5. Case study

My daughter Becky is 12 years old. She was born at 23 weeks’ gestation.

She is a happy, well-behaved, caring, active and healthy girl, who lives a good life. However, her extreme prematurity has left her with a wide range of issues.

Educationally, Becky has always struggled. She finds it extremely difficult to focus on one thing at a time, for any length of time. Even playing simple games, she loses focus easily. In the classroom, this means that distractions have to be kept to a minimum – loud noises, children being active and different discussions can all distract her easily. This lack of attention inevitably makes learning and social interaction difficult and she finds the general busyness of school difficult to deal with.

Becky also suffers with anxiety, which she internalises, and she has extremely low self-esteem. She is constantly asking what are we doing today, tomorrow and then the next day. Even now, I try to remind her to live for the moment!! This fixation with routine and time, eventually resulted in an Autism referral when she was 9. Whilst they found that she was not on the autism spectrum, they concluded that much of her behaviour was due to anxiety, brought on by social and learning difficulties, which were a direct result of her prematurity.

The majority of school staff were surprised to learn about her anxieties and worries. To them, she presented as a happy girl, willing to please and with excellent behaviour in school. However, this willingness to please often means that she subsumes her own wants and needs in her desire to form friendships and, whilst it might appear that Becky has friends, these are rarely reciprocal relationships. This concerns me greatly as a parent as I can see that this pattern of behaviour may well persist into adulthood and she will be very vulnerable.

Now, at age 12, Becky is unable to follow the sophisticated social interactions that girls of this age have. This issue of being excluded from social groups has persisted even from first year of primary school. She has rarely been invited on playdates or to parties. Only occasionally, has she shown her true feelings. One time she was particularly upset, she cried “Why does no-one invite me round to their house?” How can I answer that? She’s lovely. She has a great sense of humour and is very kind. I just want her to have a friend who treats her with respect and loves her for being her.