Table 2 Considerations for adaptation during psychosocial support

Where possible, we suggest that 1:1 support or supplementary 1:1 support is provided. Consideration could be given as to whether the individual would prefer to engage in-person or on-line. The following adaptations may be helpful when working with autistic individuals of all ages:

 • Introduce and maintain a structured approach (e.g. frequency, duration and timings of sessions)

 • Consider using the three ‘V’ approach to structure: visual schedules, visual instructions and visual clarity

 • Ensure that the rules of the individual or group work are understood

 • Use clear, concrete language and avoid abstract language

 • Provide time and space for the individual to process new information

 • Consider whether some autistic individuals need more sessions and more time to apply and generalise skills in between sessions

 • When establishing rapport and working therapeutically, alternatives to verbal communication may be helpful. Where feasible, this might include communicating via music, art or computer games

 • Behavioural, rather than cognitive work may be more effective, when applicable. However, some autistic individuals will respond well to the detailed theoretical and logical analysis, which can be critical in some interventions

 • Incorporate healthy special interests/passions when appropriate, as sources of reward and wellbeing. Manage risky special interests/passions and develop the individual’s skills to do this

 • Adapt materials to attend to autism learning styles such as visual learning, modelling with practice, social stories and appropriate handouts to summarise and integrate the learning

 • Create an environment that attends to possible sensory sensitivities (e.g., minimising noise,

 • artificial lighting, strong smells, need for movement)

 • It may also be helpful to keep work areas clutter free and quiet

 • Remain mindful of frequently co-occurring conditions such as anxiety and low mood, which may affect motivation and engagement during intervention

 • Remain mindful that limited verbal and non-verbal communication (such as limited eye contact or facial expressions, lack of expressed victim empathy, insight into the emotional states of self and others and insight into typical social relationships) should not be misinterpreted as non-compliance, disengagement, or deception

 • Pre- and post- intervention outcomes may need to be adapted to the needs and abilities of the individual. This may be different from neurotypical individuals

 • Consider the individual’s ability to identify, understand and communicate their own emotional experiences. Use visual rating scales, emotional scales and feelings boards

 • Support to apply and generalise learning to new contexts and situations that look different from the offence or current predicament