Assessment & Research

Attention deficit hyperactivity disorder and autism spectrum disorder symptoms in school-age children born very preterm.

Bröring et al. (2018) · Research in developmental disabilities 2018
★ The Verdict

School-age kids born very preterm show clear ADHD and autism signals that both parents and teachers notice.

✓ Read this if BCBAs doing assessment or consultation in elementary schools or early-intervention follow-up clinics.
✗ Skip if Clinicians who only serve adults or full-term-born clients.

01Research in Context

01

What this study did

Bröring et al. (2018) asked if kids born very preterm show more ADHD and autism traits at school age.

They compared parent and teacher reports from VP-born children to reports from full-term classmates.

02

What they found

The VP group had clearly higher scores for attention, hyperactivity, and social-communication problems.

Both parents and teachers saw the same pattern, so the leap is not just one adult’s view.

03

How this fits with other research

Sanchez-Joya et al. (2017) saw wide cognitive delays in VP preschoolers; Tinka shows those same kids now struggle with ADHD and autism traits in grade school.

de Leeuw et al. (2024) looked at all kids, not just VP, and found each extra neuro diagnosis piles on more behaviour issues. Tinka’s VP group lines up with that trend, giving a clear early-risk source.

Maciver et al. (2023) counted how many Scottish primary pupils have autism or other neuro needs. Tinka explains part of that rise: VP survivors entering mainstream class with hidden ADHD/ASD symptoms.

04

Why it matters

If a client was born before 32 weeks, screen for ADHD and autism even if they look ‘fine’. Use both parent and teacher forms; agreement is high, so you won’t miss the need for extra social, attention, or self-regulation supports.

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Add ADHD and autism rating scales to your intake packet for any client with a VP birth history.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
114
Population
developmental delay
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: Very preterm (VP) children face a broad range of neurodevelopmental sequelae, including behavioral problems. AIM: To investigate prevalence, pervasiveness and co-occurrence of symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in school-age children born very preterm. METHODS: Using questionnaire and diagnostic interview data, parent and teacher reported symptoms of ADHD and ASD of 57 VP-children (mean age = 9.2 years) were compared with 57 gender and age matched full-term children using t-tests. Intra-class correlation coefficients quantified parent-teacher agreement. Correlation analysis investigated co-occurrence of ADHD/ASD symptoms. ADHD/ASD measures were aggregated using principal component analysis. Regression analyses investigated the contribution of perinatal risk factors, sex and SES to ADHD/ASD symptoms. RESULTS: VP-children showed higher levels of parent and teacher reported attention problems, social impairment and compromised communication skills. Fair to strong agreement was found between parent and teacher reported ADHD and ASD symptoms, indicating pervasiveness of observed difficulties. Co-occurrence of ADHD and ASD symptoms in VP-children was found. Lower gestational age was associated with higher ADHD and ASD symptom levels, male sex with higher ADHD symptom levels and lower SES with higher ASD symptom levels. CONCLUSION: School-age VP-children show higher levels of ADHD and ASD symptoms, and attention, socialization and communication difficulties in particular. Routinely screening for these problems is recommended in follow-up care.

Research in developmental disabilities, 2018 · doi:10.1016/j.ridd.2018.01.001