A Pilot Study of a Behavioral Parent Training in the Republic of Macedonia.

A small non-government group ran free parent-training classes in Macedonia.

Twelve parents of preschoolers with autism joined six two-hour Saturday talks.

Trainers taught one parent who then taught the rest, a pyramid style.

Before and after, staff scored each child’s skills and asked parents how they felt.

Kids used more words, played better, and had fewer tantrums after the course.

Parents said they felt calmer and more sure of themselves.

All gains were medium to large, even with no control group.

Hilton et al. (2010) got similar child gains by simply mailing parents a book.

That looks like a clash, but the 2010 study used typical kids and tiny changes.

Here, kids had autism and changes were bigger, so both results can be true.

TWCosta et al. (2017) also ran short telehealth sessions and saw quick gains.

Both papers show brief low-cost help can work when clinics are far away.

If you serve rural or low-budget families, copy this pyramid plan.

Train one eager parent well and ask them to coach the others.

Six short meetings may be enough to cut parent stress and lift child skills.