Making Friends & Sustaining Friendships



Social development of children born very pretern: a systematic review 
Kirsten Ritchie, Samudragupta Bora, Lianne J Woodward.

Children born very preterm are at increased risk of social competence difficulties throughout childhood and adolescence. Several developmental trends were also evident including social adjustment difficulties, evidence of poorer interpersonal behaviour and suggestions that social-cognitive processing may be spared in children born very preterm, at least during early childhood.

Parents, teachers, or service providers, such as psychologists, can positively influence an at risk child's social competence by guiding the child, and giving advice and feedback, by providing opportunities for social interaction and prompting appropriate behaviours. By teaching children about their emotions, they can understand and cope with them as well as interpret how peers may be feeling.


The ability to make a friend and sustain that friendship can be difficult for some children during the ages of 6 to 12 years. The art of making friends is usually subtle and learned by watching other children and with careful guidance of the primary care givers, teachers, and interacting with older siblings. But as children born premature or sick mature, they may find that it is not a skill that comes as easy as other children. The desire is there to connect and have a buddy to play with but they may lack the skills for peer Interactions. For example, some children born premature have trouble with attention and inattentiveness plays a part in hindering a conversation because they could get lost in two-ways. Firstly, by missing parts of the conversation and also mis-interpreting the conversation. There is also a level of cooperation that is needed in conversations, it’s that ability to talk and then allow the other person to have their say without interrupting, body language and reading facial cues, and the ability to have emotional regulation. Also, academic performance can also play a part as well. If school performance is poor this could impact the confidence needed to make and sustain a friendship.

Next, it is important that social‐development goals be met consistently, this helps make successful friendships. Being able to understand and develop several friendships at the same time requires a lot of social ability. Also, to have the resilience to bounce back from disagreements or be flexible in friendship circles. The group that needs some closer monitoring are the very preterm babies and extremely low birth weight babies that are now school age. But this can be supported and these kids can learn the skills if there is some attention given to this area of a child’s development.

Some children who are in primary school that were born premature might need help in these areas:

  • Staying focused in a conversation.
  • Playing with other kids and letting others enjoy themselves.
  • Talking to others and letting that two way communication happen that meets the needs and feelings of other children.
  • The child may want to interact and know what they can do to join their peers but their timing may not be off, not reading the tone of the conversation or situation correctly.


We encourage you to speak with your family GP or school counsellor about your concerns and they can help refer you and your child for further support.

Some questions to ask:

  • What can I do at home to help the home atmosphere to be a safe positive place to express the worries and stresses of the day?
  • Do I still plan social activities so that my child can interact with peers?
  • What does advocacy for preschool and school environments do to help with social skill development and what does this look like?
  • Can I help make a social skills plan and make sure it can be implemented into the school day each day?
  • Seeking out additional professional help when necessary. People that can help are Psychologists and some Speech Therapy can help train children in developing their ability to understand social cues they may be missing. But not all speech therapists do this, you will need to do some research for the right people that specialise in social skills.
  • Sports and other team events can help.
  • Ask yourself, “when does my child appear most successful socially, and why?”
  • When is it the hardest for my child to socialise?

Points to remember when supporting and helping your child:

  • Try not to judge yourself and your parenting style but look at it as evolving into helping your child in a new way to have and keep friendships. Everyone needs help at different times.
  • Reflect on your self-talk to be more accepting to changing approaches to problems. All parents styles change to the needs of their child’s situation and evolving skills.
  • Meditations and affirmations are good ways to help yourself and why not try this with your child too. “I like myself and so will others” ;“I choose friends that make me feel happy, liked and safe.”

International Friendship Day: July 30th  is a day to promote friendship in positive ways.

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Need support? NurtureConnect allows you to connect with our NurtureProgram support team, or call our 24 hour NurtureLine 1300 622 243 or join our Facebook community.


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Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances.To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].