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Effectiveness of the social communication emotional regulation and

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DOI: 10.37018/IENH3595

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 Original article

Effectiveness of the social communication emotional regulation

and transactional support (SCERTS) model based intervention in
language development and fostering social communication in
children with autism spectrum disorder
Hafsa Fiaz 1,2, Atia-ur-Rehman 3
1
Speech-Language Pathologist, Council of Allied Health Sciences, Pakistan, 2Council of Allied Health Practitioners Qatar, 3Assistant Professor,
Department of Health Professionals Technologist, Faculty of Allied Health Sciences, University of Lahore, Pakistan
Correspondence to: Hafsa Fiaz, Email: [email protected]

ABSTRACT
Background: Social Communication Emotional Regulation Transactional Support (SCERTS) model is based on
studies and has manuals for assessing children and designing individual treatment plans. However, limited research has
been done to evaluate the efficacy of this model. This study attempts to evaluate the impact of SCERTS model-based
intervention on children with Autism Spectrum Disorder (ASD) in Lahore with the objective to determine the
usefulness of SCERTS in promoting language development and improvement in social skills in children with ASD.
Patients and methods: This quasi experimental study was conducted at Roots and Wings autism center, located in
Bahria Town Lahore, for the duration of nine months. Children with formal diagnosis of Autism Spectrum Disorder,
with age range of 3 years to 6 years old. Prior to intervention and subsequently after that, the children were evaluated
with the portage checklist in the domain of language and socialization skills.
Results: Participating children demonstrated improvement in their language and social skills after the intervention, as
assessed by portage.
Conclusion: SCERTS based intervention can facilitate children with autism spectrum disorder to improve their
language and social communication skills.
Keywords:
Quasi Experiment, Social communication, Language development, Autism Spectrum disorder, SCERTS model

INTRODUCTION exhibit considerable problems in their communication

Autism spectrum disorder (ASD) has been defined as a and socialization. (American Psychiatric Association).5
complex developmental condition that Communication and language problems typically are
involves restricted or repetitive behaviors with what define autism. Thus, language development is a
consistent challenges in communication and social common focus in the treatment programs for ASD
interaction.1 According to the Centers for Disease children. It is a wide-ranging approach to improve the
Control and Prevention (2018), one in fifty-nine communication and socio-emotional skills of autistic
children, aged 8 years, is now classified as having ASD.2 children and helping them to become a better social
One previous study determined the prevalence of communicator.6 SCERTS Model's SC component
autism as 6.31% in special education schools of directly deal with the key issues in social
Lahore.3 Poor social relationship was reported to be the communication exhibited by children with autism
most prominent feature among all associated features of spectrum disorder. Specific objectives are targeted for
the disorder.3 From the age two to six years, language enhancing symbolic and social communicative
develop from simple telegraphic speech to fully capacities in different settings. So that, children who
grammatical forms of utterances of a typical child.4 In show a better ability to follow the additional attention
individuals with ASD, in contrast to other challenges, can be facilitated to begin communication interaction.6,7
spontaneous reciprocal communication appears to be a ASD children commonly show impairments in both the
definite problem. According to APA children with ASD receptive and expressive language. However, studies
showed noticeable comprehension problem as compare
to expressive language, in at least one-third of young
Conflict of interest: The authors declared no conflict of interest exist.
Citation: Fiaz H, Atia-ur-Rehman. Effectiveness of the social communication children with ASD. It emphasizes on setting realistic
emotional regulation transactional support model based intervention in suitable goals for communication intervention.8
language development and fostering social communication in children with
autism spectrum disorder. J Fatima Jinnah Medical Univ. 2020; 14(1): 16-18. Presently it is estimated that about thirty percent of
ASD children remain minimally verbal, despite
DOI: https://doi.org/10.37018/ienh3595

© 2020 Fatima Jinnah Medical University, Lahore, Pakistan. J Fatima Jinnah Med Univ 2020; 14: 16-18
Fiaz et al 17

