The research, published in BMC Pediatrics by Sıla Uzkul of Bitlis Eren University and Şengül Pala of Kırıkkale University, focuses on a group that often falls between the cracks of follow-up care. Extreme prematurity attracts intensive neonatal monitoring and structured developmental surveillance. Moderate to late preterm birth, defined as delivery between roughly 32 and 37 weeks of gestation, is far more common but is frequently treated as low risk once the newborn period passes. The new study asks a deceptively simple question: how do the mothers of these children, now aged three to six, actually experience and interpret their children’s development, learning, and early school experiences?

To answer it, the researchers turned to one of the most information-rich designs in developmental science: the in-depth qualitative interview. Eight mothers who had given birth moderately to late preterm, and whose children were between three and six years old, took part in the study. Data came from three sources. A demographic information form captured family and birth background. Semi-structured interviews allowed the mothers to narrate their experiences in their own words, guided but not constrained by the researchers’ questions. Most distinctively, the mothers kept digital diaries over a ten-week period, recording day-to-day observations of their children’s behavior, health, and school life as it unfolded in real time.

The analytical approach matched this dual data structure. Interview transcripts were examined using thematic analysis, a method that identifies recurring patterns of meaning across participants’ accounts and organizes them into coherent themes. The diary entries were analyzed with content analysis, which systematically codes textual material to reveal frequency and salience of particular topics. Combining a snapshot interview with a longitudinal diary window gives the study an unusual texture: the interviews capture how mothers make sense of their parenting story retrospectively, while the diaries document the small, daily decisions that story is actually made of.

The central finding is what the researchers describe as perceived vulnerability. The mothers consistently saw their preterm children as more susceptible to health problems than their peers. This was not a clinical diagnosis but a maternal interpretation, built from the memory of an early birth and reinforced by everyday comparisons with other children. In developmental psychology, this pattern echoes a well-documented phenomenon in which parents of children with early medical histories perceive fragility that persists beyond the period of actual medical risk. What makes the new study notable is what that perception did next.

According to the findings, the sense of vulnerability prompted the mothers to adopt what the authors call an early-intervention role. Rather than waiting for problems to surface, they positioned themselves as the first line of detection and response, monitoring symptoms, anticipating difficulties, and acting before issues escalated. Strikingly, the researchers report that this proactive stance appeared to function as a protective factor against school absenteeism. In other words, the same maternal vigilance that might, in some contexts, become overprotective here seemed to keep children in the classroom, presumably by catching health concerns early enough to prevent prolonged absences. It is a counterintuitive result: worry, channeled into action, became a form of school engagement.

On the cognitive side, the picture the mothers painted was largely reassuring. Most perceived their children’s learning abilities and academic performance as appropriate for their age. There was, however, a consistent caveat about attention. The mothers reported that their children’s attention varied depending on interest and motivation, a pattern familiar to any parent or preschool teacher but one that the mothers in this study connected explicitly to their children’s preterm history. Attention regulation is one of the executive functions known to be sensitive to early birth, and maternal observation of motivation-dependent attention may represent an everyday, lay version of what clinicians measure with structured attention assessments.

The difficulties that did emerge clustered around the social and physical demands of school life. The most frequently reported challenges involved school adjustment, bullying, peer interactions, and social skills. For children aged three to six, the transition into preschool is a developmental milestone in its own right, requiring the child to separate from caregivers, negotiate a new social hierarchy, and sustain engagement in group activities. The study suggests that moderate to late preterm children may find this transition harder than their peers, and that their mothers are keenly aware of it. In some cases, the mothers also reported that fine- and gross-motor difficulties interfered with participation in school activities, from classroom tasks to playground play, adding a physical dimension to the social challenges.

Across all of these domains, the researchers found that the mothers assumed dual roles, acting both as supporters and as guides in response to their children’s developmental needs. The supportive role involved buffering, comforting, and protecting; the guiding role involved actively steering the child toward skills, interactions, and independence. This dual posture, the study argues, has direct implications for pediatric care. If mothers of moderate to late preterm children are already performing surveillance and early intervention at home, health systems could build on that capacity rather than assume that the absence of extreme prematurity means the absence of need. Structured follow-up, anticipatory guidance about school transition, and support for social-emotional development could all be offered to this population, not just to families of very preterm infants.

