Children born prematurely are at higher risk for medical, learning and developmental concerns than children born full term. This study analysed the files of 73 pre-term children who completed an Assessment and Monitoring programme in New Zealand between 1998 and 2007. The participants were 39 boys and 34 girls with gestational ages ranging from 23 weeks to 32 weeks at birth and who attended the programme until they were 4 years chronological age. Analysis of the reports sent to paediatricians following the children’s monitoring visits at 8 months, 12 months, 18 months, 24 months and 36 months (corrected age) and at 48 months, chronological age indicated delays in achieving the expected developmental milestones in expressive language, cognition and gross motor skills for up to half of the cohort. Moreover, the findings further suggest that a ‘sleeper effect’ or ‘invisible prematurity’ emerged for up to half of the cohort at age 36 months. This ‘invisible prematurity’ and the developmental delay in cognition, expressive language and gross motor skills have implications for early childhood teachers as teachers need to develop an awareness of, and skills to identify and work effectively with these young children and their families. Practical teaching and learning strategies are presented for teachers.