Parental Sense Research Articles

Dealing with Childhood Externalizing Behavior: Protocol for a Feasibility RCT of the Being a Parent Program.

Concerning numbers of childhood behavior problems have been reported worldwide. Parenting interventions are considered one of the most effective early strategies to intervene with externalizing conduct. This protocol outlines a feasibility RCT that aims to implement a parenting intervention in Portugal and (a) test key feasibility parameters, (b) assess the fidelity and acceptability of the program, and (c) explore its effectiveness in childhood behavior problems, parenting skills, parental concern, and parental sense of competence. A double-blinded, two-arm feasibility RCT is described. The participants are the primary caregivers of children between the ages of two and eleven years old that identify difficulties in managing their child's behavior. Families will be randomly assigned to an intervention arm and a waitlist control arm. Parents in the intervention arm will participate in the Being a Parent program (Portuguese version: Ser Pai & Ser Mãe), an eight-week group intervention. Outcomes will be assessed using quantitative and qualitative measures throughout three assessment periods (pre- and post-intervention, and follow-up). This study marks the first feasibility RCT of the Being a Parent program outside the UK. The findings will provide information on the global strength of this program. Challenges and clinical implications are also discussed.

Parent-focused online video intervention for promoting parenting sense of competence: a randomized controlled trial.

Apart from child behavioral problems which were ameliorated by increasing parenting skills, parental well-being is one of the important components for development of parenting sense of competence (PSOC), which subsequently affects parenting style and child outcomes. This randomized controlled trial study aims to determine whether a brief asynchronous parent-focused online video intervention (POVI) that was easily accessible would be effective in increasing PSOC and parental well-being. One hundred and twenty parents, with a poor Thai Mental Health Indicators-15 score or mild-moderate depression/anxiety, of children aged 3-10 years, were randomized into two parallel groups, intervention and control groups (1:1). The intervention group received six online, weekly, parent-focused sessions. Parent and child outcomes were measured at baseline, 6, and 10 weeks. The Generalized Estimating Equations model was used for the analysis. At 10 weeks, the intervention group reported a higher PSOC (p = 0.005), particularly on the parenting satisfaction subscale, and mental health indicator. Both groups experienced reduced depression and anxiety from baseline, and child behaviors remained unchanged. POVI improved PSOC and parental well-being among parents with mild to moderate mental health problems. POVI may be used as a primary tool to promote parental well-being in general pediatric practice. This study demonstrates the efficacy of a parent-focused online video intervention (POVI) in enhancing parenting sense of competence and parental well-being. It addresses the gap in interventions that focus primarily on parental well-being, particularly for those who face mild to moderate mental health challenges. The findings contribute valuable insights for healthcare professionals, highlighting the potential of POVI, an easy-to-access and less time-consuming intervention, as a primary tool to promote parental well-being in general pediatric practice settings.

Parent and Youth Interventions for Chinese American Families to Address COVID-19 Related Discrimination and Promote Youth Mental Health

Asian American youth experienced high levels of discrimination during COVID-19, which negatively impacted their mental health. To address discrimination and promote youth mental health, we developed a novel and culturally sensitive virtual intervention involving both Chinese American parents and youth through collaboration with local Chinese language schools and community organizations. The parent component was based on Parent-Child Connect, a culturally sensitive parenting program for Chinese American parents. The youth program was culturally adapted based on the Strong Kids curriculum. Ninety-one Chinese immigrant parents (Mage = 47.64; SDage = 5.51) and 62 Chinese American youth (Mage = 12.71; SDage = 1.65) participated in the intervention between 2021 and 2023. Retention rates were high: about 82% of parents and youth completed the intervention and post surveys. Results suggest the intervention was effective in promoting positive parenting behaviors (autonomy granting, parental warmth), reducing negative parenting behaviors (verbal hostility, punitive parenting, shaming, directiveness), and improving parental sense of competence, parent-child communication, and parent self-efficacy to support youth during discrimination. Youth also reported significantly greater social and emotional learning knowledge and resilience, increased positive coping, emotional regulation, and mental health. Findings contribute to the limited literature on culturally adapting interventions for Chinese American youth and parents. Impact Statement This is one of the first culturally responsive mental health program involving both Chinese American parents and youth to address discrimination and youth mental health challenges. Findings contribute to the limited literature on how to collaborate with schools and communities to culturally adapt interventions for Chinese American youth and their parents.

