SCERTS Intervention

SCERTS Intervention
(Social Communication Emotional Regulation Transactional Support)

 

 

What is Social Communication, Emotional Regulation and Transactional Support (SCERTS)?

 

The SCERTS model addresses the core challenges of individuals with autism spectrum disorders that meets the guidelines outlined by the National Research Council, 2001.  SCERTS stands for Social Communication, Emotional Regulation and Transactional Support and was founded by Dr. Barry Prizant and Dr. Amy Wetherby in 2003.  The model is derived from an integration of more than two decades of empirical and clinical work and is consistent with recommended tenets of evidence-based practice espoused by researchers and clinical scholars focusing  on autism spectrum disorders and related disabilities.

The SCERTS model balances extensive research and theory with developmentally appropriate practices.  Building positive relationships with the child and developing the use of functional communication and emotional expression are key components of this model.  This is accomplished through experiences in the educational setting and with caregivers and familiar partners within the everyday environment of the child.  The learning style of the child and the on-going needs of the family, goals of increasing social communication and emotional regulation are addressed.  The SCERTS model is implemented through a multidisciplinary approach including expertise from a number of individuals. 

The SCERTS Model core domains include:

-         Social Communication: communicating and playing with others, sharing joy and pleasure in social relationships, joint attention, symbol use, means of communication

-         Emotional Regulation: attend to the most relevant information in an activity or setting, remain socially engaged with others, process verbal and nonverbal information, initiate interactions using higher level abilities, respond to others in a reciprocal interaction, actively participate in everyday activities

-         Transactional Supports: Interpersonal supports (adjustments made by communicative partners in language use and expression, peer support, friendships, social models), Learning supports (visual supports, curriculum modifications, adaptations to support learning process), Support to families (sharing of helpful information and resources, enhancing family members ability to cope with the challenges of raising a child with ASD), Support to professionals (informal and planned opportunities to enhance to educational and therapeutic skills, emotional support to prevent burnout)

 

Stepping Stones utilizes the seven essential components necessary for reliable and significant progress and change as outlined by Prizant and Wetherby, et al (2007) as a result of implementing the SCERTS model.  Together with families, our staff ensures:

1)      Goals emphasize the functional use of language and communication in all natural settings, not simply the teaching of language and speech behaviors.

2)      A child’s emotional regulation and its effect on communication, social interaction, and learning are always considered, and arousal states are monitored constantly.

3)      Approaches to problem behavior are fully integrated with social-communicative programming and are determined by understanding the range of challenges to a child’s emotional regulation.

4)      Environments are arranged and activities are designed to foster motivation to encourage initiation of communication, a high priority goal for children with ASD.

5)      Transactional supports are used to promote active and independent participation in activities.

6)      Learning and playing with peers is an essential component of education and social learning.

7)      The development of positive relationships among professionals and family members is the foundation for successful collaboration.  A priority is placed on the development of mutually respectful relationships to enhance family members’ sense of competence and trust.

 

The SCERTS Model is NOT exclusionary of other practices or approaches.  Its flexibility allows for the incorporation of practices from a variety of interventions and teaching strategies.  The founders of SCERTS allow that there are a multitude of positive practices and instructional strategies coming from a variety of approaches that have been developed over the last 3 decades for children with Autism Spectrum Disorders (ASD), and as such, where appropriate for each individual child and family, permit clinicians to infuse elements of other approaches into the SCERTS Model.  The staff at Stepping Stones is able to employ these strategies as they deem necessary for the child.  They may include, but are not limited to: Discrete Trial Teaching, Floortime, Natural Environment Strategies, Picture Exchange Communications System (PECS), Visual Schedules and Supports, Video Modeling, Social Stories, TEACCH Strategies, and Positive Behavioral Support. 

 

Teaching Format

Initially teaching is conducted in an environment that will lend to early success.  This often entails removing distracting noise, objects, or other factors.  However, it is important that teaching is quickly extended to ordinary environments.  This serves a dual  purpose: it is more natural instruction, and it promotes the transferal of learning across settings.  Thus, Stepping Stones strongly advocates for therapy and teaching to be occurring at home, at the park, at the grocery store, at the doctor’s office and any other place in the community that the child and family frequent.  Children must be able to learn in varied environments amidst distractions such that they are more adequately prepared for learning in a typical setting such as school.

  

Therapy

 It is our belief at Stepping Stones that the strongest tool we have when teaching a child is our mutual rapport.  To that end, the establishment of a trusting, reciprocal relationship built on respect, playful interactions, and supportive communication is our foundation for teaching and subsequent learning.  We deem it imperative for our therapists to create a warm, playful, reinforcing social relationship with their students.  This relationship isn’t simply important during the first few months of therapy; rather it is the basis of each interaction for the duration of our time with a student. 

