Improving access to social care for adults with autism
Two common approaches
Among many frameworks for supporting people with autism, two interventions are common at a service level. We list them here not as a recommendation for any individual, as different approaches may work more or less effectively for different people, but for information purposes.
The SPELL framework, developed by the National Autistic Society, is based around five key pillars:
- the importance of STRUCTURE in making the world predictable and manageable
- POSITIVE approaches and expectations as a way of building people's strengths
- an EMPATHY for the way a person with autism perceives their world, so that things they find positive can be focused on, and things they find distressing can be avoided
- LOW-arousal approaches, in both a sensory and interactional sense
- LINKS with families and supporters to ensure consistency and predictability in how people are supported.
SPELL also stresses the individuality of each person with autism as the basis of all interventions with them, and therefore the importance of getting to know a person in real depth. Applying SPELL principles can support people across the autistic spectrum, and can complement other approaches such as TEACCH.
TEACCH stands for the Treatment and Education of Autistic and Communication-handicapped Children, and although there is an education focus, it is also used with adults. It was developed in North Carolina in the 1960s and 1970s, and now forms the basis of a range of interventions with children and adults with autism, such as diagnosis and assessment, individualised support, special education, social skills training, employment training and support to families.
The TEACCH programme aims to support people with autism to manage successfully their home, educational and professional lives, by addressing environmental obstacles, and by working with people to adapt their behaviours. There is a focus on structured learning and skill development.
Several tools are used to assist the communication of people with autism, many involving visual devices. PECS - Picture Exchange Communication System - involves swapping pictures for a desired activity or object, and labelling involves attaching a symbol to the thing it represents. Some people with autism use Makaton - a communication system that combines words, gestures and a small core vocabulary of signs.