Preterm birth & Attention Difficulties

Preterm babies are more likely than babies born at term to have a range of attention difficulties that can affect learning and achievement at school.

Attention difficulties are some of the most common concerns expressed by parents and teachers of children and adolescents who were born very preterm. Very preterm means babies born before 32 weeks gestational age.

Attention Difficulties

Common attention problems in preterm children

  • easily distracted and fidgety
  • problems concentrating at school
  • maintaining attention during lengthy activities
  • attending when performing multiple activities at a time

preterm birth is associated with attention difficulties and ADHS

Attention, ADHD and Preterm Birth

According to the Diagnostic Manual of Mental Disorders IV (DSM IV), inattentive and hyperactivity behaviors should be present in multiple contexts (e.g., home, school) and should have been present for at least 6 months and only then a diagnoses should be considered. Importantly, parents should note that ADHD should only be diagnosed by a qualified professional (e.g., clinical psychologist) and NOT the child’s teacher, GP, or child health nurse, for example. A diagnoses is usually not provided before a thorough case assessment including interviews with the child, the parent, and the teacher, and an evaluation of the child’s medical history is conducted. Labelling a child as having ADHD without a formal examination by a qualified professional is counterproductive. This is important to note since not all very preterm children with attention difficulties have ADHD. However, this does not mean that the child is not affected by these attention problems. In some cases, these difficulties could still be disrupting the preterm child’s day-to-day living.

Subtle attention difficulties may also be confused with disobedience, laziness, or lack of interest from the preterm child, therefore parents need to remember that children with attention difficulties usually apply themselves more than a child with no attention problems, as it may take them double the effort and time to complete a set activity. For example, at school it may affect the ability to attend to instructions given by the teacher whilst trying to filter out noise made by classmates, to concentrate in examinations, or to flexibly move from one activity to the next. These may affect the ability of a preterm child to acquire new knowledge and develop the necessary skills to cope well at school. Attentional problems may be equally disruptive at home. There are many strategies that the preterm child, their parent, and their teacher could implement to ameliorate attentional difficulties.

Learn about Strategies to help preterm children with attention difficulties

Consulting experts for your preterm child

Because very preterm children are vulnerable to having problems with various thinking skills (e.g., memory, time processing information, planning, language) it is important that parents consult a clinical neuropsychologist that can pinpoint the exact areas that a particular child is having difficulties with and provide suitable strategies to deal with those. It may also be possible that the “root” of their problems is not attentional, therefore consulting an expert is an important step to understanding the nature of your preterm child’s problems.

  • Written by Dr Michelle Wilson-Ching Ph.D
    Dr Wilson-Ching is an expert in attention and preterm children. She completed her dissertation in 2010 and now works as a Postdoctoral Research Fellow at Australia's Murdoch Children's Research Institute.


Technical Reference List

Allen, M. C. (2002). Preterm outcomes research: a critical component of neonatal intensive care. Ment Retard Dev Disabil Res Rev, 8(4), 221-233.
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington: American Psychiatric Association.
Aylward, G. P. (2005). Neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr, 26(6), 427-440.
Bhutta, A. T., Cleves, M. A., Casey, P. H., Cradock, M. M., & Anand, K. J. S. (2002). Cognitive and behavioural outcomes of school-aged children who were born preterm. JAMA, 288(6), 728-737.



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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 

Read More: Defining Preterm birth



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