Preterm children’s long-term academic performance after adaptive computerised training

Altered brain development and academic underachievement are potential consequences of preterm birth. A recent study from Germany now showed that adaptive computerised training can increase short-term academic growth in preterm children.


Low attention, working memory and mathematic scores can be the result of preterm birth, making preterm children more vulnerable to reduced academic performance. While research has shown that an adaptive working memory training (Cogmed) has no long-term benefits on school performance for preterm school-aged children, this study tested the long-term effects of a math training (XtraMath).

65 preterm children, who were born before 37 weeks of gestation, and who started elementary school in August 2015, were included in the study. They were recruited from birth registries of seven neonatal intensive care units in North-Rhine Westphalia, Germany. The participants were randomly assigned to the intervention or the control group. The intervention group tested the XtraMath training according to the program’s standard protocol for five weeks and the other group (control group) the Cogmed training. Teacher ratings and standardised tests, administered by psychologists before, directly after, and 12 months after the training, were carried out to determine children’s academic performance.

Perinatal variables, e.g. information on sex, gestational age, birth weight and brain injury, as well as social variables, e.g. parental education, were assessed before the intervention and included in the analysis. 60 children and 59 parents answered questions on their experiences with the online program after the training. This was done to examine how feasible and accepted computerised interventions at school age for preterm children and their parents are.


The results show that total academic growth according to teacher evaluation and standardised math tests was significantly higher for children in the XtraMath group directly after the training, as compared to the control group (Cogmed). However, these effects could not be observed 12 months after the intervention. Moreover, the researchers did not find a relevant difference in math test scores between the two groups. Nevertheless, children in the math training group seemed to achieve stable performance in contrast to the control group. The acceptance of both trainings was high, while feasibility was rated higher in the XtraMath group.

A limitation of the study is the small number of participants. Out of 532 parents of preterm children who fulfilled the participation criteria, only 88 were interested to take part.

Overall, computerised math training can increase short-term academic growth for preterm children and may complement classroom teaching. Further research should be done to gain more knowledge on preterm children’s specific educational needs and on how to optimally meet these needs in the classroom and at home.


Paper available to view at: Nature

Full list of authors: Julia Jaekel, Katharina M. Heuser, Antonia Zapf, Claudia Roll, Francisco Brevis Nuñez, Peter Bartmann, Dieter Wolke, Ursula Felderhoff-Mueser & Britta Huening

DOI: 10.1038/s41390-020-01114-w