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From NICU to school
This page has been provided for parents, carers and education professionals who want to know more about how children develop and learn.
This page is intended to support children who had problems in the neonatal period, who are now attending school and need help with learning. It is not for children with severe cerebral palsy or epilepsy. It will cover common neonatal health conditions that may affect development, such as prematurity, hypoxic-ischaemic encephalopathy (HIE), perinatal stroke, neonatal hypoglycaemia, and meningitis.
Find a NICU Babies in School Brochure, with patient stories, and up-to-date research evidence in accessible language.
Explore the topics on this page:
Matthew's story
“Matthew was born at 25 weeks and 6 days of gestation. He required neonatal intensive care for three months. His medical health has always been fine, and he did not have any physical problems identified subsequently.
He is now 10 years old. On the surface, he looks the picture of health. His expected date of delivery was in November, but his birthday is in August. This means that he has always been the youngest in the class. He is currently in year 6 at primary school.
In preschool, it was noticed that he was a little behind the others of his age group, but there was nothing specific that could be identified to get him any extra help. When he started school, it became more noticeable. He was the smallest in the class, and he started to suffer from terrible shyness and anxiety. He was not able to retain information, and everything needed to be repeated several times before he could understand it or remember it. His fine motor skills were slower, affecting his pencil skills and self-help skills. Everyone put it down to him being ‘smaller’ and that he would catch up.
School has always been a struggle for both Matthew and us as a family. I really wish that the needs of children who were born prematurely were recognised by professionals. We hope that this booklet will help parents and educational professionals recognise these problems and address them as early as possible.”
Development and learning of children who were born preterm or had medical difficulties around the time of birth.
Different health conditions—like prematurity, hypoxic-ischaemic encephalopathy (HIE), perinatal stroke, neonatal hypoglycaemia, and meningitis—are very different from each other. However, children who had these conditions as newborns can sometimes show similar difficulties at school. This is because a baby’s brain develops rapidly during the last part of pregnancy and the first two years of life, so problems during this time can affect development in similar ways.
During pregnancy and the first two years, the brain is very sensitive. A baby's overall health and any medical complications they have can affect the way the brain cells grow, connect and communicate with each other. There is a link between health conditions in the neonatal period (the first 28 days of a newborn's life) and development in childhood.
The brain's complex network of connections is essential for planning complex tasks, organising activities and social and emotional development. At the same time, during this stage of development, the brain is also highly adaptable. It can compensate for many early health difficulties when a child is provided with a supportive, low-stress environment and a wide range of learning experiences.
After the first few years, most parents’ early worries about their baby’s health settle and their attention shifts to their child’s schooling. Even if the early development, like walking and talking, happens at the expected time, sometimes children can show difficulties when they grow older, and their brain is required to do more complex tasks like reading, writing, concentrating for long periods of time, understanding social cues and developing friendships.
A child may have extra learning needs, which may not be immediately obvious or visible. These may be hard to identify, especially if a child has a variety of subtle difficulties. Sometimes, periods of transition (moving from nursery school to primary school, or from primary school to secondary education) will make difficulties more noticeable.
Noticing differences
Parents may feel frustrated if their child's differences are not recognised by friends, family or professionals. They may also notice that their child behaves differently in different settings, like at school and nursery, compared to at home.
Some children may no longer be receiving support from health services, whilst other children might still be under follow-up. In many cases, education staff are well placed to notice developmental differences and might be able to offer support more quickly and effectively, especially if health services are no longer involved.
Every child is an individual, and all children have their personal set of learning strengths and needs, regardless of their early journey in life. At the same time, research has found that there are similarities in the difficulties children experience if they were born prematurely or had difficulties around the time of birth.
We hope that this page and the NICU Babies in School Brochure can give you a greater understanding of why developmental differences can happen, and what can be done to support children who experienced health complications around the time of birth in the weeks after birth.
Common concerns
At home, you might notice your child has some differences or delays with:
Often, it is the school or nursery that first notices difficulties. Recognising those difficulties early allows teachers to plan and prepare for further support, and to help a child learn how to use their strengths to compensate for their needs. They might notice some delays or differences in:
Specific conditions
For more information on specific conditions like hypoxic-ischaemic encephalopathy (HIE), meningitis, hypoglycemia, and perinatal stroke, please refer to the full NICU Babies in School Brochure.
Last reviewed: 12 June, 2026