The Narrativist Turn in Healthcare and its Implications on the Experience of Perinatal Grief

The non-recognition of perinatal bereavement in society leads parents to an isolated condition that may hinder their psychological adjustment after the loss (Layne; Markin and Zilcha-Mano). Improving bereaved parents’ experiences of communication in healthcare practice thus seems to be crucial to lessening the risk of dysfunctional grief. This paper presents a research project on the topic of perinatal death, “Words Fail Me”: Naming the Unnamable (PERINAT), funded by the French National Agency for Research (2023-2027). By focusing on the metaphorical constructions used by bereaved parents in their narratives of perinatal death, PERINAT seeks to improve the communication experience of the bereaved by furthering health care practitioners’ understanding of this grief. The study is conducted by means of a dataset collected in 2022-23 from interviews with a hundred bereaved parents in France. The preliminary findings of this ongoing project are meant to be used to inform and improve the support offered by health care providers who are likely to come across a bereaved parent in their professional capacity. More specifically, from a perspective of narrative medicine, this contribution seeks to explore what the study of metaphor can potentially offer to the development of narrative competence in the training of health professionals. By developing higher awareness of bereaved parents’ narrative, more specifically of their use of figurative language, practitioners can make sense of parents’ needs and emotional responses to their experience of loss in order to ease it. As Norwood (122) has it, metaphor, like poetry, “can make unknown known and the unspeakable speakable”. This is also in line with the most recent promotion of a relationship-centered and patient-centred notion of care (Bensing; Pluut).

Short Preventive Intervention Improves Parents’ Perceived Support and Knowledge after Divorce: A Quasi-Experimental Study

Worldwide, parental divorce and separation rates are high. These include impactful experiences to all involved, posing risks on well-being and functioning of parents and their children, and leading to increased professional care seeking. The Dutch ‘Divorce ATLAS’ training aims at informing and empowering parents after divorce or separation. The intervention offers preventive support and psychoeducation in a 2-sessions group program. We aimed to assess the effectiveness of Divorce ATLAS for parents in the Dutch setting. We performed a quasi-experimental study in which we compared parents participating in Divorce ATLAS groups (n = 187) and parents on a waiting list for online support (n = 111). Outcomes included well-being of parents and their children, parental sense of competence and social support, and children’s prosocial behavior. We performed regression analyses to assess differences in outcomes between intervention and control group. Additionally, we measured and reported parental knowledge and trigger to act after the intervention. As compared with routine family support of parents in the control group, the Divorce ATLAS group intervention led to increases in parents’ sense of parenting incompetence (Hedges’ g = 0.19), and in perceived social support (Hedges’ g = 0.23). Moreover, most parents indicated that Divorce ATLAS had increased their knowledge and had triggered them to act accordingly. Hence, the increased sense of parenting incompetence in the intervention group may be due to increased participants’ awareness of their parenting behaviors. In sum, Divorce ATLAS is promising for educating and supporting parents after divorce.

Digital Health Delivery of Parenting Skills to Improve Conduct Problems in Middle School Youth Across Two Distinct Randomized Trials

AbstractThis study evaluated direct and indirect effects of the Family Check-Up Online (FCU-O) across two distinct randomized trials with middle school youth and families. The FCU-O is a digital health adaptation of the Family Check-Up that is delivered in a brief, online format with supportive coaching. The FCU-O was delivered to parents of middle school youth with a focus on targeting both proximal and distal outcomes that impact the development of conduct problems, including a range of parenting skills, effortful control, and youth emotional problems. Participants were primary caregivers of children aged 10 to 14 years. Eligibility varied across the trials and included endorsing depression or significant stress, or having a child enrolled in a school with limited resources. A total of 374 participants across trials were included in the analysis and were randomly assigned to receive the intervention or control. Using Integrative Data Analytic techniques, we examined the effects of random assignment on a range of outcomes, including emotional and behavior problems, parenting skills, parenting confidence, and effortful control. We examined the indirect effects of the FCU-O on changes in conduct problems from baseline to 6 months via changes in mediator variables at the first follow-up assessment (2–3 months). The FCU-O improved emotional problems, effortful control, parenting confidence, and parent sense of importance at the first follow-up. Mediation analyses suggested indirect effects on conduct problems at 6-month follow-up via improvements in effortful control and emotional problems, but not via improvements in parenting confidence or sense of parenting importance. Results indicate the FCU-O has potential as a public health intervention for families with middle school youth to reduce behavioral risk. ClinicalTrials.gov Identifier: NCT 03060291; NCT 05117099.

