Social Challenges



Social development of children born very preterm: 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.


Being born too early or too small does not mean your child will have problems with socializing or making friends but it is helpful to know that this could be something to keep in mind when your child starts school and during the ages of 6 – 12 years. There are a lot of different factors that make up the temperament of your child but children that are born very preterm are at increased risk. Social adjustment difficulties in children born very preterm showing up early and can persist into adolescence. These difficulties tend to be in socializing. What you would notice is withdrawal in their peer relationship but not as aggressive naughty behaviour. Boys tend to show this problem more than girls and it could be because they tend to have communication problems more than girls do.

The development of good social skills is left to the keen eye of the parents and teachers that have an understanding of the challenges of the premature baby who is now a school age child.  

Signs of Interpersonal Communication problems are as follows:

  • They have problems making and keeping close friends.
  • They are bullied or being bullies. Too intense or too passive.
  • They can be too overbearing or too passive.
  • They misunderstand conversations frequently and make inappropriate comments. They miss facial cues needed to understand the conversation and follow it.
  • They find it difficult to understand sarcasm.
  • They interrupt conversations frequently and inappropriately.


Take time to give yourself permission to accept that there might be a problem but also knowing that this can be helped. This is a problem but also an opportunity to grow. Making sure that your own self talk is supportive and kind to yourself. As a parent of a premature or sick baby you have weathered through a number of issues and your ability to bounce back could be your strong point by now and with little eyes watching you become a role model to how they bounce back from difficulties.

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 worry’s 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 kids to developing their ability to understand social cue’s 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 socialize?

Useful links

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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].