Parent Coaching Did Not Significantly Reduce Developmental Disability Costs

The analysis identified a possible improvement in the mental-health component of parental well-being, but the estimated difference was not statistically significant. Families continued to experience substantial caregiving and financial burdens despite access to coaching. The health-economic analysis used data collected for the BRIGHT Coaching randomized controlled trial in Quebec, British Columbia, Nova Scotia and Manitoba, Canada.

Families were randomized in a 1:1 ratio to the intervention or control group, with randomization clustered by province. BRIGHT Coaching is designed to help parents navigate service systems and manage the complex needs associated with a child’s emerging developmental disability. Researchers collected information at baseline and eight months after the intervention through a Resource Use Questionnaire and the 36-Item Short Form Health Survey, which assessed parental health-related quality of life.

The analysis focused on publicly funded services used by children and parents, household productivity losses and parental well-being, rather than directly measuring the clinical effects of the children’s developmental conditions. Parents most frequently reported using publicly funded children’s services including speech-language therapy, occupational or physical therapy and additional health services, reflecting the multisector needs associated with developmental disabilities. Costs were analyzed from a public payer’s perspective and expressed in 2024 Canadian dollars.

Parents reported service use and lost household productivity, while a two-part regression model estimated public-payer costs per child. Across both trial groups, the model estimated mean public-payer expenditure of CAD $2,571.84 per child, with a 95% confidence interval of CAD $1,800.07 to CAD $3,343.62. The intervention group’s estimated cost was CAD $1,097.43 higher than the control group’s, but this difference was not statistically significant: its 95% confidence interval ranged from a reduction of CAD $467.44 to an increase of CAD $2,662.30, and the p-value exceeded 0.05.

The study also detected no significant between-group differences in median public-payer costs, household productivity losses or overall parental health-related quality of life. Productivity losses were reported by more than half of households and were estimated at CAD $9,830.54 per family, with a 95% confidence interval of CAD $7,624.41 to CAD $12,036.66. At eight months, the intervention group’s average mental-health component score was 2.51 points higher than the control group’s average, indicating a possible direction of benefit for parental mental health.

That estimate, however, was not statistically significant, with a 95% confidence interval of -0.025 to 5.05 and a p-value above 0.05. The findings therefore do not demonstrate that BRIGHT Coaching reduced public spending, household economic losses or parents’ overall quality of life during the assessment period. The authors concluded that the program may support parental mental health and service access, while the persistence of substantial caregiving burdens shows that coaching did not remove the financial challenges faced by these families.

As an analysis of one randomized trial, the study also limits how broadly its estimates can be applied: its findings describe families of preschool children with or at risk of developmental disabilities in four Canadian provinces over an eight-month period, and the statistically uncertain cost and mental-health estimates do not establish either benefit or harm.

Subject of Research: Health-economic effects of parent coaching for preschool children with or at risk of developmental disabilities

Article Title: Public payer resource use, costs and parental well-being in children with emerging developmental disabilities

Article References: Jia, X. Y., Moretti, M. E., Ungar, W. J., Wittmeier, K., Filliter, J. H., O’Donnell, M., Khan, F., Smith, T., Zwicker, J., & Majnemer, A. (2026). Public payer resource use, costs and parental well-being in children with emerging developmental disabilities. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15425-x

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15425-x

Keywords: developmental disabilities, parent coaching, BRIGHT Coaching, public-payer costs, household productivity losses, parental well-being, randomized controlled trial, preschool children, health economics, Canada, Public, payer