62 Outcomes from a randomized controlled trial of a brief virtual group intervention for adolescents with mild to moderate suicidal ideation and their caregivers: The BRAVA study

Abstract Background Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a brief virtual group intervention designed for adolescents with mild to moderate suicidal ideation (SI) and their caregivers. The goal of BRAVA is to reduce SI in adolescents and increase family connection. The intervention consists of six independent, 90 minute modules that are delivered in a group setting on a weekly basis. Independent modules allow for rolling admission thereby reducing wait time to start the intervention. The modules include components of Dialectical Behaviour Therapy. Attachment Based Family Therapy, Cognitive Behavioral Therapy, Collaborative Problem Solving and psychoeducation. Adolescents and their parents attend separate groups. Adolescents focus on emotional regulation, coping skills, managing crisis situations and caregivers focus on connecting with their teen, validation and crisis management Objectives This randomized controlled trial (RCT) assessed the efficacy of BRAVA in reducing symptoms of SI, depression and anxiety in adolescents, and improving life stress and competency in caregivers. Design/Methods Ninety-nine eligible youth (13-17.5 years) presenting with mild to moderate SI (rated 1 on the suicide item of HEADS-ED MH screening tool) and their caregivers were recruited from hospital and community services. Families were randomized to BRAVA (n=50) or the control group (n=49). The control group intervention consisted of weekly text messages and the opportunity to join the BRAVA group post-exit assessment). Outcome measures were administered at intake and exit for adolescents (Suicidal Ideation Questionnaire-Junior, SIQ-JR; Revised Children’s Anxiety and Depression Scale, RCADS) and caregivers (Perceived Stress Scale, PSS; Parent Sense of Competency Scale, PSOC). Outcomes were analyzed using repeated measures of multivariable analysis of variance (MANOVA). Results Preliminary analyses showed no significant differences between groups at intake for any demographic or clinical variables. Most adolescents and caregivers completed their exit assessment (nBRAVA=37; nControl=39). Adolescents and caregivers attended a median of six and five groups, respectively. Comparing to the control group, BRAVA was superior in reducing SI (p = 0.05) and depression (p = 0.005) in adolescents and caregiver life stress (p = 0.026). Preliminary MANOVA of adolescent outcomes were significant for time [p <0.01, Effect size (ES) = 0.98] and between groups (p = 0.03, ES = 0.11). Caregiver outcomes were significant for time (p=0.051, ES=0.70). Conclusion This study demonstrates that a brief virtual group intervention can have a significant impact on adolescent SI and depression compared to an enhanced treatment as usual control group. In addition, BRAVA can reduce caregiver perceived stress, helping them view their lives as less unpredictable, uncontrollable and overloaded.

Participation in health promoting occupations among mothers of children aged 3-8years with and without difficulties in sensory processing.

Participation in personally significant occupations often contributes to quality of life. Parenting a child with difficulties in sensory processing may present challenges that can affect subjective and objective components of parental participation, thus possibly decreasing their quality of life. This study aimed to compare these components between mothers of children with and without difficulties in sensory processing and explore their relationship with maternal quality of life. Seventy mothers of children aged 3-8years with (50%) and without difficulties in sensory processing completed questionnaires measuring subjective occupational experience, objective frequency of participation in health promoting activities, and quality of life. No consumer or community involvement occurred. Satisfaction with participation competence as well as objective frequency of participation in health promoting activities among mothers from the study group was found to be significantly lower than the control group. Additionally, a significant moderately strong correlation was found between these variables and the quality of life of all mothers. Subjective and objective participation in health promoting activities is lower in mothers of children with difficulties in sensory processing. Additionally, the quality of life in all mothers was linked to their perceived capability and frequency of engagement in health-promoting activities. Raising awareness to the experience of mothers of children with challenges in sensory processing may help bring to attention the importance of enhancing mothers' engagement in health-promoting activities. Mothering a child with difficulties in sensory processing can influence parents' emotional states and sense of competence, affecting how mothers take part in activities that support their health and quality of life. In this study, 70 mothers of children aged 3-8, with and without difficulties in sensory processing, were asked about how often they participate in activities that promote their health, their experiences, and about their quality of life. The mothers of children with difficulties in sensory processing felt less confident in their abilities and did fewer activities that support their health. Also, in all the mothers, their quality of life was related to how competent they feel and how often they performed these types of activities. This shows how important it is to support mothers of children with sensory processing difficulties helping them feel confident and join in activities that support their health. It is a reminder that family-focussed intervention is key to making sure mothers are doing well too.

