14 Chapter 1 meta-analysis found limited effects of very early pre-emptive intervention on child outcomes (such as autism symptoms, cognitive or expressive language outcomes) (Hamptom & Rodriguez, 2022; McGlade et al., 2023). Although these recent reviews found limited effects of pre-emptive interventions on child developmental outcomes, there is one specific intervention to be found more promising: iBASIS-Video Interaction to Promote Positive Parenting (iBasisVIPP). This intervention used video feedback techniques to enhance parental awareness of the infant’s individual social communication skills and needs and offered tailored guidance for parental responses to promote social engagement and interaction (Green, Wan, Guiraud et al; BASIS Team, 2013). Results of an intervention such as iBASIS-VIPP are very promising in that they demonstrate that pre-emptive interventions have the capacity to a) reduce ASD symptom severity and lower the odds of an ASD diagnosis in early childhood; b) elicit a (positive) change in sensitive parental responses; c) improve parent-child interaction; and d) improve the child’s development (Charman,2019; Green & Garg,2018; Kasari,2019; McGlade et al., 2023; Whitehouse et al., 2021). However, further research on the effects of pre-emptive interventions is still needed, not only on documenting the short-term but the long-term effects as well. Early interventions of children with ASD or at increased likelihood of ASD can vary immensely across the world, even within countries and regions (Elsabbagh & Johnson, 2016). This is also the case for the Netherlands, where up until now there is a very limited availability of pre-emptive interventions for infants and toddlers at high likelihood of ASD, as well as their families. Although there is greater global awareness regarding the significance of early detection and intervention, in practice children and their parents receive access to suitable interventions at a later stage than preferred. What makes early detection and access to early intervention so difficult? Both previous research and concerning signals from the clinical field tell us that early detection and access to early intervention for infants and toddlers at elevated likelihood for ASD can be a complex and challenging process. But what makes this process so difficult? As ASD is a heterogeneous disorder with a wide variety in expression of symptoms and clinical severity, there is elevated risk that a subgroup of infants and toddlers receive later care than preferred. For example, children with more subtle and milder ASD symptoms, (above) average IQ and language skills, girls and/or children from ethnic minorities are at a risk of late identification (Mandell et al., 2009; Rutherford et al., 2016). Next, from parents’ perspectives, it is sometimes difficult to acknowledge and accept that their child might develop differently or even has a delayed development. Therefore, parents might be reluctant to be referred to specialized mental healthcare when their child is still very young (Boshoff et al., 2018). Furthermore, it can be difficult for parents to discuss
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