Beyond Parent Training: Perceived Needs and Gaps in Family-Mediated Early Intervention for Autistic Toddlers in Spain

Parent-mediated early interventions are widely used to support autistic toddlers, yet concerns remain regarding caregiver burden, contextual fit, equity, and sustainability in real-world services. This study aimed to identify perceived needs and gaps in family-mediated early intervention for autistic toddlers in Spain, with particular attention to the conditions that make family participation feasible, meaningful, and sustainable. A qualitative exploratory study was conducted using focus groups with families and professionals from early intervention and autism-specific services across different geographical locations in Spain. Family participants were parents or primary caregivers of autistic children, or children at elevated likelihood of autism, who had started intervention before the age of three. Professional participants were practitioners working in early autism intervention. Data were analyzed using codebook thematic analysis, combining deductive and inductive coding to identify emergent themes. Five interrelated macro-themes were identified: diagnostic validation and initial guidance; family participation and overload; everyday life, regulation, and relational connection; coordination with real-life contexts; and equity and model sustainability. The findings highlight the perceived importance of moving beyond a narrow caregiver-training approach to family-mediated early intervention. Participants identified emotional, relational, practical, and structural conditions that may shape families’ opportunities to engage meaningfully and sustainably in intervention. These priorities may inform the development and future evaluation of more context-sensitive and equitable approaches.