The study also carries a methodological and ethical footprint worth noting. It was approved by the Kırıkkale University Ethics Committee, with both verbal and written consent obtained from participants, and interview recordings were permanently deleted after transcription so that only anonymized text was analyzed. The authors state that they used AI language tools solely to improve readability and format the reference list, not to generate content or bibliographic information. The work was conducted without external funding, and the authors declare no competing interests. As with any qualitative study of eight participants, the findings are not statistically generalizable; their value lies in depth and hypothesis generation. But they open a window onto a stage of preterm development that quantitative scales often miss, and they suggest that the most sensitive instrument for detecting the long echo of an early birth may be a mother paying close attention, ten weeks of diary entries at a time.

Subject of Research: Maternal experiences and perceived developmental vulnerability in children born moderate to late preterm during the preschool years

Article Title: Maternal experiences of moderate to late preterm children aged 3–6: a qualitative study on child development, school life, parenting roles, and implications for pediatric care

Article References: Uzkul, S., & Pala, Ş. (2026). Maternal experiences of moderate to late preterm children aged 3–6: a qualitative study on child development, school life, parenting roles, and implications for pediatric care. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07744-z

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07744-z

Keywords: preterm birth, moderate to late preterm, child development, maternal experiences, qualitative research, preschool education, school adjustment, parenting roles, early intervention, pediatric care, developmental risk, Türkiye

The research team, led by Hongchang Teng of Ludong University in Yantai, China, together with Yanli Liu of Zibo Municipal Hospital, Yuehua Li of Yantai Vocational College, and Moxuan Song of Ludong University, set out to do what psychometricians call scale development: the painstaking process of turning a fuzzy psychological concept into a set of questions that reliably and validly measure it. Their starting point was a straightforward observation. Although adolescent school adaptation has attracted considerable research attention, psychometrically robust assessment tools designed for students in correctional education settings were lacking. Without such tools, educators in these schools have had little systematic way to identify struggling students, evaluate interventions, or contribute comparable data to the research literature.

The team followed a standard, multi-stage scale-development procedure that is widely regarded as the gold standard in psychological measurement. First came item generation. Rather than guessing at what adaptation means in a correctional school, the researchers grounded their initial pool of questions in three complementary sources: a review of the existing literature, semi-structured interviews, and open-ended surveys. This triangulation is important because it lets the voices of the people who actually live the experience—students and the professionals around them—shape the content of the instrument before any statistical machinery is applied. The result was a preliminary scale whose items reflected the lived realities of specialized schooling rather than assumptions imported from mainstream educational contexts.

Next came the empirical winnowing. The researchers recruited a pilot sample of 210 students and subjected the preliminary items to item analysis and exploratory factor analysis, or EFA. Item analysis examines how individual questions perform: whether they discriminate between students with different levels of adaptation, whether any items are redundant or confusing, and whether each one contributes meaningfully to the scale. Exploratory factor analysis, meanwhile, is a statistical technique that looks at patterns of correlation among items to discover how many underlying dimensions—or factors—are needed to explain the data. In essence, EFA asks the data to reveal its own structure rather than imposing one from the outset. Using these tools, the team revised and optimized the preliminary scale, trimming and refining until a coherent, streamlined questionnaire emerged.

The refined instrument was then put to the test with a fresh validation sample of 270 students. Using an independent sample is a critical safeguard in scale development: it ensures that the final structure is not simply an artifact of the particular quirks of the first group. With this second dataset, the researchers conducted confirmatory factor analysis, or CFA, along with a battery of reliability and validity tests. Where EFA explores, CFA confirms. The researcher specifies in advance a model of how many factors exist and which items load on which factor, and the analysis quantifies how well that specified model reproduces the observed patterns of responses. A questionnaire that survives CFA has demonstrated that its internal architecture holds up under scrutiny.

