Use of telemediated caregiver coaching to increase access to naturalistic developmental behavioral interventions within a statewide early intervention system.

There was no comparison group or randomisation, so the pre-post changes cannot show that the coaching caused the improvements; child maturation and post-diagnosis caregiver adjustment could explain them. Only families who completed at least one post-intervention measure or had fidelity data were analysed, and families who dropped out were more likely to have lower caregiver education or report Hispanic/Latino ethnicity, so results may not represent all families. Child outcomes relied on caregiver and consultant reports rather than direct observation of the child's behaviour. Satisfaction was measured only in families who completed three or more sessions, which may overstate acceptability. Group comparisons for BIPOC and Hispanic/Latino families used small samples, so differences in satisfaction and fidelity should be read cautiously.

Funding came from the Tennessee Department of Intellectual and Developmental Disabilities through the Tennessee Early Intervention System (Grant no. 70785), and REDCap was funded by UL1 TR000445 from NCATS/NIH. The paper does not report additional author conflicts of interest.

Do not read the improved caregiver-reported communication and language scores as proof that telehealth coaching caused them. The study had no comparison group or randomisation, so maturation and other factors could explain the changes.