Analysis: many preterm born children may not receive additional support in school as some of their difficulties may not be picked up

By Victora Simms, Ulster University

Every year around the world about 15 million babies are born preterm. Children born very preterm (before 32 weeks of gestation) are at a higher risk for poorer thinking skills and educational attainment than their term-born classmates (children born at 37 weeks gestation or after). It is very important to highlight that not all children born preterm will struggle in school, but many do. We need to understand what difficulties may be faced by children born preterm and also understand why these difficulties happen so that we can support them in school.

Preterm born children have problems with thinking skills, such as attention (being able to focus on important content), working memory (holding information in their mind and working with it) and visual-spatial skills (being to identify important information in a picture and line up or move this information). In addition, very preterm born children poorer attainment in all subjects, but especially in maths. Poor mathematical attainment is a concern as research shows that this can lead to poorer future attainment and job opportunities.

From RTÉ Radio 1's Today with Sarah McInerney, Professor Roy Philip on a new study which shows a fall in preterm births

But why do very preterm born children struggle with mathematics? Our research confirms that children born very preterm have significant problems with mathematics when they are 8-10 years-old.  When we looked carefully at these children, their difficulty with mathematics was because they had poor working memory and visual-spatial skills (very important thinking skills for doing mathematics) and not because they had specific problems with basic number content or concepts. 

Children born very preterm have heightened rates of special educational needs compared to term-born children. However, many preterm born children may not receive additional support as some of their difficulties may not be picked up. For example, as a group, preterm children have poor attention but are not hyperactive. The profile for Attention Deficit Hyperactivity Disorder (ADHD) includes poor attention and high levels of hyperactivity so preterm children do not fit the typical profile for ADHD. These children may struggle with learning due to their poor attention and social-emotional skills, but may not get additional support.

From Ulster University, Victoria Simms on how children's thinking changes over the years, in particular how they understand maths.

What can we do to support preterm children in the classroom? A study carried out in England in 2015 with a large group of teachers and educational psychologists found out that only 15% of teachers and 40% of educational psychologists said they had received any training about the issues that preterm children may face in the classroom. Some 85% of teachers and 88% of educational psychologists wanted to find out more about how they could support learning for preterm children.

With funding from UK charity Action Medical Research, and using lots of research on the long-term impact of premature birth, our research team worked with teachers, parents, educational psychologists and young people who were born very preterm to create an online training resource. This resource is free to access and covers key evidence on what preterm birth is, socio-emotional, cognitive and educational outcomes associated with preterm birth and strategies or approaches that teachers may use to attempt to promote learning. 

From RTÉ Radio 1's Morning Ireland, Louise Byrne reports on World Prematurity Day's aim to highlight the challenges of preterm birth

Our team carried out a study with teachers who used these resources and the overall responses to the resource were very positive. We saw that teachers showed large gains in knowledge of the long-term impact of very preterm birth and also their confidence in teaching children who were born very preterm. Teachers and support workers enjoyed using the resource and found it very accessible.

When we followed up after 6 months, the teachers reported that they felt confident about teaching children who were born preterm and had made changes in the way they taught. We have received really positive responses from parents who have passed the resource onto their children’s teachers and from teachers who actively use the resource in their schools.

Our research team aims to improve outcomes for children born preterm. We believe that by carrying out basic scientific research to understand learning difficulties in preterm children and then making accessible and engaging evidence-based training resources, we can help parents and teachers support children’s learning.

Dr Victora Simms is Research Director at the School of Psychology at Ulster University

The views expressed here are those of the author and do not represent or reflect the views of RTÉ