Del Graff's office studied the case of a seven-year-old boy who was living in a group home when he drowned in an Edmonton pool in 2012.
Graff said in a report released Tuesday that the boy's short life was just as tragic as his death.
The child didn't adjust well to his uncertain living arrangements over the two years it took to schedule a court hearing about permanent guardianship.
"The situation may not be unique," Graff wrote.
"It is concerning that the best interests of children appear to be secondary to excessive delays in the court system."
The boy was four years old when social workers received a complaint that he was out with his mother when she was panhandling.
About a year later, staff determined his parents, who were transient and lived in hotels, were using cocaine, so he was apprehended.
The child appeared happy and well-cared for but was underweight and malnourished, said the report. He could name several candy bars but no vegetables.
He was first placed in a stable foster home but received mixed messages about where he would be in the long term. He was having problems at school and started seeing a therapist.
The boy was moved to the home of another family, who hoped to eventually adopt him, but he became aggressive.
He was then put in the group home.
The report said the government decided to apply for a permanent guardianship order eight months after he was in care. But three court delays pushed back the date over the course of two years.
The assigned courtroom was initially double-booked, "a common practice," said Graff. The boy's mother failed to show up at the next hearing, then his father fired his lawyer.
Graff said he was discouraged to learn of the delays and said the child must also have found it disheartening.
"There was no certainty in his placement, no certainty in his relationships and no certainty in his future," Graff said.
"For those children who are in care and live with these uncertainties, we need to do better."
Other provinces have identified and addressed court delays for children in care and Alberta needs to do the same, Graff suggested.
Alberta Justice is reviewing the report and recommendations and will assist with Human Resources to provide a response to the advocate, said spokeswoman Michelle Davio.
"The death of any child is a tragedy ... We will continue to work toward reducing unnecessary delays in accessing justice. The case went to the Fatality Review Board for consideration as per the Fatality Inquiry Act. If a fatality inquiry is held, we would carefully review any recommendations made."
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