The outcome was a final 21-item questionnaire organized into four factors: Rule Adaptation, Academic Adaptation, Peer Relations, and School Attitude. Together, these four dimensions explained 69.21 percent of the total variance in responses—a substantial share indicating that the four-factor structure captures most of what the questionnaire measures. The four factors also make intuitive sense for a correctional school context. Rule Adaptation speaks to the heightened role of institutional discipline and behavioral expectations in these settings. Academic Adaptation addresses engagement with learning itself. Peer Relations captures the social fabric of the school, and School Attitude reflects the emotional bond, positive or negative, that a student forms with the institution. The inclusion of rule adaptation as a distinct dimension is precisely the kind of content that generic school-adjustment scales tend to miss.

The statistical evidence for the final model was strong. Confirmatory factor analysis demonstrated an adequate model fit, with a chi-square to degrees-of-freedom ratio of 1.467, a root mean square error of approximation (RMSEA) of 0.045, a normed fit index (NFI) of 0.918, a Tucker-Lewis index (TLI) of 0.968, and a comparative fit index (CFI) of 0.972. For readers unfamiliar with these metrics, the chi-square ratio is expected to fall below roughly 3 for a good model, and RMSEA values below 0.05 indicate close fit. The NFI, TLI, and CFI all range from 0 to 1, with values above 0.90 conventionally considered acceptable and values above 0.95 excellent. By these standards, the four-factor model fits the validation data remarkably well, suggesting the questionnaire measures a stable, coherent structure rather than statistical noise.

Reliability—the consistency of measurement—was equally impressive. The overall Cronbach’s alpha coefficient for the full 21-item scale was 0.94, a value indicating that students who score high on some items tend to score high on the others, and that the instrument would likely yield similar results if administered to comparable students under comparable conditions. The alpha values for the four subscales ranged from 0.81 to 0.92, comfortably above the 0.70 threshold typically regarded as acceptable for research instruments. Taken together with the structural validity evidence, the authors conclude that the School Adaptation Questionnaire for students in specialized correctional schools possesses excellent psychometric properties, with strong reliability and structural validity.

Why does this matter beyond the technical details? Assessment is the foundation of evidence-based practice in any educational setting. In mainstream schools, decades of validated measurement have allowed researchers to track how adjustment predicts achievement, mental health, and long-term outcomes, and to evaluate whether programs actually work. Students in specialized correctional schools deserve the same standard of care, but until now the measurement toolkit has lagged behind. A validated questionnaire gives teachers and counselors a common language for describing student adjustment, gives administrators a way to monitor progress across a school or a system, and gives researchers an instrument that can support rigorous evaluation of correctional education programs. The authors describe it as a valid evaluation tool for both research and practice in specialized correctional education.

The study also carries broader lessons for measurement science. It demonstrates how a careful, theory-driven, multi-stage process—literature review and qualitative interviews to generate items, exploratory analysis with one sample to shape the structure, and confirmatory analysis with an independent sample to validate it—can produce a robust instrument even for a population that has long been neglected by mainstream psychology. The work was approved by the research ethics committee of Ludong University, conducted in accordance with the Declaration of Helsinki, and carried out with informed consent from participants or, for those under sixteen, from their parents or legal guardians. As correctional and specialized education systems around the world grapple with how best to help vulnerable adolescents re-enter society, tools like this questionnaire offer something deceptively simple but powerful: a reliable way to see whether, and how, those students are finding their footing.

Subject of Research: Development and validation of a school adaptation questionnaire for students in specialized correctional schools

Article Title: School adjustment scale for students in specialized schools: development and initial validation

Article References: School adjustment scale for students in specialized schools: development and initial validation. (n.d.). https://doi.org/10.1186/s40359-026-05684-y

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05684-y

Keywords: psychometrics, school adjustment, specialized correctional schools, scale development, exploratory factor analysis, confirmatory factor analysis, reliability, validity, educational psychology, adolescents, questionnaire validation, BMC Psychology