Frequently Asked Questions

Implementing PACT

Materials and equipment required include a video camera (e.g. camcorder or pad), memory card, screen for video play back (e.g. laptop), secure video storage (e.g. encrypted external hard drive) and a range of toys. The list of suggested toys is contained in the PACT manual.

PACT may be delivered in the home, at a centre/clinic, other caregiver setting  or online. PACT practitioners are advised to consider home factors that assist the PACT sessions e.g. an appropriate space/ room, considering creating a quiet, calm setting, managing distractions (e.g. TV, video, radio off).

 In low resource settings play may include available everyday or household items, e.g. cooking utensils, large boxes, food, fabric, a ball, bubbles. The child's motivation is considered when selecting suitable play material.

PACT can be delivered through live online methods. Please see our PACT teleconference guidance:

PACT Teleconference adaptations 150320.

For children who are not motivated by toys, interaction and play with no toys is included in PACT e.g. songs, music, rhymes, actions, interaction games.

Post-Course Supervision

PACT requires practice in implementing the clinical competencies and PACT techniques e.g. using cascading probes in therapist feedback, developing therapeutic alliance with parents/ carers, observation skills and video analysis, selecting video clips, setting social communication goals and measuring progress through the stages. Training in these clinical competencies is progressive from the 2 day live training course through supervised post-course clinical practice to gain PACT accreditation.

Trainees have 6 months to complete the post-course work following the Level 2 training course. Trainees should identify practice cases prior to attending the course. The first video for supervision should be submitted within 3 months, and the second video within 6 months. Extensions may be offered in exceptional circumstances, at the discretion of the IMPACT team.  You may submit your two practice videos of the same family or two different families.

You will need to submit:

  • A video of a full PACT session including: review, adult-child play session, feedback and goal setting.
  • A copy of the written programme.
  • A translation of the session into English, where applicable. Please email info@pacttraining.co.uk to confirm whether a translation is needed.

Please email info@pacttraining.co.uk to request a secure link to upload your files.

Trainees may choose to practice with more than 2 families. The IMPACT senior trainer will view two case videos (including the parent-child play, therapist's feedback session with the parent, setting home goals and a copy of the written home programme). The senior trainer provides supervision and feedback once one video has been viewed, the trainee continues to practice, and then submits the second case video for fidelity rating. Once trainees pass the fidelity, they receive a PACT certificate. The trainee may be asked to submit a further case video if they do not pass fidelity initially, please note that there is an additional fee for this.

This depends on how quickly the trainee can find the practice cases. If parents have agreed to practice sessions prior to the professional attending the 2 day PACT course, the practice usually takes 3 months. Where trainees need time to identify practice cases and may require more practice, post-course fidelity may extend to 6 months. It is recommended post course work commences within 1 month of completing the 2-day live PACT training. You may  submit  your two practice videos of the same family or two different families.

Post course supervision is  delivered individually where the senior  PACT supervisor views and rates your individual trainee videos.

Trainees send the case video using a secure web link or on an encrypted memory stick for senior trainer review. Feedback and supervision is provided online and a written summary provided by email. For centres becoming PACT centres of excellence, a local PACT lead may review trainee post course videos in face-to-face supervision sessions.

 If you are unable to upload videos online, we can use an encrypted memory stick to send the videos to IMPACT.

In usual circumstances, we ask you to identify two practice cases before attendance at the face-to-face training and deliver a 2-3 sessions for both cases. However, we understand that identifying practice families may be more difficult at the moment.If you are unable to identify two suitable cases due to COVID-19 restrictions, we recommend that you identify a friend or extended family member with a child to work with instead. The child does not need to present with any communication difficulties. The post-course work and accreditation process focuses on your therapeutic skills and ability to implement the PACT protocol, rather than the skills of the child. Following feedback from your supervisor, you may then continue to work with the same family or identify another family to work with for 2-3 sessions to complete your post-course work.

During times of  restricted face-to-face contact, you may record the parent-child play and your PACT practice feedback session with the parent using the record button on the online platform and submit your video recording  of your practice PACT session. When you click 'record' on the online platform, the recording  is automatically saved on your computer  (usually  in  documents). Parents  have  the choice  of sending 2-3 2 minute pre-recorded home-made clips of  parent-child play or you may record the parent-child play using the online platform. You  can save the recording on your computer, then click 'share screen' to watch the full video and review the two best 1 minute video clips whilst delivering PACT feedback with the parent. PACT supervisors are only observing your practice and demonstration of  PACT  techniques.

Only PACT associates and local PACT leads can provide post-course supervision. Please see ‘Developing a PACT service’ for further details. Please email info@pacttraining.co.uk if you wish to become an associate or local lead.

The videos should show a full PACT session which usually lasts 1-1.5 hours. Often, trainees break the videos down into three separate videos (review, adult-child play video, feedback & goal setting) to make the uploads quicker.

The video can show any PACT stage, but we’d recommended completing a couple of sessions before recording a session to submit. We need to see all elements of a PACT session including the review of previous goals.

You can choose which would be most beneficial for you. We ask you to submit only one session initially and then practice some more, focusing on areas identified in supervision, before recording and submitting the second session.

Most trainees choose cases that reflect their usual caseload, so consider what will be most helpful to your usual work. Some trainees also choose to select two different presentations (e.g. a non-verbal child and a verbal child) to gain more varied experience.Our main focus in supervision is on your skills as a therapist and ability to follow PACT protocol, rather than the child/family presentation, therefore we don’t give specific recommendations about this.

The Sharepoint platform we use does allow large video files to be uploaded, however you may wish to break the session down into 3 videos – the review, the adult-child play session and then the feedback/goal setting, by stopping and restarting the video between these. This reduces the time it takes to upload files.

DEVELOPING A PACT SERVICE

A professional wishing to become a PACT trainer gains experience of 5 clinical cases after achieving accreditation. Following this, they may become a PACT trainer by co-training on a Level 2 training course and co-rating two post-course supervision videos with a senior IMPACT trainer.In the UK, PACT trainers are associates for IMPACT. All training courses are arranged and advertised through IMPACT. If you would like further details, please email info@pacttraining.co.uk to express an interest in becoming a PACT trainer.

We have a number of implementation trials to test PACT in different communities, countries, cultures. We support local communities piloting and delivering local implementation trials by gaining feedback from users and parents (e.g. measuring changes in parent self-efficacy, family life questionnaire, parental values and aspirations) to inform help inform local service delivery and feedback social values to our IMPACT social enterprise. Several UK based PACT services have gained NHS funding based on quality measures of this kind.

Qualified  professionals with experience in working with children with autism and families is required to be able to train in PACT. A minimum of 5 years clinical experience including 2 years experience of working with children with autism and their families is required to be eligible for accredited PACT training. Professionals with less experience may still complete the PACT level 1 e-learning course.

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