160 Chapter 7 if we were to explore changes at the individual level, some parents do show treatment effects regarding lowering parenting stress and improved mental well-being. Future research should also consider incorporating qualitative methods, rather than exclusively questionnaires. Additionally, given the psychological and biological effects of stress, measuring biomarkers like cortisol levels could offer further insights into the influence of pre-emptive interventions on parental stress and well-being (Dijkstra-de Neijs et al., 2021). The importance of parent-child interaction The development of a young child primarily occurs in relation to their parent(s), particularly with the first two years—the first 1001 days—being highly important for shaping the child’s physical and mental health (manifest 1001kritiekedagen.nl). The quality of parent-child interactions is therefore crucial for the child’s overall development. Research has shown that the way psychopathology manifests in very young children is partly determined by the nature of their relationship and interactions with their parent(s) or caregivers (Zeanah, 2019). When a child’s development deviates from typical patterns, parent-child interactions often become more challenging. This means that there is an increased risk in fewer positive contact moments between parent and child. Specifically, if the child shows limited initiatives or responsiveness to the parent, there is a risk that the parent’s engagement and involvement in the interaction also decreases. Previous research highlights the importance of investing in parental skills to improve the quality of parent-child interactions (Salomone, Settanni, et al., 2021). Findings from this thesis suggest that foremost parents seem to benefit from the brief, pre-emptive BEAR intervention and potentially enhance the fluency and connectedness of parent-child interactions. However, definitive conclusions cannot be drawn, as sensitivity analyses showed significant improvements immediately post-treatment, while analyses on imputed data did not. Shift in focus and in terminology The first two studies (Chapters 2 and 3) focused on the early identification of ASD and strategies to enhance and accelerate this process , with the aim to positively stimulate child development. However, in subsequent studies (Chapters 4, 5, and especially 6), the emphasis has moved away from the early detection of autism in young children (i.e. the earlier, the better) toward providing timely and appropriate support to parents of children with vulnerable social-communicative development. Furthermore, several terms are used interchangeably in this thesis: high risk, elevated risk, elevated likelihood, neurodevelopmental vulnerability and social-communicative vulnerability. This shift in both focus and terminology reflects broader trends in the research field and society as well as the researchers’ own developing perspective over the years. Rather than emphasizing a categorical diagnosis (yes/no) or
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