Co-parenting, parental competence and problem behaviours in children: examining differential parental roles

In recent years, the increase in child problem behaviours has become a significant public health concern. It is crucial to understand the complex dynamics between parental co-parenting, parenting competence, and child problem behaviours to develop effective interventions. This study explored the intricate relationship between parental co-parenting, parenting sense of competence, and child problem behaviours in a sample of 407 parent-child pairs from Shanghai, China. Findings indicated that neither maternal nor paternal perceived co-parenting significantly predicts child problem behaviours directly. However, maternal parenting sense of competence emerges as a significant mediator between maternal perceived co-parenting (both supportive and non-supportive) and child problem behaviours. This highlights the pivotal role of mothers as primary caregivers in shaping parenting dynamics and child outcomes. Conversely, paternal parenting sense of competence does not mediate the relationship between paternal perceived co-parenting and child behaviours, suggesting a nuanced dynamic within paternal care-giving roles. The study underscores theoretical contributions, validating the theory of inconsistent compensation effect and emphasizing the primary caregiver effect within the Chinese family context.

Caring for a child with cancer: Parental competence, distress, and cortisol levels

Parents of children facing cancer are subject to psychological distress. In this study, we explored whether the time that had passed since a child’s cancer diagnosis was associated with parents’ distress levels and whether parental sense of competence (PSOC) moderated this association. Forty-four parents of children with cancer who were hospitalized during 2022 participated. Parents completed questionnaires and provided hair samples for the examination of hair cortisol concentration (HCC). Correlations indicated no significant association between time since diagnosis and distress indices. Yet, linear regression analysis revealed that PSOC moderated the association between time since diagnosis and parental HCC ( β = −0.36, p < 0.05). For parents with low PSOC, time since diagnosis did not predict parental HCC. For parents with high PSOC, a longer time since diagnosis was associated with lower levels of parental HCC. Our results provide support for the clinical significance of PSOC as a target for intervention.

Does It Take a Village? The Impact of LGBTQ+ Community and Geographic Location on Associations among Parenting Stress, Parent Mental Health, and Child Adjustment.

While LGBTQ+-parented families share many similarities with their cis-het parent counterparts, they still experience unique factors exclusive to them. One such factor is access to the LGBTQ+ community. Utilizing a diverse sample of LGBTQ+ parents with adolescents in the U.S., primarily living in Southern and Midwest states, we examined the potential moderating impact of a parent's sense of LGBTQ+ community on the relationship between parenting stress, parent mental health, and child adjustment. Regression analyses demonstrated a series of positive associations between LGBTQ+ parent stress, parent mental health concerns, and child adjustment issues. However, sense of community failed to moderate these associations. Parent sexual identity, age, and recruitment method were found to have unique associations with outcome variables. Implications for policy, clinical practice, and future research are discussed.

Impact of Rumination, and Dyadic Coping on Parenting Sense of Competence Among Puerperal Women in China: A Cross-sectional Study

This study aimed to explore the potential categories of parenting sense of competence and to analyze the influence of rumination and dyadic coping on the potential categories of parenting sense of competence. A total of 199 postpartum women who met the criteria were surveyed from a tertiary grade-A hospital in Shanxi (China) from May 2023 to August 2023. The instruments included the general demographic characteristics, Chinese version of parenting sense of competence scale, Chinese event related rumination inventory, and Chinese version of dyadic coping inventory. Latent profile analysis (LPA) was used to classify the parenting sense of competence in postpartum women, and logistic regression analysis was used to identify the influencing factors. The characteristics of parenting sense of competence in postpartum women can be divided into two potential categories, namely, easy-to-satisfy group (39.3%) and strict-demand group (60.7%). Logistic regression analysis showed that years of marriage, place of residence, deliberate rumination, and dyadic coping were the influencing factors of the potential categories of parenting sense of competence in postpartum women (p<.05). Through Latent profile analysis (LPA) analysis, it was found that postpartum women's parenting sense of competence exhibits different characteristics. Clinical workers should identify the characteristics and influencing factors of different categories of women and adopt targeted intervention strategies to promote the level of parenting sense of competence.

Resilience and mental health among perinatal women: a systematic review.

