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Pediatric Autism Communication Therapy (PACT): To improve outcomes in Children on the ASD spectrum

One of the characteristics of a child on the ASD spectrum is deficits in his/ her social communication. To bridge the gaps in communication skills, the intervention needs to be tailored to match the individual communication developmental level of the ASD child.

Pediatric Autism Communication Therapy (PACT) is an intervention that is evidence based and has proven to improve the social communication skills in children 2-10 years of age, who are on the Autism spectrum Disorder.

In this intervention, the caregivers or the parents are involved and are trained to interact with their ASD children using behavioral strategies that enhance communication development, through a video mediated approach. The concept aims at increasing the quality of parental response to the child which leads to an improved child imitated communication with his/her parent. These communication skills begin at a home setting and are gradually transferred to school, ultimately empowering the child to communicate in the social environment.

The Paediatric Autism Communication Trial – Generalised (PACT-G), a randomised control study conducted by a team of neuro scientists led by Jonathan Green, examines whether PACT therapy is successful at reducing symptoms in the home and school environments of children aged between 2-11 years of age who are on the ASD spectrum.  The subjects were recruited from home, school and NHS clinic setting in in Greater Manchester, London and North-East England.

PACT-G has evolved to include advances in scientific research. It emphasizes on strategies to improve the child’s skills like shared attention and develop object interest and play. These are important steps in the early stages of language development 

The PACT Intervention is a staged approach with caregivers receiving 12 therapy sessions which are alternate between Skype assisted video session and home visit sessions taking into consideration the needs and convenience of the family.  The child and the parent are filmed while doing a pre mediated activity. The video is shared with the qualified therapist which coaches the caregivers to identify behaviours that can incorporate PACT – G strategies to improve social communication outcomes in ASD children. Caregivers are empowered to set goals specific to their child and inculcate these strategies as a part of day to day life for a fixed set of time.

The next stage in therapy is introducing PACT -G intervention at the child’s school environment. The intervention is flexible and modified to suit the school- term schedule.

The sessions are imparted to the trained learning support assistants (LSA), who are qualified to assist children with special needs. The LSA uses the PACT -G strategies to interact with the ASD children in class time on a regular basis (12 therapist – LSA sessions over 6 months over Skype consolations). The videos are shared with the therapists for feedback and evaluation of each child.

REFERENCES

Green, J., Aldred, C., Charman, T., Le Couteur, A., Emsley, R. A., Grahame, V., Howlin, P., Humphrey, N., Leadbitter, K., McConachie, H., Parr, J. R., Pickles, A., Slonims, V., Taylor, C., & PACT-G Group (2018). Paediatric Autism Communication Therapy-Generalised (PACT-G) against treatment as usual for reducing symptom severity in young children with autism spectrum disorder: study protocol for a randomised controlled trial. Trials, 19(1), 514. https://doi.org/10.1186/s13063-018-2881-3