 

While Stepping Stones does not prescribe generic treatment protocols and programs for students, we do recognize that therapy typically progresses through a series of phases, regardless of the starting point or functioning level of each child.

 

The Beginning Phase   (Social Partner Stage)

  • Focuses on a child’s ability to orient to a partner by sharing attention, showing emotion, and expressing a wide range of communicative intents
  • Reciprocity of bids for communication is a critical component at this time.
  • Using learning strategies, gestures, and vocalizations are other critical skills to be addressed at this early stage.

 

The Middle Phase   (Language Partner Stage)

  • Monitors the attentional and emotional focus of partner and self
  • Uses a range of communicative functions to include more social purposes
  • Utilizes reciprocity in speaker/listener roles while engaging in extended interactions
  • Uses familiar objects conventionally as directed toward self and others in play
  • Uses learning strategies, conventional and symbolic gestures, and core vocabulary to express a variety of semantic relations are other critical skills to be addressed at this middle stage.

 

The Advanced Phase    (The Conversational Partner Stage)

  • Modifies language based on what a partner has seen or heard
  • Figures out the emotional state of others based on nonverbal social cues, repairs communicative breakdowns
  • Working on subtler social, play, affective, cognitive, communication, perspective taking and Executive Functioning skills is a priority at this time.

 

What sets Stepping Stones’ SCERTS Model apart from other SCERTS models?

Through each of these phases Stepping Stones monitors each students’ level of engagement and rapport with his/her therapists and peers, such that social and emotional development is an ongoing area of growth.  Progress is maximized when the student is actively engaged with the therapist, the learning environment, and his/her peers.  Another way we maximize progress is to encourage generalization of skills from the very first day of therapy. 

 

And finally, through each of these phases, of prime importance to the staff at Stepping Stones are the behaviors a child exhibits or doesn’t exhibit that most dramatically impact the quality of life for the family or the child.  There are a plethora of these types of behaviors and skills.  Some include:  being able to have a family photo taken, sleeping through the night, dining in a restaurant, playing with a sibling, going grocery shopping, a trip to the dentist, playing in the snow, opening a present, and getting a hair cut.  This is by no means an exhaustive list, but it does illustrate some of the areas our families and staff have identified in the past as important.  Each phase of therapy involves identifying these behaviors, creating goals and objectives around change, establishing a way to measure the behaviors, creating and implementing strategies to teach newer, more desired behaviors, and monitoring the effectiveness of the intervention.

 

Of Critical Importance to the SCERTS Program at Stepping Stones

  • Every child is an individual with unique strengths and challenges.  Thus, we will not project a generic treatment plan that is designed to encompass every child.  Our intervention is grounded in research yet crafted to address an individual child and family.
  • Every child must have a manner to communicate that is universally understood.
  • Behavior is a form of communication.  Our charge is to uncover what is being said by that behavior.
  • All children should laugh and smile every day, and an interaction with one of our students is not complete if that does not happen.
  • Academics are only one small piece of a very large puzzle.  There are dozens of other skills that enhance the quality of life for a child and family.
  • The trust of a child and family is priceless.  We will do everything in our power every day to be worthy of that trust.

 

Philosophical Components of our SCERTS Program

  • Relationship building and trust between the child and therapist is an ongoing process.
  • Individual differences in a child’s style of learning, interests, and motivation are respected.
  • The culture and lifestyle of the family are understood and respected.
  • The child is engaged in meaningful and purposeful activities throughout the day.
  • Supports are developed and used consistently across partners, activities, and environments.

 

Program Goals

  • To be an effective early childhood program for children with autism spectrum disorders.  The program is child specific, comprehensive, individualized and family focused
  • To provide an educational environment in which the core deficits of autism spectrum disorders are addressed.  The focus is on building social communication, increasing emotional regulation and providing transactional supports to help the child learn
  • To be flexible and individualized when planning for the social, cognitive, communication, adaptive and motor needs of children with autism spectrum disorders 
  • To join with families to create a treatment team to further the child’s development
  • To help children develop skills that will generalize to alternate settings
  • To facilitate the child’s development of successful social relationships
  • To utilize a data tracking system and the SCERTS Assessment Process (SAP) that fulfills standardized requirements, and to measure progress on the core domains and components

 

References

Leaf, R.. & McEachin, J. A Work in Progress.  New York: DRL Books, 1999.

 

Prizant, B, Wetherby, A., et al.  The SCERTS Model: A Comprehensive Educational Approach for Children with Autism Spectrum Disorders, Volumes 1 and 2.  Maryland: Paul H. Brookes Publishing, 2006.