Paediatric Autism Communication Therapy (PACT)

What is PACT?

PACT is an evidence-based, neuro-affirming intervention that supports parents and carers to strengthen communication and emotional connection with their child who is autistic or experiences differences in social communication.

PACT is not about changing who a child is. Instead, it focuses on understanding and responding to each child’s individual communication style and supporting enjoyable, meaningful interaction between the child and their caregiver.

PACT is an indirect therapy approach. This means the therapist works with parents and carers rather than directly with the child, supporting them to adapt their own interaction style in ways that are responsive, attuned and supportive of their child’s communication.

What does PACT involve for families?

• PACT is typically offered as 12 online sessions over approximately 6 months.
• Before each session, parents record and share a short (around 10-minute) video of everyday play or interaction with their child.
• During sessions, the therapist and parent watch and reflect on the video together. The therapist supports the parent to notice their child’s communication signals, how they respond to their child, and how small, and how small, achievable changes may further support connection and communication.
• Families are encouraged to practice these strategies in short, regular playtimes at home (usually around 30 minutes per day).
• As PACT is an indirect intervention, the therapist does not work directly with the child but instead supports the parent through collaborative discussion, video feedback, and reflection.

When might PACT be suitable?

Child factors:

• An autism diagnosis or clear differences in social communication (with or without a confirmed diagnosis).
• Typically aged around 2-11 years, with the strongest evidence for preschool and early primary-aged children.
• Shows intent to communicate in any form, such as vocalisations, gestures, facial expressions, leading an adult, or emerging words.
• Experiences differences with back-and-forth interaction, for example, shared attention, turn-taking, or initiating and maintaining interaction.
• May have additional developmental needs, with social communication being a key area of focus.

Family Factors:

• Parents or carers are willing and able to take part in a parent-led intervention, with the therapist working with them rather than directly with the child.
• PACT works best when one identified lead caregiver (for example, a parent or primary carer) takes part in the sessions. This helps build a shared understanding over time and allows individualised learning within the parent child relationship to build gradually across the programme. Other family members may be involved in everyday play and practice where appropriate.
• Families feel comfortable with video recording and receiving feedback in a supportive, collaborative way.
• Parents can commit to the programme, usually 12 fortnightly sessions, alongside regular play-based practice at home.

PACT was developed by leading UK clinicians and researchers, Professor Jonathan Green and Dr Catherine Aldred, and is supported by a strong research evidence base. For full information about PACT, including its evidence base and how it works, visit the official PACT Training website: www.pacttraining.co.uk.