receiving a range of educational opportunities and years selected children before and after intervention.
of interventions.9 Because of the major problem of Evaluation was done to compare before and after
communicative deficits in ASD individuals, the intervention and the scores was compared in order to
management of communication challenges is the main monitor progress. The Language Scale measured the
area of treatment. it is essential to support especially the comprehension and expression of language and
communicative development in order to enable these Socialization Scale measured positive social functioning.
children to integrate themselves into society and be able Statistical analysis was carried out using SPSS version
to participate in daily life in the best possible way. This 25. Qualitative variables were described as frequency
study intends to evaluate improvement in language in and percentages while quantitative variables are
the form of responses during the spontaneous speech measured in the form of mean ± S.D (Standard
opportunities and social communication of young ASD deviations). After checking normality assumptions
children using the SCERTS model. paired sample t-test was used to monitor intervention
results as assessed by portage checklist. A p-
PATIENTS AND METHODS was considered as significant.
This was a quasi-experimental study conducted at Roots
and Wings Autism Center Lahore for a period of nine RESULTS
months. Children were selected on the basis of their age Post intervention assessment showed improved scores
from 3 to 6 years and diagnosis of ASD. Intervention in target domains of their development, as measured by
was made after receiving informed consent from their Portage. These findings support SCERTS model
parents or primary caregivers. Children who had ASD incorporation into autism management services. Table
with any co-morbid disease, similarly children with 1 shows the frequency distribution of age, 30 children
ASD but was taking psychiatric drugs or receiving any were included in the study following the inclusive
medical treatment or whose age was below 3 or above 6 criteria, with the mean age 4.7±0.8years, minimum 3.1
years were excluded. Purposive sampling (non- years and maximum 6.0 years of the age. Out of 30
probability) technique was utilized and sample size was children, 76% were male 23% were females. Children
calculated by using the WHO software and to rectify were assessed before and after the intervention on the
dropouts and for better statistical analysis sample size of Portage subscales. Comparison of the before and after
30 participants was calculated.3 Participating children intervention scores was done in each target domain
attended SCERTS model-based intervention with which resulted in considerable improvement in
45 minutes of individual therapy session five days a language development and social communication after
week and one weekly group therapy session (5 children intervention. Pearson coefficient of Correlation was
in each group). Therapy sessions were carried out in computed to measure the effectiveness of SCERTS
speech therapy booth (2.1 m by 2.1 m) of Roots and model based intervention. The results are presented in
Wings Autism Center. The cubical contained a one- Table 1.
way observation mirror, a table and two chairs The coefficient of correlation between pre-
positioned facing each other. The group training intervention and post-intervention Portage language
sessions was conducted in the classrooms immediately test scores was 0.895 and for Portage socialization test
adjacent to speech booth, at the center. This additional scores was 0.768. And the paired sample t test
location is incorporated to promote use of language administration showed t = -9.893, p <0.0005 for
in social context. Portage assessment tool was utilized to language skills and t = -8.930, p < 0.0005 for Social
rate the child participants, before and after the skills. Based on the means of the independent variables
intervention. It assesses children in major and the direction of the t-value, a statistically significant
developmental areas that includes motor skills, improvement was observed in participants following the
language, socialization, cognition and self-help skills.
Table 1 Frequency distribution of language and socialization scores
Portage checklists have been used as an evaluation before and after SCERTS intervention
instrument level in Variable Mean± S.D Correlation p-value
different domains. For the present study, two subscales Language score
Pre-intervention 11.47±3.711 0.895 .000
relevant to intervention areas were used to rate Post-intervention 14.47±3.471
individual child's developmental progress, which Socialization score
includes the Language Scale and Socialization Scale. Pre-intervention 6.31±1.907 0.768 .000
Post-intervention 8.33±2.040
Portage was administered individually to each of the

© 2020 Fatima Jinnah Medical University, Lahore, Pakistan. J Fatima Jinnah Med Univ 2020; 14: 16-18
 18 Effectiveness of the SCERTS model based intervention in ASD children

SCERTS intervention from 11.47±3.711 to Acknowledgments: This research is supported by Ibadat

Educational Trust a project at University of Lahore, Pakistan. We
14.47±3.471 in language skills and 6.31±1.907 to
also thank management of Roots and wings autism centre, especially
8.33±2.040 socialization skills. Ms. Wajeeha Raouf and Ms. Hajra Jahangir, for helping to conduct
this study.
DISCUSSION
Present study showed that children received the REFERENCES
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special needs centre in Lahore. Regardless of these
limitations, the present study provides primary practical
support to the SCERTS model-based intervention for
ASD in Pakistani context. Discussion also highlighted
further the positive outcomes, such as children was
demonstrating the increased number of opportunities in
beginning interaction for communication which directly
influece on their behavior as there was less behvior
problems noted after SCERTS implementation. Focus
on encouraging the
facilitated their learning. On the whole, significant
improvement was observed in the participating children
in multiple areas after SCERTS model intervention.

CONCLUSION
Children scored better on assessment after the
intervention which proves SCERTS as a better
treatment approach than conventional treatments.

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