1 13 General introduction al., 2023). It is hypotized that, due to the dynamic and plastic nature of the brain during preschool years, (very) early interventions have the possibility to alter the course of brain and behavioral development in children with ASD (Webb et al., 2014). Additionally, some studies report positive changes in both parent and child behaviors, parent-child interaction and improving parental responsiveness after early intervention (Green et al., 2017; Jones et al., 2017; Kasari et al., 2014; Watson et al., 2017). These findings suggest that starting early intervention in the earliest years of life can have a positive impact on both child, parent and dyadic interactions. 1. From early concerns to early detection Early detection is the first step in receiving timely intervention, not only for children with ASD but also for their parents. Early detection starts with the recognition of initial concerns related to a child’s development, indicating the possibility of developmental delay or disorder in a young child (Buitelaar et al., 2009). After recognizing concerns, the next step would be screening: asking clarifying questions to parents, possibly using screening tools, to assess the risks in a more quantitative manner (Buitelaar et al., 2009) and determine if further steps are needed. After screening, a next step can be referral to a specialized healthcare center for diagnostic assessments. Research indicates that even at a very early age it is possible to provide an ASD diagnosis that is relatively stable over time, in many cases (Cleary et al., 2023; Guthrie et al., 2013; Lord et al., 2022; Zwaigenbaum et al., 2018). Currently, the global average age at which a child receives an ASD diagnosis lies around 5 years (van ‘t Hof et al., 2021). Typically, it is the (one of the) parents who are the first to express concerns about the child’s development. Such concerns often arise during the first 2 years of life (Landa, 2008; Zwaigenbaum et al., 2015) or, in some cases, even before the first birthday. In other cases, it is a professional, for example a preventive care physician or nurse, who expresses initial concerns regarding the child’s development. Unfortunately, the entire diagnostic procedure from concerns to clinical assessment, diagnosis and intervention can be lengthy and time consuming with delay varying between 1.5 and 3.5 years (Crais et., 2020; Crane et al., 2016; Zuckerman et al., 2015). Such delay is undesirable as, a) parents experience high levels of stress during the process of obtaining an ASD diagnosis for their child, and b) delay in early detection and diagnostics results in later access to early intervention services. 2. From early detection to early intervention After diagnostic assessment early interventions can start. In recent years, there has been an uptake in interest in pre-emptive interventions: intervening at a very early age and even before diagnosis. This field has gained traction over the years with mixed but promising results. Previous research shows positive effects on child outcomes such as improvement in social communicative development and language development. (Anderson et al., 2014; Lord et al., 2018; Estes et al., 2015; Fuller & Kaiser, 2020; Pickles et al., 2016). On the other hand, two recent systematic reviews and
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