Premature birth: Hop on Baby | Action Medical Research | Children's Charity | Children's Charity

Premature birth: hop on baby

First published on 18 February 2010

Updated on 26 May 2015

What did the project achieve?

“We’ve developed an online programme, nick-named HOP-ON, that shows parents how to promote the physical development of very premature babies – who were born more than eight weeks early,” says Professor Cristine Glazebrook, of the University of Nottingham.

“So far, we’ve studied whether giving parents HOP-ON affects babies’ physical abilities at what would have been their first birthday, if they hadn’t been born early,” says Professor Glazebrook. “Results show HOP-ON seems safe, and parents who used it said they really like it. The programme didn’t seem to improve babies’ physical skills, but we will be assessing the babies again at two and three years. We suspect that many parents may not have prioritised using HOP-ON in the busy months after coming home from hospital, so we’re considering ways to encourage that, possibly by texting reminders.”

The latest information suggests around 16,000 babies are born very prematurely, before 32 weeks of pregnancy each year in the UK.1-4 Such an early birth increases babies’ chances of having difficulties with their hand-eye coordination, balance or manual dexterity, for example, which can affect many aspects of day-to-day life during childhood, from writing to playing sports. Large numbers of babies stand to benefit if HOP-ON proves helpful over the longer term.


1. National Institute for Health and Care Excellence. Preterm labour and birth final scope. 10 July 2013. Website accessed 28 January 2015.

2. ISD Scotland. Births in Scottish Hospitals. Year ending 31st March 2013. Publication date – 26th August 2014. Website accessed 19 January 2015.

3. Northern Ireland Statistics and Research Agency. Births. Live Births, 1887 to 2013 (Excel). Website accessed 19 January 2015.

4. Office for National Statistics. Births in England and Wales 2013. Website accessed 19 January 2015.


This research was completed on 31 July 2013

Latest figures show over 10,000 babies are born very prematurely, before 32 weeks of pregnancy, each year in the UK.1,2 Many of these babies go on to have some problems coordinating their movements during childhood and adolescence, meaning things like writing, doing up shoelaces and catching a ball can be more difficult than usual. This can affect children’s progress at school, their friendships with their peers and even their fitness levels. Researchers are trying to help parents stimulate their child’s physical development, using a computer-based education program called HOP-ON.

What's the problem and who does it affect?

A cycle of disadvantage

Latest figures show over 10,000 babies are born very prematurely, before 32 weeks of pregnancy, each year in the UK.1,2 Many go on to have poor motor skills during childhood and adolescence – their hand-eye coordination, balance, agility levels and manual dexterity may be affected, for example.

Children with poor motor skills can have difficulties with activities such as writing and drawing, throwing and catching a ball, and doing up buttons. This can affect their performance at school, irrespective of their intelligence.

The children tend to lack confidence in their physical ability and can be reluctant to join in with playground games and sports. They are typically less active than their peers, less physically fit and at higher risk of being overweight. Their friendships with other children can also be affected.

The children can seem stuck in a cycle of disadvantage – the less they take part in activities, be it sports or classroom activities such as writing and drawing, the less chance they have to practise and improve.

What is the project trying to achieve?

Interactive education

The researchers are developing a computer-based education program, called HOP-ON, which shows parents of very premature babies how to stimulate their child’s physical development during the first year of life.

The interactive, multimedia program combines text, photos, interactive questions and answers, and video clips. It shows parents how to encourage supervised play in a variety of positions appropriate to their baby’s stage of development. It demonstrates, for example, how lying babies on their tummy, propped on their elbows, can promote hand-eye coordination and shoulder stability, with easy follow-on activities such as encouraging the child to reach out for a toy.

Around 140 very premature babies, born before 32 weeks of pregnancy, are taking part in the study along with their parents. Half of the parents are being given the HOP-ON programme on CD-ROM (or on DVD if they don’t have a computer).
The researchers are assessing, for example, how HOP-ON affects parents’ confidence in their parenting skills and babies’ progress by one year of age.

What are the researchers' credentials?

Project LeaderProfessor C Glazebrook PhD
Project team
  • Dr Sarah Redsell RGN RHV PhD CPsychol
  • Dr Samantha Johnson PhD CPsychol
  • Dr Charlotte Beer PhD
  • Sarah Westwater-Wood MCSP FHEA
  • Dr Helen Budge PhD FRCPCH,
  • Dr Heather Wharrad PhD
LocationDivision of Psychiatry, School of Community Health Sciences, University of Nottingham in conjunction with the School of Nursing, Academic Division of Child Health and Division of Physiotherapy Education, University of Nottingham and the Institute for Women's Health, University College London
Other locations
  • School of Nursing, University of Nottingham
  • Institute for Women’s Health, Division of Academic Neonatology, University College London
  • Behavioural Sciences, Queens Medical Centre, Nottingham
  • Division of Physiotherapy Education, University of Nottingham
  • Academic Child Health, University Hospital, Nottingham
  • School of Nursing, Midwifery and Physiotherapy University of Nottingham
Duration2.5 years
Grant awarded18 November 2009
Start date6 May 2010
End date31 July 2013
Grant amount£116,044.00
Grant codeAP1224, GN1760

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The project team includes researchers with an impressive range of relevant expertise – in the care of premature newborns, developmental psychology, health psychology, physiotherapy, health visiting and educational technology.

Team members have direct experience of working with children with poor motor skills. They have a strong record of research into how babies who were born very prematurely grow and develop, as evidenced by numerous publications in prestigious journals.

Team members also have a track record of producing innovative, award-winning, multimedia educational materials for parents and children with chronic health conditions.

Who stands to benefit from this research and how?

Helping parents to help their own child

The researchers hope their new computer-based education program, HOP-ON, will give parents of very premature babies, born before 32 weeks of pregnancy, the skills and confidence they need to encourage their child’s physical development in the first 12 months of life.

Currently, parents often feel unsure about how best to help and support their child. Many think their premature baby is too fragile or sleepy for play in the early months, meaning babies can miss out on important opportunities to practise motor skills.

The researchers are assessing whether HOP-ON can boost parents’ confidence in themselves and their baby, whether it helps parents feel less stressed about caring for their child in the early months, and whether their babies have developed better physical skills by the time they reach their first birthday.

If HOP-ON helps premature babies develop important motor skills such as hand-eye coordination, balance and manual dexterity early on in life, it could mean the babies are better placed to tackle the everyday activities of childhood, such as writing, drawing and playing sports, which are so important to their success in school life and beyond.


  1. The information centre. NHS Maternity Statistics 2008-9.
  2. Hospital Episode Statistics (HES) Online. Maternity Data. Gestation. Table 27: Deliveries by length of gestation and method of onset of labour. 2008-9.
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