We are the Association for child and adolescent mental health, or ACAMH for short. And this is ACAMH learn. [THEME MUSIC] Worldwide, one in 10 babies is born preterm. Meaning, that the baby is born before 37 weeks of gestation. These are over 30 million babies each year. These children have a higher risk of developing mental health problems than term born children. Despite the important progress in neonatal care, mental health outcomes of these children have not improved over the past decades. We know that roughly half of the preterm born children have positive mental health. We wanted to know what helps these children thrive so that we can support more children to develop positive mental health outcomes. We analysed data from over 1,500 preterm born children in two large cohorts from Germany and the UK. Children in the Bavarian longitudinal study were born in the '80s. And their mental health was assessed at eight years of age. Children in the Millennium Cohort Study were born between 2000 and 2002, and assessed at age seven. This plot shows the association between gestational age at birth and symptoms of mental health problems. Lower gestational age was associated with more symptoms. The scores of some children are in line with the estimation of the model. However, there were also children with more symptoms than predicted. Whereas other children had less symptoms. The observations in green below the line are from children with less symptoms than expected, given their gestational age. These children have better than expected mental health, which we call resilience. In our study, we focus on modifiable factors different systems in the child's life. We looked at individual factors such as self-regulation and cognitive abilities. The parent child relationship. Broader family factors such as the home environment. The peer group, including bullying and friendship quality. And characteristics of the neighbourhoods. We found that mental health resilience was shaped by factors at all levels. For seven factors, we found consistent evidence in both cohorts that they were associated with resilience. These included higher self-regulation, lower emotionality, higher cognitive abilities, a positive mother child-relationship, a structured family climates, and a better quality of the relationship between parents. Being bullied by peers and siblings had a negative effect on mental health resilience. Some of the effects were stronger for boys than for girls. Or boys had less access to these promotive factors, which subsequently lowered their resilience. Promotive factors were also less prevalent in children growing up in adverse family contexts, which explains their lower resilience. Our findings suggest a multi-layered approach to foster mental health resilience in preterm born children. Some factors can be used for universal support because they benefit all preterm born children. Whereas other factors can be used for targeted support for specific risk groups. By early identifying difficulties in promotive factors, we can also offer personalised support tailored to the unique needs of each child. The social and environmental factors that we studied explain 30% to 40% of the variation in mental health resilience. That is hopeful because it means that there is really potential for improving mental health outcomes in preterm born children through multiple everyday systems. Children's self-regulation, the parental relationship quality, the parent child relationship, and protection from bullying, seem particularly promising targets. Improving these aspects may help more preterm born children to thrive. If you want to learn more about this study, scan the QR code to read the full publication. [THEME MUSIC]