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Subclinical but significant: A multi-informant comparative study on early socio-emotional difficulties in preterm

Rowena Van den Broeck1, Lisa Gistelinck2, Bieke Bollen3,4

  • 1Center for Developmental Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium. rowena.vandenbroeck@kuleuven.be.

Child and Adolescent Psychiatry and Mental Health
|April 16, 2026
PubMed

Insights

Preterm preschoolers show subtle socio-emotional challenges, with parent and teacher views differing. Early NICU pain predicts later problems, while kangaroo care may help social development.

Area of Science:

  • Developmental Psychology
  • Neonatal Medicine
  • Child Psychiatry

Background:

  • Children born preterm are at higher risk for neurodevelopmental issues, known as the "preterm behavioral phenotype".
  • Understanding behavioral and socio-emotional development in preterm preschoolers is crucial for early intervention.

Purpose of the Study:

  • To examine behavioral and socio-emotional development in preterm preschoolers.
  • To characterize behavioral profiles and mental health outcomes.
  • To explore associations with gestational age, birth weight, and early medical experiences.

Main Methods:

  • Assessed 102 five-year-olds (70 preterm, 32 full-term) using parent/teacher questionnaires and clinical observation.
  • Utilized measures like the Child Behavior Checklist, Teacher Report Form, and Autism Diagnostic Observation Schedule-2.
  • Analyzed associations with gestational age, birth weight, and neonatal intensive care unit (NICU) parameters.

Main Results:

  • Preterm children exhibited a subclinical phenotype with elevated difficulties across domains.
  • Parents reported more internalizing symptoms and social-communication issues; teachers noted stronger links to medical factors.
  • Early NICU procedural pain correlated with higher behavioral problems; kangaroo care associated with fewer social difficulties.

Conclusions:

  • Preterm preschoolers have subtle socio-emotional vulnerabilities requiring ongoing surveillance.
  • Multi-informant assessment is vital due to divergent parent and teacher perspectives.
  • Minimizing early procedural pain in the NICU is a modifiable factor for improving later socio-emotional outcomes.
Abstract

Keywords:
Multi-informant assessmentPrematurityPreschoolPreterm behavioral phenotypeSocio-emotional development

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