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Updated: May 16, 2026

Multimedia Battery for Assessment of Cognitive and Basic Skills in Mathematics (BM-PROMA)
Published on: August 28, 2021
Mathematics difficulties in extremely preterm children: evidence of a specific deficit in basic mathematics
Victoria Simms1, Camilla Gilmore, Lucy Cragg
1Department of Health Sciences, University of Leicester, Leicester, UK.
Insights
Extremely preterm children show math difficulties due to weaker numerical representations, unlike term-born peers. Interventions should focus on improving number sense to boost mathematical skills in these children.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Extremely preterm (EP) children (<26 weeks gestation) exhibit lower academic achievement than term-born peers, particularly in mathematics.
- This study explores the underlying reasons for mathematical difficulties in EP children.
Purpose of the Study:
- To investigate the relationship between numerical representations and mathematical achievement in extremely preterm children.
- To compare these relationships with those in term-born children.
Main Methods:
- Compared 219 EP children with 153 term-born controls at 11 years of age.
- Administered standardized cognitive tests and a number estimation test to assess numerical representations.
- Analyzed the correlation between number representation performance and mathematical achievement, controlling for cognitive ability.
Main Results:
- EP children scored lower on all cognitive and numerical tests compared to term controls (P < 0.001).
- A significant association between number representations and mathematical performance was found in EP children (r = 0.346, P < 0.001) but not in controls (r = 0.095, P = 0.256), even after controlling for cognitive ability.
Conclusions:
- Deficits in numerical representations may underlie mathematical difficulties in extremely preterm children.
- Interventions aimed at improving numerical representations could potentially enhance mathematical skills in this population.
Background:
Extremely preterm (EP, <26 wk gestation) children have been observed to have poor academic achievement in comparison to their term-born peers, especially in mathematics. This study investigated potential underlying causes of this difficulty.
Methods:
A total of 219 EP participants were compared with 153 term-born control children at 11 y of age. All children were assessed by a psychologist on a battery of standardized cognitive tests and a number estimation test assessing children's numerical representations.
Results:
EP children underperformed in all tests in comparison with the term controls (the majority of Ps < 0.001). Different underlying relationships between performance on the number estimation test and mathematical achievement were found in EP as compared with control children. That is, even after controlling for cognitive ability, a relationship between number representations and mathematical performance persisted for EP children only (EP: r = 0.346, n = 186, P < 0.001; control: r = 0.095, n = 146, P = 0.256).
Conclusion:
Interventions for EP children may target improving children's numerical representations in order to subsequently remediate their mathematical skills.
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