Hybrid Behavioral Intervention for Caregivers of Children With Developmental Delay: Pilot Study

Abstract

Caregivers of children with developmental delays often experience high stress and challenges in parent–child interactions. The objective of this study was to examine the feasibility, acceptability, and preliminary effects of a caregiver behavioral intervention delivered in hybrid and self-study formats. Forty caregivers were randomized to an 8-week hybrid program (online modules plus therapist consultations) or a self-study program. Primary outcomes included caregiver stress and self-efficacy, with feasibility assessed through satisfaction and intervention fidelity. Both groups showed improvements in caregiver stress and parent–child interaction, with no significant between-group differences. The self-study group demonstrated additional gains in parenting competence. The hybrid group reported higher satisfaction and fidelity, with large effect sizes (Cohen’s d = 3.96 and 4.08) and described stronger parent–child connections. The intervention was feasible and supported a stepped-care approach, with self-study as a first-line option and hybrid models for families needing additional support. Trials: ClinicalTrials.gov, NCT05827952.

Plain Language Summary

Helping Parents of Young Children With Developmental Delays: A Study Comparing a Hybrid Online Program and a Self-Study Approach to Reduce Stress, Build Parenting Confidence, and Strengthen Parent–Child Relationships Through Small, Meaningful Behavior Changes

Parents of children with developmental delays often face high levels of stress and uncertainty in daily caregiving. This study tested a program that helps caregivers make small, consistent changes in routines to reduce stress, build parenting confidence, and improve parent–child relationships. The program used simple behavioral strategies and occupational therapy principles, focusing on role balance and meaningful play. Forty caregivers were randomly assigned to one of two groups: a hybrid group that joined online lessons and consultations with therapists, and a self-study group that completed guided readings on their own. Both programs lasted 8 weeks. Caregivers completed questionnaires before and after the program to measure stress, confidence in parenting, and satisfaction. After the program, both groups showed reduced parenting stress and better interactions with their children. The self-study group gained more confidence, while the hybrid group reported higher satisfaction, stronger engagement, and closer emotional bonds with their children. Many parents in the hybrid group also noticed improvements in their children’s emotional control and initiative during daily activities. These findings suggest that both formats are helpful and practical. A stepped-care approach—starting with self-study for most families, and offering hybrid support for those needing more guidance—may be an effective model in occupational therapy and telehealth services to reach more families, especially those with limited access to in-person care.