Aim Mothers of very preterm children have been reported to behave less sensitively and to be more controlling. It is unknown whether this is the result of maternal factors or due to maternal adaptation to children's cognitive problems. Method We investigated a geographically defined prospective whole-population sample of very low birthweight (<1500g) or very preterm (<32wks' gestation; VLBW/VP) children (n=267, 124 females, 143 males) and a comparison group born at term (n=298, 146 females, 152 males) in Germany. Mother-child interactions were videotaped during a play situation and analysed with a standardized coding system at children's mean ages of 6years 3months and 8years 5months. Results At both 6years 3months and 8years 5months, VLBW/VP children were less task persistent and socially active (p<0.001) whereas their mothers behaved less sensitively and were more controlling than term mother-child dyads (p<0.001). Cross-sectional group differences in maternal behaviour remained when scores where adjusted for social factors but disappeared once adjusted for child IQ. High maternal sensitivity predicted higher task persistence (p<0.001), in particular in those children with cognitive problems. Interpretation Mothers of VLBW/VP children adapt their behaviour to their children's level of cognitive functioning. High maternal sensitivity is particularly beneficial for task persistence in children with cognitive deficits.