies and programs with insights from developmental science, policymakers and youth-serving organizations can find ways to more effectively meet the distinct needs of adolescents and support youth to become healthy, thriving adults who can contribute to their families, communities, and the wider world.

In the last several decades, research on adolescent development has dramatically increased our understanding of how young people ages 10 to 25 develop psychologically, emotionally, and physically. Scientists with research expertise in neuroscience, psychology, biological sciences, sociology, education, and public health, among other disciplines, have contributed to our understanding of the core developmental needs of young people. Researchers, often in partnership with young people themselves, have also investigated how these needs might be met in settings that shape adolescents’ lives, such as school, home, the workplace, faith-based communities, and out-of-school activities. As a result of this work, we know more today than ever before about the types of experiences and relationships young people require during adolescence to advance toward healthy adulthood.

Understanding the developmental science of adolescence can help generate new ways of thinking about the challenges and opportunities our youth face and ultimately advance science-inspired solutions, systems, and support.

We offer below a few examples of policies and programs that draw inspiration from a developmental approach toward adolescence. In addition, the appendix included in the PDF highlights external clearinghouses that collect and assess evidence on existing programs and practices relevant to adolescents, which may be useful as you consider how to identify and support the core developmental needs of adolescents in your policy or program.

Young adult courts

Research suggests that young people ages 18 to 25 who have committed moderate criminal offenses experience worse life outcomes and higher rates of recidivism when they are formally processed in the criminal justice system–that is, when they proceed through a standard series of court appearances and resultant sanctions, such as time in detention. This suggests a misalignment between the treatment of these young people in the adult criminal system and their developmental needs and capacities as adolescents.

One approach that several jurisdictions in the United States have implemented in response to the needs of older adolescents is to establish “young adult courts.” For example, in partnership with developmental scientists from the University of California, Irvine, the Orange County Superior Court in California launched a pilot Young Adult Court in 2018. Young men ages 18 to 25 who proceed through the Young Adult Court receive intensive case management, supervision from officials who have received training regarding adolescent development and behavior, and resources to “strengthen their health and wellness, life skills and employment, housing, and education.”

Upon completion of a minimum 18-month, court-supervised program, a judge may dismiss or reduce a young person’s felony charge. Structured as a randomized controlled trial, the Young Adult Court in Orange County will allow researchers at the University of California, Irvine to investigate the relationship between participation in this court and young people’s short- and long-term outcomes across several areas, including health, behavior, education, and career.

Later school start times

In 2019, California passed legislation requiring non-rural middle and high schools to begin the school day no earlier than 8:00 and 8:30 a.m., respectively. During the legislative process, the bill’s author noted that this shift aligns with research about the importance of sleep during adolescence. Indeed, studies have shown that later school start times make a difference for young people. In 2016, the Seattle School District shifted its school start times from 7:50 to 8:45 a.m., and a before-and-after study found that rather than simply staying up later, students slept an average of 30+ minutes more at night. Other research links later school start times to improved moods, better class attendance, and fewer car crashes among 17- and 18-year-old drivers.

Extended foster care eligibility

The earliest design of the child welfare system in the United States responded to the needs of physically abused infants and toddlers and prioritized protection and caregiver permanency for young children. As a system, it was not aligned with the unique developmental needs of adolescents, who can increasingly exert agency in their own lives as they practice reasoned decision-making and who may look to a variety of supportive adults and peers to help build resilience and a positive sense of identity.

One notable example of adapting this youth-serving system to better align with our understanding of adolescent development is the series of major federal policy reforms in the last 25 years that noted and aimed to address the needs of older adolescents with foster care experience and paved the way for state-level action. In general, these reforms have expanded the opportunities for young people beyond the age of 18 to receive services and establish or deepen connections with supportive adults.

Today, in approximately 48 states, the District of Columbia, and American Samoa, young people may elect to remain in extended foster care past the age of 18 and receive supportive resources. Although extended foster care services vary by jurisdiction, they might include a range of resources that align with the capacities and needs of older adolescents as they learn to navigate life choices related to healthcare, housing, education, and employment with appropriate support from caring adults.

Treatment Foster Care Oregon

The Treatment Foster Care Oregon program is a research-informed alternative to placing youth with severe emotional or behavioral disorders in residential group care settings. First developed in 1983, Treatment Foster Care Oregon today offers separate programs for (defined by TFCO as 7 to 11, which encompasses early adolescence) and adolescence (defined by TFCO as 12 to 17) that prioritize family settings and effective parenting over approximately nine months.

The program involves weekly meetings for foster parents that teach positive parenting strategies, crisis support and respite care for foster parents, one-to-one mentorship for youth with a young adult to promote social skill building, and family and individual therapy for caregivers and youth. The program’s design explicitly takes into account the unique developmental needs of middle childhood and adolescence. In fact, the program’s effectiveness seems to be related to the support it provides for some important developmental needs of the adolescent years, including by tapping into youths’ need to find a respected place among peers and to maintain secure relationships with supportive adults.

In randomized control trials, this program has been shown to cut in half the arrest rate of both boys and girls. In addition, girls in the Treatment Foster Care Program experienced half the rate of depressive symptoms, a third less drug use in their early to mid-20s, and about half as many teen pregnancies.

Strong African American Families Program

Strong African American Families (SAAF) is a family-centered program for rural, Black families designed to strengthen early adolescents’ relationships with their caregivers and prevent unhealthy risk taking. The University of Georgia’s Center for Family Research created the program expressly to apply key research insights about healthy adolescent development, including the importance of developing a positive sense of self and racial identity as well as maintaining relationships with supportive adults.

While participating in SAAF, youth ages 10 to 14 and their caregivers attend weekly program sessions over a seven-week period. Through interactive games, discussions, and role playing activities, youth work through topics such as setting goals, developing their sense of identity, understanding their values, and handling peer pressure. Parents complete separate sessions focused on developing communication skills and discussing ways to support their children’s development. Adolescents and their parents also attend joint sessions focused on working together, staying connected, and supporting youths’ goals.

The program reduced risky sexual behavior, substance use, and behavioral problems, and increased positive racial identity. In addition, a recent analysis suggests that SAAF participation may reduce negative mental health effects in adolescents caused by experiencing racial discrimination.

Partnering with young people to design California HOPE accounts

Young people have the ability to make well-reasoned decisions about their well-being when given the time and information to consider their options. Including young people in the design of policies and programs that impact their lives can benefit both adolescents and their communities.

The approach taken by the California HOPE for Children Trust Account Program (the “HOPE Program”) is one example of intentionally engaging young people in the earliest stages of policy development. In 2022, the California legislature created the HOPE Program to provide financial trust accounts for youth from low-income families who lost a parent or guardian due to COVID-19 and young people who have spent at least 18 months in the foster care system. The legislature required a Board to oversee the program, advised by a working group of subject matter experts. These groups recognized “that the HOPE program could not be designed without significant direction from a set of youth who were most likely to be beneficiaries of the program.”

As a result, the groups sought assistance to assemble a Youth Panel of Experts. These 12 young people ages 15 to 21 had experiences that mirrored the qualifying criteria for a HOPE account and were compensated for their participation in the HOPE Program’s design. The HOPE Program’s 2024 report to the state legislature outlines an implementation plan for the program and other critical administrative choices that reflect the contributions and collaboration of the Youth Panel of Experts. The report also outlines an ongoing role for the Youth Panel of Experts, who will provide insights into future public outreach and educational materials for young people eligible for the program and their families.

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Caregiving Students Need More Support