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Development of Emotional and Behavioral Regulation in Children Born Extremely Preterm and Very Preterm: Biological and Social Influences


  • This research was funded by grants from the Neurological Foundation of New Zealand, Lottery Grants Board, Canterbury Medical Research Foundation, and the Health Research Council of New Zealand. Special thanks to Associate Professor Terrie Inder (pediatric neurologist) and Dr. Scott Wells (radiologist) for MR imaging analysis, others in the research team (Dr. Patricia Champion, Dr. Nicola Austin, Jacqueline Knight, Kelly Hood, Michelle VanDyk, Michelle Davey. and Carole Spencer), and most importantly to the study families for their willingness to share their children’s lives with us.

concerning this article should be addressed to Caron A. C. Clark, Canterbury Child Development Research Group, Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, New Zealand. Electronic mail may be sent to


This study describes the development of emotional and behavioral regulation in a regional cohort of children born extremely preterm (<28 weeks gestational age, n = 39), very preterm (<34 weeks gestational age, n = 56), and full term (n = 103). At 2 and 4 years, children born at younger gestational ages demonstrated poorer self-regulation across multiple contexts spanning observed interactions, formal cognitive testing, and parental report of child behavior at home. Among children born preterm, the 2 strongest predictors of impairments in self-regulation were the presence of moderate-to-severe cerebral white matter abnormalities on neonatal magnetic resonance and a less sensitive parenting style when children were aged 2 years. Findings support the importance of early neurological development and parenting for developing regulation in children born very preterm.