This review aimed to assess the current evidence on the relationship between resilience and mental health employed in response to the impacts of mental health. This review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). The protocol of this review was registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023470966). Three authors searched peer-reviewed articles using several electronic databases, including Scopus, PubMed/MEDLINE, Psych Info, EMBASE, and Web of Science, from September to October 2023 and included all the studies from any time until November 1, 2023. The review included all eligible quantitative observational and qualitative studies, irrespective of geographical boundaries. Depression, anxiety, and post-traumatic stress disorders were found to be the most common, but not the only, mental health disorders during the perinatal period, and higher maternal resilience during perinatal periods was found to reduce mental health disorders. It was also found that pregnant women were more resilient to mental health disorders than postpartum women. Tolerance of uncertainty and a positive cognitive appraisal, women's self-behavior and family functioning, and protective psychosocial resources such as dispositional optimism, parental sense of mastery, self-esteem, gratitude, and forgiveness were found to be the most common mechanisms of resilience among perinatal women. Older age, having an adolescent partner, family income, and distress were found to affect resilience. Noting that women's resilience is an important tool to prevent perinatal mental health disorders, maternal healthcare providers need to counsel perinatal women on resilience-boosting mechanisms, such as applying self-behavior and having social support or close family relationships. It is recommended to counsel or provide psychosocial interventions for the woman's companion or partner to give strong support for the woman in each of the perinatal periods. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=470966, identifier CRD42023470966.

Effect of a nursing educational program on competency and parenting practices among parents having children with attention deficit hyperactivity disorder: a randomized controlled trial

BackgroundAttention deficit hyperactivity disorder is a common condition most prevalent among children worldwide. When it comes to parenting, parents of children with attention deficit hyperactivity disorder exhibit lower competency and more negative parenting behaviors than parents of children without the disease. This randomized controlled trial aimed to assess the effect of a nursing educational program on competency and practices among parents of children with attention deficit hyperactivity disorder.MethodsA total of 50 parents, most of whom were mothers with children aged between 5 and 10 years and previously diagnosed with attention deficit hyperactivity disorder, were chosen at random and split into equal study and control groups. The study group received eight sessions of the nursing educational program, with each session lasting 60 to 90 min, while the control group only received routine interventions.ResultsThe results of the current study show statistically significant differences between the study group and control group in terms of positive parenting practices, negative parenting practices, over-reactive practices, functional family practices, interactive practices, satisfactory parenting sense of competency, and effectiveness of parenting sense of competency.ConclusionThe nursing educational program presents benefits in improving parenting practices and enhancing parenting sense of competency among parents of children with attention deficit hyperactivity disorder.

Mothers’ perceptions of children’s emotional behaviour problems and parenting sense of competence: The mediating role of maternal meta-emotion philosophy

We investigated the relationship between mothers’ perceptions of their children’s emotional behaviour problems and their parenting sense of competence, as well as the mediating effect of maternal meta-emotion philosophy in this connection. Participants were 349 mothers of 4- to 17-year-old children (female children = 40.7%, mean age = 8.24 years, SD = 2.95 years). The mothers completed the Strengths and Difficulties Questionnaire, the Parental Meta-Emotion Philosophy Scale, and the Parenting Sense of Competence Scale. Structural equation modelling and simple mediation analyses results showed that mothers’ perceptions of their children’s problem behaviours were linked to higher emotion dimissing and lower parenting sense of competence. Specifically, emotion dimissing mediated the relationship between children’s problem behaviours and parenting sense of competence by the mothers. Furthermore, mothers’ perceptions of their children’s prosocial behaviours were associated with both higher emotion coaching and parenting sense of competence. Emotion coaching mediated the relationship between children’s prosocial behaviours and parenting sense of competence for higher sense of competence by the mothers. Our findings suggest that mothers’ perceptions of children’s emotional behaviour problems may explain their parenting sense of competence through their parenting philosophy. By prioritising their maternal meta-emotion philosophy when dealing with their children’s emotional behaviour problems, mothers can enhance their parenting sense of competence.

First-Grade Transitions: Teachers’ Perceptions of Parental Emotions, Communication Strategies, and Sense of Effectiveness in Parent Engagement

This qualitative study explores the perceptions of 24 female first-grade teachers from northern Israel regarding parental emotions during their children’s transition to first grade. Using semi-structured interviews, it examines the teachers’ communication strategies and their self-assessed skills and training to effectively engage with parents at this critical stage. The findings highlight teachers’ awareness of parents’ concerns about social integration, academic performance, and behavioral adaptation. Despite the importance of effective communication, teachers face challenges due to parental disengagement and over-involvement and report a lack of formal training, relying instead on self-developed strategies.

