Behavioural, social and emotional outcomes following preterm birth

9. Resources

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Attention-Deficit/Hyperactivity Disorder

A behavioural disorder characterised by a persistent pattern of inattention and/or hyperactive or impulsive behaviours that interferes with development or everyday function. This disorder is commonly known as ADHD.

Autism Spectrum Disorders

A range of conditions characterised by difficulties with social interaction and communication as well as restricted or repetitive behaviours and interests. Autism Spectrum Disorders differ from person to person in their severity and combination of symptoms.

Externalising problems

The group of emotional problems in which individuals direct their feelings and emotions outwardly, towards others. This can include being uncooperative with others and displaying defiant, aggressive and disruptive behaviours.


A tendency to be overactive. Children and young people with hyperactivity may move about constantly, including in situations in which it is not appropriate; or excessively fidget, tap, or talk. Hyperactivity may present as extreme restlessness or wearing others out with constant activity.


A tendency to act suddenly and without thinking. Individuals with impulsivity may frequently make hasty actions that occur in the moment without first thinking about them or have a desire for immediate rewards or inability to delay gratification.


A lack of attention. Individuals with inattention may frequently wander off task, lack persistence, have difficulty staying mentally focused, and be disorganised.

Internalising problems

A group of emotional problems in which individuals direct their feelings and emotions inwards, towards themselves. This can include being withdraw, shy and awkward; clingy in new situations; nervous, anxious, worried or fearful; feeling sad, lonely or depressed.

Learning outcomes

By completing this resource you will be able to:

  • To understand that children born preterm may be withdrawn, anxious, and inattentive, and have difficulties developing relationships with their peers
  • To understand that children born preterm don’t tend to be disruptive so their needs may be overlooked in the classroom

This resource was developed by:

We would like to thank the following people who all helped in the development of this resource:

Content authors: Samantha Johnson, Sarah Clayton, Lucy Cragg, Camilla Gilmore, Rose Griffiths, Neil Marlow, Victoria Simms.

Technical developers: Heather Wharrad, Mike Taylor, Aaron Fecowycz, Lydia Jones and Andrew Lee.

Contributors: Gillian Doyle.

Content reviewers: Professor Dieter Wolke, Professor of Developmental Psychology and Individual Differences, University of Warwick; Alison Brown, Teacher; Olivia Smith, Teacher.

Acknowledgements: With thanks to the participants of the PRISM-2 Study Stakeholder Workshop for their role in co-designing this resource.

Funding: The development of this resource was funded by Action Medical Research

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Brogan, E., Cragg, L., Gilmore, C., Marlow, N., Simms, V., & Johnson, S. (2014). Inattention in very preterm children: implications for screening and detection. Archives of disease in childhood, 99(9), 834-839. doi: 10.1136/archdischild-2013-305532

Johnson, S., & Marlow, N. (2016). Early and long-term outcome of infants born extremely preterm. Archives of disease in childhood, 102, 97-102. doi: 10.1136/archdischild-2015-309581

Johnson, S., & Wolke, D. (2013). Behavioural outcomes and psychopathology during adolescence. Early human development, 89(4), 199-207. doi: 10.1016/j.earlhumdev.2013.01.014

Wolke, D., Baumann, N., Strauss, V., Johnson, S., & Marlow, N. (2015). Bullying of preterm children and emotional problems at school age: cross-culturally invariant effects. The Journal of pediatrics, 166(6), 1417-1422. doi: 10.1016/j.jpeds.2015.02.055