The Predictive Power of Early Socio-Emotional Skills on Behavioral Outcomes in Very Preterm Preschoolers: A Longitudinal Study

Background: Preterm birth increases the risk of socio-emotional difficulties and later behavioural problems. Early identification is essential, but the predictive value of socio-emotional assessments at different ages remains uncertain. Aim: To examine whether socio-emotional skills at 1, 2, and 3 years predict behavioural outcomes at 4 years in very preterm children. Methods: Fifty-seven preterm children were assessed longitudinally with the Bayley-III Socio-Emotional scale at 1, 2, and 3 years, and with the CBCL 1.5–5 at 4 years. Analyses included correlations, repeated-measures ANOVA, and regression models. Results: Socio-emotional scores were within normative ranges at all ages, with improvement by age 3. Strong associations emerged between socio-emotional skills at 1 year and later behavioural outcomes, particularly internalizing and total problems. These associations weakened by 2 years and disappeared by 3 years. Regression confirmed that only the 1-year assessment predicted later difficulties. Conclusion: Socio-emotional competencies in the first year of life are robust predictors of later behavioural adjustment in preterm children. This highlights the first year as a sensitive window for screening and preventive intervention. Incorporating socio-emotional assessments into routine neonatal follow-up may enable earlier identification of at-risk children and foster resilience through timely, targeted support.