Triple P for NICU graduates (NL: Triple P na de couveuse).

At toddler age, NICU graduates show more emotional and behavioral problems than term born children without a medical condition. Having a child in neonatal intensive care burdens parenting, not only during the acute phase of illness but also in the years thereafter. Most interventions up till now take place during the NICU period or in the first year of life. These interventions usually aim at directly stimulating the motor and cognitive development of the child. The effects of early interventions are positive, but at school age the positive effects have usually disappeared. As of yet, there are no studies of interventions aimed at parenting support of parents of NICU graduates at toddler age, while emotional and/or behavioral problems surface specifically at this age. The objective of this study is to investigate the effectiveness of the Triple P program compared to a control group, for
parents and their toddler-aged NICU-graduates with emotional and/or behavioral problems. The intervention is an evidence-based parenting program, Triple P (level 3), which aimes at improving the competences and the self-reliance of parents regarding their parenting behaviour.
The duration of the intervention is four times 30 minutes. Effectivenes of Triple P concerns children's problems, parents' parenting experiences, and the interaction between parents and child.

At toddler age, NICU graduates show more emotional and behavioral problems than term born children without a medical ondition. Having a child in neonatal intensive care burdens parenting, not only during the acute phase of illness but also in the years thereafter. Most interventions up till now take place during the NICU period or in the first year of life. These interventions usually aim at directly stimulating the motor and cognitive development of the child. The effects of early interventions are positive, but at school age the positive effects have usually disappeared. As of yet, there are no studies of interventions aimed at parenting support of parents of NICU graduates at toddler age, while emotional and/or behavioral problems surface specifically at this age. The objective is to study the effectiveness of the Triple P program compared to a control group, for parents and their NICU-graduates with emotional and/or behavioral problems. Effectivenes concerns children's problems, parents' parenting experiences, and the interaction between parents and child.

The primary outcome will be at 6 months after inclusion. All secondary outcomes will be at 12 months after inclusion.

The intervention is an evidence-based parenting program, Triple P (level 3).
It aims at improving the competences and the self-reliance of parents regarding their parenting behaviour. Triple P tries to establish a more competent parenting style in dealing with the child's emotional and/or
behavioral problems, less use of cohersion and negative discipline, better communication about parenting
between parents and between parent and child, and less parenting stress for the parents. The duration of the intervention is four times 30 minutes.
Within one year time intervention group will fill out questionnaires four times, they will visit the childrens hospital six times to recieve Triple P and for observations of mother-child interaction. At the same timepoints, the waitlist-control group will fill out questionnaires at four times, and visit the hospital four times for observations of mother-child interaction. After six months, Triple P is optional for the waitlist-control group.