Child development: how to improve educational outcomes of children born preterm

In a guest blog, Dr Joanna Goodman, an independent education consultant and expert panel member for developing T Levels, writes why the new Education and Childcare T Level must signpost to evidence-based educational resources for children born prematurely.

In the UK, in an average sized classroom, two to three children are likely to have been born preterm (before 37 weeks of pregnancy). Whilst the numbers of children born preterm are rising, there has been very little training available to education professionals – teachers, educational psychologists, nursery nurses or teaching assistants– with regard to the potential learning difficulties that these children can encounter in early years settings or schools.

It is, therefore, particularly important that the new ‘gold standard’ T Level qualification in Education and Childcare signposts to the evidence-based educational resources for children born prematurely: PRISM resources. These free resources, aimed at education professionals, not only raise the awareness of the impact of prematurity on learning, but also highlight a range of strategies that can be used to improve the educational experiences of these children, ultimately leading to improving their life chances. 

As part of the panel of experts who worked on developing the curriculum for the Education and Childcare T Level, I am now keen to raise awareness and understanding of the potential needs of these children – to bridge the gap between healthcare and education.  Additionally, learning from my experience developing NICE guidelines for the follow-up of children born preterm and subsequently making a contribution to the development of PRISM resources, I feel that I am well placed to raise awareness among education professionals of the potential risk factors and learning needs of this cohort. Moreover, it is critical that any new quality training for education professionals – for example the T Level Professional Development (TLPD) offer – should include evidence-based information that is relevant to particular workplaces. This is particularly imperative when information applies to 8% of the school population, and when education professionals have received very little training in this area to date.

Research asserts that:

…education professionals receive very little training about the impact of preterm birth on children’s development and learning and have poor knowledge of how to support preterm-born children in the classroom. In a recent national survey, only 16% of teachers had received any training about preterm birth and over 90% expressed the need for training. As teachers have primary responsibility for supporting the learning and development of preterm born children in the long term, this represents a significant public health concern. (Johnson, S. et al., 2019).

To address this gap in knowledge and training, it is crucial that any new training or qualification for professionals working with children in education or early years settings, includes high quality evidence-based resources on how to improve the outcomes of children born preterm. 

For those undertaking training within the TLPD offer, the Education and Childcare courses will signpost practitioners to the PRISM resources, which serve to raise awareness and understanding of the different learning techniques when teaching preterm children.

Furthermore, as “preterm birth places children at an increased risk for a range of developmental problems and disorders later in life” and “this disadvantage persists throughout the lifespan with fewer preterm-born adults having completed high school and undertaken higher education” (Johnson, S. et al., 2019), this issue is not only of concern to professionals working in primary school or early years settings. Clearly, awareness of prematurity and potential learning difficulties is applicable to all educational settings, so appropriate teaching and learning strategies can be used for improved outcomes. 

As an experienced educator and an expert on learning, I cannot emphasise enough how fundamental it is for all staff working with children to have the right level of knowledge with regard to child development, including the impact of birth problems on subsequent cognitive, sensory or physical development. Free access PRISM e-resources provide valuable information for adults working with children on risk factors for child development and expected milestones. Despite significant improvements in neonatal care, to date there is no evidence of improved long-term outcomes for these young people. The experts highlight that:

The continued increase in preterm birth rates for extremely preterm babies [born <27 weeks gestation] means that there are increasing numbers of      preterm survivors entering societies year on year. This results in greater         demands being placed on education systems and their professionals to       identify difficulties and provide support for these children in the long term.(Johnson, S. et al., 2019).

According to evidence, these particular areas may require additional support:

  • difficulties with mathematics
  • inattention
  • working memory difficulties
  • slow processing speed
  • poor hand-eye co-ordination
  • social and emotional problems
  • sensory impairments
  • poor fine and gross motor skills.

However, as these children’s development is different to children born full term, it is important to understand that preterm children have different developmental mechanisms behind their difficulties than term-born children. For example, inattention can be linked to poor working memory or visual impairment, rather than attention-deficit-hyperactivity disorder, as known in term-born children. It is also worth noting that the attainment of these children is often lower by comparison with peers and some may never attain at the same level as their peers born at term.

For these reasons, and to minimise external interventions, it is important for any professionals working with children to engage with these interactive free e-learning resources, which are the only kind of resources available worldwide. An early evaluation of these resources indicates they have “substantially improved teachers’ knowledge of preterm birth and their confidence in supporting preterm children in the classroom.” (Johnson, S. et al., 2019). This is why the access to these resources provides another important dimension to the study of child development as part of T Level training in Education and Childcare, through the TLPD offer.


References

Johnson S. et al. (2015) Developmental Medicine & Child Neurology. Vol. 57, Issue 6

Johnson S. et al. (2019) Improving developmental and educational support for children born preterm: evaluation of en e-learning resource for education professionals. BJM Open 2019; 9.

NICE Guidance: Developmental follow-up of children and young people born preterm, August 2017 nice.org.uk/guidance/ng72

PRISM resources: Premature Infants’ Skills in Mathematics, University of Nottingham: http://www.pretermbirth.info


The PRISM resources are signposted within the T Level Professional Development offer, please see the following courses within the Role and Route Specific Training:

  • Introducing the Education and Childcare Route
  • Teaching and Learning on the Education and Childcare T Level

Dr Joanna Goodman, EdD, FCIEA is an independent education consultant. Her experience includes senior school leadership, inspecting education providers, teacher training, school improvement, curriculum and assessment development, leadership development and academic research.  She is published in educational and clinical journals. Joanna is an expert panel member for developing T Levels, ETF Associate and an Ambassador for T Levels.

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