An Historic Look at Observations of Preemie Personality in Girls

Discussion by Dr. Stanley H. Walters of what he saw as common characteristics of preemie girls, 1973.

By Helen Harrison

You might be interested in some some "old" (but, I think, still relevant) observations on preemie behavior, one made in 1973 and the other made in in the 1930s.

These are observations by a psychologist in Tustin, California , Dr. Stanley H. Walters, which I got at a parent support group meeting decades ago. Here are the characteristics Dr. Walters felt were common in preemies (defined here as birthweight under 5 lbs. 8 oz) that he had seen over the preceding 24 years. He stresses that these traits appear "on average" and that not all preemies have them. "However," he writes, "many children present very subtle personality, character, temperament, and perceptual deviations that can generate problems, especially if the child is placed under stress."

Here they are:

a) Extreme mental age range on a battery of well-standardized psychological tests.

b) In girls, the cognitive learning style is often visual-spacial instead of auditory.

c) Many girls are tomboys or have strong tendencies toward male-oriented, strenuous, athletic behaviors.

d) Hyperactivity is usually goal-directed. Children are often busy doing constructive things; one girl wove 500 hot pads.

e) The girls in the sample tended to be unusually strong.

f) Many have temperament traits that were apparent from the first day of birth: irritable and cranky, stubborn, with a mind of their own; demanding and bossy; little or no self-motivation; self-centered; have frequent temper tantrums.

g) Difficulty in learning to read write and spell.

h) Visual-motor-perceptual problems interfere with processing written symbols of language; writing tends to range from sloppy to dysgraphic; problems with gross motor development.

i) Girls tend to respond to boy-type visual-spacial and redundancy procedures if there are reading, writing, or spelling problems.

j) Girls love horses and dogs in particular, and all animals in general; they often work hard taking care of their animals.

k) Difficulty delaying need satisfaction; all demands must be met now, this moment.

l) Many have sleep cycle disturbances: light sleepers, hard sleepers; wake up crabby; stay up late at night; hard to get to bed. m) Many girls are hypochondriacs; a small scratch becomes a major event.

n) Often they do not respond to cultural systems of discipline. Yelling, spanking, take away, and anger in voice, makes them worse.

o) Difficulties with peers. Often have only one friend; complain no one likes them.

p) Many lack social finesse, even in young adulthood. (Shy and tend to be blunt).

q) They may talk as early as fullterm children, but have more speech defects.

r) They have a higher incidence of sensory abnormalities (poor gait, visual problems, oversensitive to noise, etc.) and other nervous system problems.

s) They are often less self-reliant, depending on adults more than fullterm children

t) Many of the children are controlling and oppositional.

u) If hyperactive, they don't respond to medical management like other children.

Dr. Walters adds: "Because many premature children will have these mild problems as they grow up, post natal medical consultation should include this information to parents."

What I know about Dr. Walters is based on the sheet of paper passed around at the support group meeting, and a phone conversation I had with him in the early 1980s. On this sheet of paper and in my interview notes there was the notation, which I probably should have included, that most of the preemies Dr. Walters had studied were female, so if females seem to be singled out for comment, this may be why. Dr. Shirley on the other hand singled out males as having more negative (or at least acting-out type) characteristics.

It should also be noted that both Dr. Walters and Dr. Shirley were writing well before current concepts of "sexism" were in vogue, so I doubt that either felt they were in any way being offensive on this basis.

On the other hand, the tomboy, masculine characteristics of preemie females have been noticed elsewhere, and, although this is only wild speculation on my part, may have to do with premature birth depriving them of those last few months of female hormones they would get from their mothers' bloodstream. On the positive side, this also seems to give adult female preemies greater protection from breast cancer.

Almost all of the traits described by Drs. Walters and Shirley can be construed as "negative," but there are also positive aspects. Dr. Shirley sees preemie sensitivity as leading to aesthetic pursuits in later life. This has certainly been the case with our son, who, despite severe multiple handicaps is an accomplished and creative musician. Dr. Walters see the "perseverance" (even "perseveration") as sometimes leading to goal directed behavior (however repetitive). This has also been the case with our son.

Both doctors used a range of psychological tests and intelligence tests (although in Dr. Walters case his observations came from his clinical practice of over two decades following preemies into adolescence and adulthood). In Dr. Shirley's case there were fullterm controls and examinations of fullterm siblings of the preemies. I don't have the specific tests Dr. Walters used. He doesn't specifically list them since his paper is not a scientific article, but more a handout for parents and professionals, but he does refer to a "battery of well-standardized psychological tests." I believe Dr. Shirley lists the tests she used, but I am currently up at Lake Tahoe and don't have either manuscript with me so I can't check that right now.

There are also numerous, more recent, observations of nearly identical behavior traits in today's preemies. I quoted the old observations because they are particularly descriptive and have historical interest. The other point I was trying to stress is that preemie follow-up has been going on for decades (over a century in fact) and there is a great deal physicians *could* be telling parents about what to expect.

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.