This information sheet has been written to provide information on a particular intervention/approach and any research connected with it, not as a recommendation. The outcome of any approach will depend on the needs of the individual, which vary greatly, and the appropriate application of the intervention. An intervention that may help one individual may not be effective for another. It would therefore not be appropriate for the NAS to recommend any one particular practice or therapy.

What is the SPELL framework?

Over many years the NAS schools and services for adults have developed a framework for understanding and responding to the needs of children and adults on the autism spectrum. The framework is also useful in identifying underlying issues, reducing the disabling effects of the condition and providing a cornerstone for communication. It also forms the basis of all autism-specific staff training and an ethical basis for intervention. The acronym for this framework is SPELL. SPELL stands for Structure, Positive (approaches and expectations), Empathy, Low arousal, Links.

SPELL

The SPELL framework recognises the individual and unique needs of each child and adult and emphasises that planning and intervention be organised on this basis. We believe that a number of interlinking themes are known to be of benefit to children and adults on the autism spectrum and that by building on strengths and reducing the disabling effects of the condition progress can be made in personal growth and development, the promotion of opportunity and as full a life as possible. They are:

Structure

The importance of structure has long been recognised. It makes the world a more predictable, accessible and safer place. Structure can aid personal autonomy and independence by reducing dependence (eg prompting) on others. The environment and processes are modified to ensure each individual knows what is going to happen and what is expected of them. This can also aid the development of flexibility by reducing dependence on rigid routines. Structure plays to the strengths of a sense of order and preference for visual organisation commonly associated with the autism spectrum.

Positive (approaches and expectations)

It is important that a programme of sensitive but persistent intervention is in place to engage the individual child or adult, minimise regression and discover and develop potential. In this respect it is important that expectations are high but realistic and based on careful assessment. This will include the strengths and individual needs of the person, their level of functioning and an assessment of the support they will need. We must seek to establish and reinforce self-confidence and self esteem by building on natural strengths, interest and abilities.

It is vital that assessments are made from as wide a perspective as possible and that assumptions are made on the basis of painstaking assessment and not superficial enquiry. These should include a view of the barriers in accessing opportunity. For example, many people on the autism spectrum may have difficulty with oral communication, leading to an underestimation of their ability and potential. Conversely some may have a good grasp of speech but this may mask a more serious level of disability.

Additionally, many people with autism may avoid new or potentially aversive experiences but through the medium of structure and positive, sensitive, supportive rehearsal can reduce their level of anxiety, learn to tolerate and accept such experiences and develop new horizons and skills.

Empathy

It is essential to see the world from the standpoint of the child or adult with on the autism spectrum. This is a key ingredient in the 'craft' of working with children and adults with autism. We must begin from the position or perspective of the individual and gather insights about how they see and experience their world, knowing what it is that motivates or interests them but importantly what may also frighten, preoccupy or otherwise distress them.

To make every effort to understand, respect and relate to the experience of the person with autism will underpin our attempts to develop communication and reduce anxiety. In this, the quality of the relationship between the person and supporter is of vital importance.

Effective supporters will be endowed with the personal attributes of calmness, predictability and good humour, empathy and an analytical disposition.

Low arousal

The approaches and environment need to be calm and ordered in such a way so as to reduce anxiety and aid concentration. There should be as few distractions as possible. Some individuals may require additional time to process information, especially if this is auditory. They have additional sensory processing difficulties; they may need extra time to process information or we will need to pay attention to potentially aversive or distracting stimuli, for example noise levels, colour schemes, odours, lighting and clutter. Information is given with clarity in the medium best suited to the individual with care taken not to overload or bombard.

Some individuals may be under responsive to sensory experiences and actually seek additional sensory sensations. Again this is best achieved with an approach where the input can be regulated.

Low arousal should not be confused with "no arousal". It is of course desirable that individuals are exposed to a wide range of experiences but that this is done in a planned and sensitive way. It is recognised that for the most part the individual may benefit most in a setting where sensory and other stimulation can be reduced or controlled. Additionally, supplementary relaxation and arousal reduction therapies, Snoezelen, music and massage, sensory diet etc. may be helpful in promoting calm and general well-being and in reducing anxiety.

Links

Strong links between the various components of the person’s life or therapeutic programme will promote and sustain essential consistency.
 
Open links and communication between people (eg parents and teachers) will provide a holistic approach and reduce the possibility of unhelpful misunderstanding or confusion or the adoption of fragmented, piecemeal approaches.

The people with autism, their parents or advocates are very much seen as partners in the therapeutic process. Links with the mainstream, through curriculum and other experiences, enable the individual to participate in a meaningful way in the life of the wider community.

The SPELL framework can be applied across the autism spectrum, including Asperger syndrome. It provides a context for and is complementary to other approaches, notably TEACCH (Treatment and Education of Autistic and related CommuniCation Handicapped children.)

Publications

Approaches to Autism: an easy to use guide to many and varied approaches to autism. London: The National Autistic Society, 5th ed. 2007. 1905722214
A comprehensive guide to some of the many different approaches that are used in the education and care of children and adults with autism.
Available from the NAS Publications Department

Beadle-Brown J. and Mills R. Understanding and supporting children and adults on the autism spectrum. Brighton: Pavilion Publishing (Brighton). 2010. 9781841962719

Beadle-Brown J., Roberts R. and Mills R. Person-centred approaches to supporting children and adults with autism spectrum disorders. Tizard Learning Disability Review, 2009, Vol 14 (3), pp. 18-26.
Available from the NAS Information Centre

Mills, R. Q & A: SPELL. Communication, Winter 1999, pp. 27-28.
Available from the NAS Information Centre

Povey C. Autism spectrum conditions and services In: Chaplin E., Hardy S. and Underwood L. eds. 2013, Autism spectrum conditions: a guide. Hove, UK: Pavilion, pp. 67-79

Povey C. Commentary on person-centred approaches to supporting children and adults with autism spectrum disorders. Tizard Learning Disability Review, 2009, Vol 14 (3), pp. 27-29.
Available from the NAS Information Centre

Available from the NAS Information Centre

Siddles, R.  After diagnosis - how to go forward dealing with your child’s difficult behaviour.   Communication, Winter 1997, p. 10.
Available from the NAS Information Centre

Siddles, R. et al.  SPELL - The National Autistic Society Approach to Education. Communication, Spring 1997, pp. 8-9.
Available from the NAS Information Centre

Tutt, R., Powell, S. and Thornton, M. Educational approaches in autism: what we know about what we do. Educational Psychology in Practice, 2006, Vol 22 (1), pp. 69-81.

Contacts

If you require information on training contact:

NAS Training and Consultancy,
The National Autistic Society,
1st Floor Central Chambers,
109 Hope Street, Glasgow,
G2 6LL
tel: +44 (0)141 285 7117
fax: +44 (0)141 221 8118
email: training@nas.org.uk

 


 

 

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