ToP English

 

The ToP programme supports you and your preterm  child after discharge from hospital, with the aim that  you can support the early development of your baby  with joy and self-confidence.

Why

You as parent(s) are the most important person(s) in  your child ’s life. Therefore the bond between you and  your baby is encouraged early on after birth. Physical  contact and understanding the body language of your  baby are very important in this process. Through skin-to-skin contact your baby can become  attached to your scent, heart rhythm, voice and  movements in a comfortable way.  A preterm baby lets you know through its behaviour when s/he feels happy and how s/he likes to be  supported or comforted best. A baby also makes all kinds of attempts to get a grip on what is happening, for example by sucking, holding on to something or by trying to use its feet for support. Once you are told how you can help your baby with these efforts to get more control, it may give you (both) a lot of satisfaction and joy. Many parents have the feeling that after coming home they must get to know their baby all over again. This is not so strange, because the baby itself must also adjust to the new environment. Moreover, now your baby can maintain its temperature and grows  sufficiently, s/he is more focused on its surroundings. Your baby seeks a balance between its need for security and the curiosity of discovering the world around him/her. Changing diapers, feeding, cuddling, playing, or being walked in the pram are ordinary daily acti vities. However, sometimes these everyday activities can  give preterm children more information that they can  cope with at that time. It often happens that they are  frightened more easily or are harder to comfort than babies born at term. It may also be that they have  more difficulty in making contact, or in maintaining  their attention. Parents are often tired or stressed after the preterm birth of their baby and everything that is involved. Then the unpredictable behaviour of their  baby can cost a lot of extra energy. The ToP programme therefore supports parents at home, helping them to recognise their baby’s signals and how to respond in a positive way.

 

How it works

The ToP programme is made to fit the needs of the individual baby and gives continuation to the individual developmental care, which started in the incubator period. The ToP programme does not focus on the problems, but on the potentials that your child has, and the attempts that it makes to explore their environment and to adjust to it. The aim of the programme is that your child can  participate in the activities that are important to him/her at that moment, in an active way, without stress. The paediatric physiotherapist from the hospital will explain the content of the ToP programme before you  go home with your child. An experienced paediatric physiotherapist carries out the programme and visits you at home. S/he has followed additional training in the understanding of the ‘body language’ of young children. This body language consists of behaviour by which young  children show their interests, potential and needs. Together you follow your baby’s behaviour: what is my child trying to achieve, what can my child do by itself, where does s/he need help and how can I give this help? The support that is given, does not consist of fixed  ‘exercises’, but is determined by the choices that suit you, your child and your family.

 

For whom

The ToP programme is offered to:
- All babies that are born before 32 weeks of pregnancy and/or have a birth weight below 1500 grams.
- A condition is that your child has a health insurance that covers this programme and that there is a ToP trained physiotherapist available in your environment. You can find all participating physiotherapists here or you can contact the Expertise Centre: expertisecentrumprematuren@amc.uva.nl.

 

When and how often

The first home visit takes place in the first two weeks after coming home from the hospital. All appointments are made in consultation with you. The total number of home visits is 12. The programme ends when your child is about 1 year old.


Effects

The programme has been studied scientifically in the Amsterdam region from 2004 until 2014. On this website you can read more about the positive outcomes of these studies on the development of the child and the parent-child interaction. The programme was implemented between 2010 and 2014 in the region of AMC and VUmc and will be gradually rolled out to other parts of the country. The results and feedback from this period of implementation have lead to the development of the current ToP programme.

 

Costs

The ToP programme has been included in the basic health insurance. There are no costs associated with participation. We do ask you to fill in some questionnaires during the period you are taking part in the ToP programme. This information will be used to continuously improve the programme, meeting the needs of you and your child even better.

 

Expertise Centre

The Expertise Centre (EOP-nl) was founded to improve the development of the preterm born child and the well being of the preterm baby and its parents after discharge from hospital.
- The Expertise Centre coordinates the implementation of the ToP programme
- Provides training to professionals who work with preterm children and their parents
- Promotes innovation of developmental support in preterm babies
- Conducts research and promotes dissemination of knowledge of effective intervention for premature children and their parents.


Different professionals are linked to the Expertise Centre. They are all, by training and experience, specialised in the support of premature babies and their parents:
- paediatric physiotherapists and pedagogues
- a paediatrician, a neonatologist and a paediatric rehabilitation doctor
- a NICU nurse
- a speech therapist and an occupational therapist
- researchers

 

The Expertise Centre works on the continuity of developmental support from hospital to home, and towards cooperation and communication between the various professionals involved in the care for the premature child. When the child is discharged the paediatric physiotherapist from the hospital will arrange the transfer to a paediatric physiotherapist who works in the area where the parents live. All participating physiotherapists are affiliated with the Expertise Centre, which coordinates care and monitors the quality of care.
 

Press here for the English information letter