Information for Commissioners

PACT is a validated intervention that supports social engagement, celebrates differences, and enhances communication. It is the first autism intervention rigorously tested to show a sustained long-term impact on improved social communication outcomes in autistic and neurodiverse children and can radically improve services.

1. The current scientific evidence supports a radical move away from the well-trodden pathway in child autism services. Families face service provision that is patchy and poorly evidenced, with long waiting lists and typically focused on reactive behavioural management. Current scientific evidence demonstrates that PACT leads to long-term improved outcomes valued by autistic individuals, parents/carers, and professionals aiming to improve pressure on scarce services.
2. PACT research trials from 2000 to date and Lancet publications of PACT are the first autism interventions to show significantly increased communication skills in autistic children, with effects sustained at 6-year follow-up and a wide potential impact on public sector services. Further studies have established causal processes in autism development and a potential marker for autism intervention. For a summary of PACT please click here
3. PACT is part of an evidenced and published new Autism Care Pathway, with continuous support from early identification to pre-diagnostic and post-diagnostic intervention recommended in the NHS and internationally. The care pathway is being trialled in Greater Manchester NHS, and further rollout is planned across the UK and globally. PACT shares the concepts and terminology with ADOS 2 and video autism diagnostic tool, thus more aligned to a continuous care pathway.
4. Rigorous health economic evidence shows that investing in the early proactive application of this intervention leads to a threefold reduction in later service needs. Click here.
5. The PACT therapists work through parents or caregivers rather than directly with the child, which is efficient with therapist time and empowers families. An international survey of PACT training (2020, n=332) found strong parental endorsement of relevance and acceptability. Click here.
6. IMPACT has trained over 1,300 professionals in PACT in 30 countries to date, a potential reach already to >500,000 families worldwide and projected to be >2 million families by 2027, based on  PACT therapist delivery. Efficiencies in online PACT delivery have created an international digital PACT practice community.
7. IMPACT webinars on the PACT model and evidence-based autism care had 446 attendees from 12 countries in 2020 and 1005 registrations from 19 countries in 2022.
8. NHS England recommends an integrated care pathway combining PACT with iBASIS- VIPP early intervention and is funding its NHS implementation. Click here.
9. Social communication interventions like PACT are the sole NICE recommendations for autism symptoms, as well as the European ESCAP Guideline, which recommends interventions that focus on early parent–child interactions. Click here.
10. PACT has been highlighted in Parliament and national reviews and recommended for roll-out in the NHS. Click here. Autistica charity recommends the implementation of PACT in the autism care pathway throughout the NHS. Click here.
11. PACT is the first autism evidence-based intervention to be successfully replicated in Low and Middle-income Countries (LMIC), demonstrating its potential for incorporation into existing world health provision delivered in communities, focusing on culturally appropriate, feasible and scalable delivery with a trial developing efficient online delivery. Global Health trials are digitising practitioner training to support worldwide reach. Click here.

1. PACT is efficient and accessible for children in a range of caregiver settings and adapted to online video conference delivery. It also embodies a more progressive approach that embraces autistic people’s differences and attributes, realising individual potential instead of aiming to ‘normalise’ or ‘mask’ atypical behaviour, a valued priority reported by the autism community.
2. PACT is ready for use, and accredited training is immediately available. The therapy resources and training for PACT have been digitalised for efficient online delivery.
3. For commissioners interested in PACT introduction awareness training click here.

PACT is ready for use, and accredited training is immediately available. The therapy resources and training for PACT have been digitalised for efficient online delivery.

To register for PACT introduction awareness training, please click here

Costs

The only significant costs in providing PACT are the one-off costs of training health and care staff and the salary costs of those staff delivering the therapy course, which largely depend on the arrangement of local personnel. A range of health and care professionals from NHS pay band 5 upwards can be trained to deliver PACT, including speech and language therapists, psychiatrists, psychologists, occupational therapists, specialist teachers, and nurses. NHS teams may consider a skill mix of PACT professionals. Some existing UK services managers are happy to advise and guide others on embedding PACT in an Autism Care Pathway.