An Historic Look at Preemie Personality and the Impacts of Premature Birth on Children

A Revealing description of the preemie personality as defined by Dr. Mary Shirley in 1939.

By Helen Harrison

These observations come from Dr. Mary Shirley of the Harvard Center for Child Health and Development and were published in 1939 in Child Development. The preemies weighed below 5 pounds and were less than 8 1/2 months gestation. They were examined between the ages of 6 months and 30 months.

Here were some of the results: "Sensory acuity: In auditory sensitivity the premature child either is more keenly aware of sounds or more interested in their meaning that the term child. Prematures are highly distracted by footfalls or voices in the corridor, by traffic noises, and by the sound of other babies crying...Older preemies often manifest the 'hark' response -- suddenly stopping in their play and whispering in a startled voice 'What's that?' at the hiss of a radiator, a cricket chirp, or a fire siren blocks away. On the visual sensory side the premature babies were more fascinated and distracted by a yellow pencil than by any of the mental test objects..."

"Lingual-motor control: ...difficulties in achieving correct pronunciation...may persist in baby talk...The difficulties of the little Dionne girls in learning to talk intelligible French are probably only slightly greater than those of many prematurely-born children."

"Manual motor control: [delays in] use of index finger for pointing and for pincer grasp. Prehension is often carried out with all four digits opposing the thumb, rather than merely with thumb and index finger, which is more commonly used by fullterm babies...Often after prolonged effort to reach they exhibit tremor. Their play with toys is executed with choppy, slap-dash movements. They over-reach, spill, scatter; [and]...have a passion for throwing toys to the floor or brushing them aside with petulant gestures...Sometimes prematures work at such a task exerting the utmost effort to make the precise coordinations, until their reserve of patience and nervous control is at an end and they 'go all to pieces.' "

"Postural and locomotor control develop later in premature than in term children and once the premature achieves ambulation, he is usually less graceful and less smoothly flowing in his motor responses than the term child. Our older prematures are more often described as awkward, clumsy, as having a lunging gait or as having poor posture than our term children."

"Activity: In amount of activity premature children seem to go to two extremes. On the one hand [they] are tense, jumpy, hyperactive little creatures that seem to be mounted on springs; and on the other [they] are floppy, soggy, lazy babies and sluggish, clumsy children, slow and deliberate in their motions.

"Emotionality: ...irascible, petulant, and more often shy and negativistic than the term child. Prematures are upset by slighter stimuli; they are capable of standing just so much, then they explode in a tantrum or a panic.

"Attention: The attention span of the premature is very short; he flits from toy to toy in the playroom; and at the test situation he is extremely susceptible to distraction. It is often difficult to get him to stick to a difficult task and to see it through, particularly if it is possible for him to appeal for adult help in finishing it. Conversely -- and this seems a contradiction -- the premature sometimes works to the point of nervous exhaustion on a difficult motor task. He continues working at a high level of interest and coordination until he collapses in rage from fatigue and frustration."

Other observations: "questions asked during a 30-minute period in the playroom was consistently higher for premature boys than for controls"... "[many] prematures were predominantly left-handed" ..."Premature boys displayed more temper than girls, whereas the girls displayed more stubbornness, passive resistance, and negativism. Prematures were also more fearful of persons and animals than their [term] siblings, but the siblings showed more fear reactions of other types."

"Much of the behavior of prematures is understandable if we assume that he is more sensory than motor. There is good evidence that his sensory development is in advance of his motor control, age for age. The premature is highly receptive to stimulation, particularly to auditory stimulation; but he is less capable than the term child of making an adequate motor adjustment to the stimulus...The frustration that comes from inability to manipulate materials may well become a source of irascibility that is expressed in petulancy and in the tendency to throw or scatter toys. Such a condition might well lead to habits of inattention, flitting interest in toys and subsequently to versatility of interests and development of many hobbies -- a trait that seems to characterize adult prematures. The prematures' stubborn refusals, withdrawals from proffered toys, and their tendency to give up on a task before its completion may be a way of reducing the amount of stimulation they receive. Superior sensory ability...might also lead to certain types of aesthetic appreciation that seem to crop out often among prematures. Indeed, the word 'sensitive' as used by the layman begins to take on a literal meaning when applied to the premature."

A Behavior Syndrome Characterizing the Prematurely-Born Child

Here are some more excerpts from "A Behavior Syndrome Characterizing the Prematurely-Born Child" by Mary Shirley (a doctor at Harvard) published in Child Development. Vol. 10, no. 2, June 1939:

"In auditory sensitivity, the premature child either is more keenly aware of sounds or more interested in their meaning than the term child.  Prematures are highly distracted by footfalls or voices in the corridor, by traffic noises, and by the sound of other babies crying ... Older premature children often manifest the 'hark' response, --suddenly stopping in their play and whispering in a startled voice 'What's that?' at the hiss of a radiator, a cricket chirp, or a fire siren blocks away...prematures have difficulty achieving correct pronunciation.  They persist longer in baby-talk...The difficulties of the little Dionne girls [the Dionne quintuplets] in learning to talk intelligible French probably are only slightly greater than those of many prematurely-born children....Prehension often is carried out with all four digits opposing the thumb rather than merely with thumb and index finger...often after prolonged efforts at reaching they exhibit tremor.  Their play is executed with choppy, slap-dash movements.  They over-reach, spill, scatter; and prematures of 12 and 18 months have a passion for throwing toys to the floor or brushing them aside with petulant gestures...Sometimes prematures work at such a task [as filling in a pegboard] exerting the utmost effort to make precise coordinations, until their reserve of patience and nervous control is at an end and they 'go all to pieces'...Once the premature achieves ambulation, he usually is less graceful and less smoothly-flowing in his motor response than the term child.  Our older prematures are often described as awkward, clumsy, as having a lunging gait, or as having poor posture than our term children...In amount of activity, premature children seem to go to two extremes.  On the one hand they are tense, jumpy, hyperactive little creatures that seem to be mounted on springs; on the other... they are sluggish and clumsy children, slow and deliberate in their efforts...Achievement of bowel and bladder control is slower and more difficult ... Emotionally the premature child is more irascible, petulant, and more often shy and negativistic than the term child.  Prematures are upset by slighter stimuli; they are capable of standing just so much, then they explode in a tantrum or a panic ... The attention span of the premature is very short; he flits from toy to toy in the playroom; and..is extremely susceptible to distractions.  It is often difficult to get him to stick to a difficult task and to see it through ... Conversely -- and this seems a contradiction -- the premature sometimes works to the point of nervous exhaustion until he collapses in a rage from fatigue and frustration.... The median number of questions asked during a 30 minute period was consistently higher for premature boys than for controls..."

This was all written in 1939!


Helen Harrison was the well known author of The Premature Baby Book, for many years referred to as the "Bible of Prematurity" by older preemie parents. These observations are excerpted with permission from posts to the Preemie-child support group.