Neurodiversity

The intent of the PACT approach

24/02/2025

By Professor Jonathan Green, Carrie Alvarado PhD, OTR, Louisa Harrison, Hannah Danvers, Wilson Mora and Kate Lemon

This article was originally published in August 2024 on the PACT Training website, www.pacttraining.co.uk.

What PACT recognises of autistic children and their families

PACT is a therapeutic support for autistic, or possibly autistic children and their families that is quite different from traditional models of care. PACT recognises that autistic children deserve to have their emotional needs met and their interests honoured, just like every child. PACT also recognises that parents of autistic children aim to meet these needs yet may struggle to understand their children, whose state of regulation, communication styles and motivations can feel perplexing.

What PACT intends to do through it's therapy

PACT seeks to build bridges of connection, understanding and trust between parents and their young autistic children. In PACT, we help parents find ways to notice, attend and attune to the individual needs of their children. Together with the parents, we review their video of play with their child to capture moments of connection and capacity to relate to both the parent and the child. Through video feedback, we can freeze key moments in time, rewind, slow down, and reflect on what we see. By doing so, parents recognise their own existing strengths in understanding and responding to their children. We help them build on these skills, affording a greater sense of empowerment and validation for both the children and their parents. We can help unpack anxieties. We can sharpen observation and intent. We can illuminate increasingly frequent and robust moments of confidence and communicative agency. By identifying strategies parents can use to stay connected with their children, we can gradually strengthen the parent-child relationship.

'The knowledge and mediation offered by PACT have allowed us to have an unwavering connection with Cameron. We were told he would not have an imagination or really show love or connection with family or friends. Although easy to believe when you are told by a doctor, that is the farthest thing from the truth. Social reciprocity,... imagination, and LOVE, are in each of our autistic kiddos when they are supported, heard and understood. PACT taught us as parents how to be the ones to show Cameron how meaningful every action, feeling, and form of communication is, and he finally felt heard.' - Cameron’s parent

What research has shown

Research in PACT has told us that autistic children who are met with parents who can attune, who can validate, and who can meet the child where they are, become increasingly confident and spontaneously communicative as they grow. Parents report PACT support as a “game-changer” for themselves and for their children, and, most importantly, for their relationships with each other.

'He seems to be enjoying things so much more now and having confidence in himself. There are still things that are difficult for him, but now he keeps trying, whereas before he would give up. I feel very peaceful these days.' - Aaron’s parent

'He used to cry with his haircuts. He would see the building and cry. Now he goes up to the chair alone and sits like a big boy. I added a video of my birthday this past Tuesday. I was so glad my husband caught it on camera! It was the best present ever to hear him tell me “Happy Birthday” and try to blow the candles. He is doing so good in school right now. He is talking and singing so much. He loves his baby brother and is always trying to snuggle him.' - Edwin’s mom

Research has also told us that this growth in confidence and connection for children who experience PACT continues to deepen over time. Children with early-on support via PACT experience persisting benefits in their social confidence and communication, their management of stress, and their ability to navigate the wider world as they grow. These autistic children flourish as they age, as they receive what they need early, a relational ecosystem that supports their struggles and honours their strengths.

'I think experiencing shared attention (in early PACT years) gave me that skill of knowing how to share; let's call it a shared experience…I’m that open person who gets on with everyone… It's like, come on, join us. It was an exposure to those sensitive adults; I thought, this person is interested in me, knows what I'm thinking and sees what I see. It was just having fun, it was play, just enjoyment, your style, things you're really interested in and building a relationship. Yeah, the child finds a way, like he's always… once you join it with me, I'lI join you, and it’s a connection… Even my teachers seemed like friends in that relationship building; you felt like you were connected to someone. Even if it's just like a very small thing.' - 21-year-old who received PACT as a child