Through Parents' Eyes: Perspectives on Child Development and Family Experience During ESDM Intervention.

There was no control group, so improvements cannot be attributed to the intervention rather than development, testing, or other factors. Children received therapist-delivered ESDM and weekly parent coaching together, so the contribution of any single component cannot be separated. The Parental Perceptions of Change Questionnaire was developed by the authors, not formally co-created with parents, and some items may be outdated. Parent reports can be influenced by expectations, familiarity with ESDM goals, and emotional state. The study followed only the first six months of a two-year program. The sample came from Geneva centers where diagnostic assessment and early intervention are largely reimbursed, which may not match other systems. Most questionnaires were completed by mothers, and the factor analysis used 97 of the 104 children after excluding seven with incomplete data. One child used PEP-3 instead of baseline MSEL data. A subgroup with perceived worsening included only five children, so it cannot establish a pattern. The study did not compare ESDM with other interventions.

The authors declared no conflicts of interest. Funding came from Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, National Centre of Competence in Research Synapsy, Fondation Privée des Hôpitaux Universitaires de Genève, and Fondation Pôle Autisme. Fondation Pôle Autisme runs 82 of the CIPA centers in the sample. Four parents contributed to interpretation and later volunteered as co-authors without compensation. ChatGPT was used only for language editing.

Do not read the reported improvements as proof that intensive ESDM works. The study had no control group, and children received therapist-delivered ESDM plus weekly parent coaching, so the contribution of any single component cannot be separated.