Combined, Multi-Component Interventions and Autism

Introduction

Combined, multi-component approaches use a wide range of techniques to target a specific range of behaviours or developmental areas. For example, the SCERTS model is designed to target ‘Social Communication, Emotional Regulation and Transactional Support’. By contrast, TEACCH approach uses a set of techniques known as structured teaching to target a range of behavioural and developmental issues.

In practice, many behavioural and developmental interventions found elsewhere on this website (such as some forms of early intensive behavioural intervention) are comprehensive, multicomponent approaches. Here we focus on those comprehensive, multi-component interventions not covered elsewhere in this website: the SCERTS model and the SPELL framework.

Combined, multi-component interventions

use a wide range of techniques such as: modelling (demonstrating desirable behaviour) and reinforcing (e.g. praising desirable behaviour)
may be delivered by parents and carers, by professionals, or by a combination of these
may have a 'treatment manual', which tells the providers how to deliver the intervention

Some multi-component interventions (such as the SCERTS Model and the SPELL approach) are designed for anyone on the autism spectrum.

Other multi-component interventions are designed for specific groups of autistic people. For example, the Early Start Denver Model and PACT are designed to help pre-school children. For more details please see Pre-School Interventions.

Evidence

Some high-quality evidence shows that autistic people have difficulties with the core features of autism such as difficulties with social communication and social interaction, restrictive, repetitive and stereotyped patterns of behaviour and sensory issues. The evidence for the effectiveness of comprehensive, multicomponent approaches is mixed. For example, some approaches, such as TEACCH, may provide some benefits to some autistic people according to a limited amount of research evidence of sufficiently high quality. Determining the benefits of other approaches, such as SCERTS or SPELL, is not possible. We must wait for further research of sufficiently high quality to be completed.

Risks and safety

No risks are known for most forms of comprehensive, multicomponent approaches

Specific interventions

SCERTS model

The SCERTS model is an approach which focuses on Social-Communication, Emotional Regulation and Transactional Support.

The aim of the model is to directly address the core deficits observed in the individual autistic child. It does this by addressing key areas such as social communication, social relatedness and sensory characteristics, as well as by providing support to the individual and to the family.

Practitioners following the model use a combination of techniques and strategies, many of them borrowed from other interventions, in order to meet the specific needs of the individual child.

More information please see

publications on the SCERTS model

SPELL Framework

The SPELL framework was developed by the National Autistic Society for understanding and responding to the needs of children and adults on the autism spectrum.

The framework is useful in identifying underlying issues, in reducing the disabling effects of the condition, and in providing a cornerstone for communication.

It also forms the basis of all autism specific staff training and an ethical basis for intervention.

SPELL stands for Structure, Positive (approaches and expectations), Empathy, Low arousal, Links.