Maternal interactive behaviors, mothers’ history of childhood adversities, and parental sense of competence

Maternal interactive behaviors, mothers’ history of childhood adversities, and parental sense of competence

Parent stress and social support in a randomized controlled trial of individual versus group parent training for children with HKD/ADHD

AbstractObjectivesAssess (a) the relative benefit of individual versus group parent training compared to treatment as usual (TAU) with an emphasis on parent outcomes. Investigate (b) if group parent training increases social support more than other modes of treatment and explore (c) how social support interacts with different modes of treatment.MethodCompared individual with group parent training and treatment as usual (TAU) in a randomized controlled trial for N = 237 children with Hyperkinetic Disorder/Attention Deficit Hyperactivity Disorder (HKD/ADHD). Employed two formats of the same cognitive‐behavioural parent training in the same settings to maximize comparability. Controlled for medication status and assessed changes from pre‐ to post‐treatment and 6‐month follow‐up.ResultsParents reported more positive changes in the parent training groups than in TAU in relation to child behaviour problems and moodiness as well as more positive changes in parent stress and sense of competence. However, gains on parent stress were limited after group training as were gains on satisfaction. Social support improved similarly in all treatment groups. While results indicated clear main effects of social support on all child and parent measures, interactions of social support and treatment outcomes were found for child moodiness and parent stress.ConclusionsCognitive‐behavioural parent training is beneficial beyond TAU, especially when it can be provided individually. Surprisingly, group training did not reduce parent stress more than TAU or individual training. Social support related to all measures and interacted with treatment on some outcomes. The findings have numerous implications for research and practice.

The Living and Growing Together Program: Effects on Parental Self-Efficacy and Positive Parenting Practices

A number of countries worldwide aim at developing parenting support programs designed to enhance positive parenting practices, and reduce violence against children to enable positive child development. This study aimed at assessing the efficacy of the Living and Growing Together® parenting support program on parental sense of competence and positive parenting practices, well-being, self-kindness, and coherence between parental values and behaviors. The quantitative results, measured through online questionnaires showed that, compared to the control group, the Living and Growing Together® participants reported increased parental sense of competence after the program, improved positive parenting practices, greater levels of well-being, self-kindness, and feeling of coherence between values and behaviors. The qualitative findings indicated that a majority of parents reported improved active listening abilities, emotional acceptance and understanding, use of play to enhance the relationship quality within the family, and finding creative solutions and alternatives to coercive child behavioral control. These results encourage further research on this program and its benefits on child development.

Changes in Caregiver Outcomes After Participation in the Engaged Eaters Program: A Caregiver-Mediated Feeding Intervention for Autistic Children and Their Families.

Caregivers are essential partners in caregiver-mediated interventions that build on family routines and practices. Research identifying how participation as an intervention partner influences caregivers' outcomes, including stress and self-efficacy, is scarce. To evaluate caregiver outcomes (stress, self-efficacy, and positive feeding responses and confidence) after participation in the Engaged Eaters Program. Quasi-experimental pretest-posttest design. In-home via telehealth. Fourteen primary caregivers of an autistic child (ages 2-7 yr) with feeding challenges. The Engaged Eaters Program-Telehealth, a caregiver-mediated 6-mo in-home telehealth feeding intervention for autistic children ages 2 to 7 yr that included 24 intervention visits, eight caregiver training modules, and consultation with a dietician. Relationships between child feeding challenge severity and caregiver outcomes and individual differences in caregivers' intervention responses were evaluated. We assessed caregivers' stress (Parenting Stress Index, Fourth Edition Short Form), self-efficacy (Parent Sense of Competence Scale), Positive Feeding Responses and Confidence (PFRC; composite score of items from other assessments), and individual intervention response using pre- to postintervention change in scores. Exploration of individual differences revealed that only caregivers with intake PFRC scores below the mean made significant improvements by the end of the intervention. No significant group-level changes were identified for stress, self-efficacy, or PFRC. Feeding challenge severity was not significantly related to caregiver outcomes. The results emphasize the importance of considering baseline practices, efficacy, and caregiver confidence when engaging caregivers in intervention. Future research should explore the nuanced relationship between caregiver outcomes and child characteristics. Plain-Language Summary: Caregivers are essential partners with feeding interventions that build on family routines and practices. When working with caregivers, occupational therapists should consider caregivers' readiness for and responses to an intervention because intervention practices may differentially affect caregivers' parenting practices, confidence, and self-efficacy. Caregivers' responses may also affect the overall effectiveness of a caregiver-mediated intervention. Positionality Statement: The term caregiver-mediated in used throughout this article in place of parent-mediated to be inclusive of all types of caregivers.