Supporting caregivers within caregiver-mediated interventions: a commentary on Brown et al. (2024).

Edmunds et al. (2024) wrote a commentary, not a new experiment. They looked at Brown et al.’s recent work on parent-mediated NDBI and asked, “Are we forgetting the parents?”

The team listed six fixes researchers should bake into every caregiver study. Top of the list: check and support caregiver stress from day one.

The paper finds a gap. Most trials teach parents skills but never track how the training itself affects parent mood, workload, or burnout.

Their six directions are practical: measure stress early, offer respite, train in shorter bursts, and report any parent-side harm just like child-side harm.

de Kuijper et al. (2014) shows why the warning matters. When the team re-analyzed Hanen “More Than Words” data, the choice of missing-data method flipped the result. Listwise deletion made it look like the program raised stress in already-depressed moms; multiple imputation did not. Same families, opposite answers.

McGarty et al. (2018) gives a cheap fix. A fifty-cent reward per session lifted parent adherence and, in turn, child print skills. Edmunds wants more levers like this tested in autism work.

Conine et al. (2025) and Suberman et al. (2020) prove parents can run BST at home for response-to-name and SGD mand training, but both note gains faded when reinforcement stopped. Edmunds says plan maintenance support up front instead of adding it later.

Next time you start a parent-mediated program, slide a brief stress check-in into session one. Use a one-page mood scale and have a respite or reward plan ready before anyone signs consent. Treat parent data as primary, not optional.