SPELL is an acronym that stands for Structure, Positive approaches and expectations, Empathy, Low Arousal, and Links. This framework is designed for the unique needs of children on the autism spectrum, so treatment planning and interventions can be organized appropriately. While all people on the autism spectrum benefit from the SPELL approach, regardless of age or autism severity, it is especially beneficial for children.
One of the common symptoms of autism is struggling with change, and those with autism benefit from routine and ritual. SPELL helps people on the autism spectrum using visual information to create structured environments, which supports them in becoming more autonomous and independent. This can reduce dependence on others and reduce anxiety as the person with autism can better understand what is expected of them.
The Five Steps That Spell SPELL
SPELL was originally established by the National Autistic Society as the best approach to support people on the autism spectrum. SPELL not only helps individuals with autism, but their caregivers, parents, teachers, therapists, pediatricians, and others.
The five aspects of SPELL that make up the acronym are:
- Structure. Structure and learning how to create it is vital for people with autism. For people who struggle with socializing and communication, understanding how the world works is challenging and stressful. Reading body language and facial expressions is harder for people on the autism spectrum, so they need direct instruction. Helping people on the autism spectrum develop structure for their lives can ease stress and anxiety from feeling uncertain. When someone on the autism spectrum has more structure in their lives, they can feel more confident, which can improve their independence.
Structure should enable the individual with autism to predict future events as much as possible. When creating structure, work with the person with autism to modify their environment, choice, learning, and communication to set up routines that will work the best for them. This can be based on existing routines but enhancing them to make sure each step is clear. This can be especially important for children. Visual calendars, timetables, or programs that the child helps create can all be good ways to develop and review structures. - Positive approaches and expectations. One of the best ways to support someone on the autism spectrum as they strive for more independence is to focus on that person’s strengths and abilities. Positive encouragement involving praise for proven skills can help people on the autism spectrum overcome apprehension about going into unfamiliar situations. Many children on the autism spectrum avoid unfamiliar situations and become distressed when they experience sudden changes. This step can help them relax and focus on what they know, so they can move forward.
Those working with neurodivergent children should not simply leave the child to their own devices once the structure is in place. Work with parents or caregivers to ensure the child receives praise for completing steps and doing well, especially when it involves a skill the child has just learned or is proud of. Actively intervene in ways that enhance the child’s quality of life. This may involve finding physical, emotional, and educational support, adding to the child’s social support network. - Empathy. Parents, caregivers, teachers, and therapists for people with autism must have empathy. It is essential for those involved in the life of someone with autism to understand what that person loves, becomes excited by, and finds appealing. This can also give insight into what causes distress in people on the autism spectrum, so that you as the caregiver can respect their feelings and support them better with positive reinforcement.
Empathy should be the basis for Applied Behavioral Analysis (ABA) therapists to assess the child’s improvements and struggles as they go through behavioral therapy. This may include recording causes of stress that lead to escape or aversive behaviors, eliminating or reducing known stressors as much as possible, examining the therapy space regularly for stressors, talking to parents or other caregivers about potential stressors, and self-examining to determine any potential stressors. - Low arousal. New experiences and changes in events can lead to overstimulation in people with autism, so it is important for caregivers, parents, teachers, and therapists to help the person remain calm during interactions. During sessions involving SPELL, therapists should reduce stimulation in the room in a way that is beneficial to the individual. This may involve lowering the lights, providing soft or soothing toys, finding ways to reduce noise, or offering sensory distraction toys such as fidget spinners or weighted blankets.
Creating an emotional and physical environment that reduces arousal is based on empathy. It is important to develop a nonconfrontational and nonjudgmental style of interaction, sticking to routines for scheduled therapy sessions and taking regular audits of self and space to continue to support a low arousal experience. - Links. The final step in SPELL is links, which are the positive social connections between people on the autism spectrum, their families, and their caregivers. These connections help everyone share information to best support the individual with autism, so there is less confusion about treatment plans, symptoms, methods of support, positive changes, and other approaches.
It is important for ABA therapists, parents, teachers, and other caregivers to maintain a high level of consistency in communication, including setting up regular opportunities for meeting and talking.
SPELL Creates a Supportive Worldview
SPELL is an important approach to take when supporting a child or adult on the autism spectrum. It provides a broad overview for how caregivers of all kinds, including parents and ABA therapists, should engage with the individual with autism and with each other. While SPELL is not a treatment plan in and of itself, using it can greatly improve the life of the person with autism.
References
Strategies and Interventions — SPELL. (August 2020). National Autistic Society.
Understanding and Responding to Autism: The SPELL Framework. (2018). Pavilion Publishing and Media Ltd.
SPELL Framework Training. University of Kent.
