The Medical Model is the traditional model of finding deficits or things that are wrong and that people suffer from then treating these as a “cure” or fix. In a physical health clinic, this may be diagnosing an infection or broken bone and prescribing antibiotics or applying a splint to heal the problem. This model was, over time, also applied to neurodevelopmental differences and forms of disability. For a long time now, advocates and allies have challenged the traditional ‘Medical Model’ of problem or deficit focused treatment that pursues fitting to the norms of society expectations.

The Social Model of disability, for example, can be seen as the opposite of the Medical Model when applied to neurodevelopmental differences. This model recognises that in some cultures and societies, neurodivergent individuals have been living in a world that was made for the neurotypical brain rather than the diverse range of brains that our neurodiverse world has. This has meant some people have felt obliged to work hard to change themselves or felt inadequate or like they don’t fit in. The Social Model turns this narrative around and puts the source of the "disability" on the environment and other people’s expectations – it is not the person’s difference that needs changing.

Nowadays the Neurodiversity Paradigm and Neurodiversity-Affirming Practices are becoming more common and recognise diversity in all people. These practices need to focus on supporting people to respect and communicate their own preferences and needs as well as respect and support the needs of others. Under this framework, difference and diversity is not deficiency, it is something to be understood, respected and embraced. It comes from a perspective where different ways of interacting, thinking, or feeling are accepted and understood and no one way is better/right than another (within safe, respectful and legal limits of course!).

As we know, there have been and continue to be many society barriers for children with neurological differences that make it difficult for them to live their own lives where their differences are seen as strengths, and they are supported to learn and grown in the ways that they want to and that work for them. Autistic and other neurodivergent people may have been told that their deficits need to be fixed, treated, or cured for a long time. Rather than focusing on their innate strengths and valuing a diverse range of skills to connect with others, they may have been encouraged to put their energy into changing themselves to "fix" their socially perceived "weaknesses". The thing is, trying to act like someone you're not and thinking that there is something wrong with you can become exhausting and distressing over time.

Neurodivergent-Affirming Practices helps neurodivergent people (like autistic children) feel safe to be themselves while also reaching out for supports that account for both their needs and their strengths.

Let’s look briefly at the evolution of SAS from its early beginnings.

Dr Renae Beaumont is the original author of SAS. The program grew out of her PhD at the University of Queensland, Australia in the early 2000’s. Dr Beaumont was inspired by a brilliant autistic flute student that she had once taught and then set out to start developing a program that could assist children like her student to meet their social and emotional goals while being fun and integrating their interests. The program was originally called "Junior Detective Training Program" and the first children to complete the program were invited to help shape the future of the program. In the original Randomised Controlled Trial children gave clear feedback that saw the program name change to "BetFiery" and inclusion of more espionage-themed language. This original RCT produced the highest clinical change (increased social-emotional skills) published for a program of its kind - which is a massive outcome for an initial research edition within a PhD.

Although the sentiment of the neurodiversity paradigm has long been held by many people who know, love or are someone with a neurodivergent profile, in the early 2000’s it was not well known by clinicians and not promoted amongst the research community. The long-standing published research involving SAS is a reflection of understanding and academic custom of its time. You will find use of older terminology in past published research that cannot be updated. The research community in general is starting to take on new approaches. We are confident in the growing influence the neurodiversity advocates on the research community

Along with developments in research and community trends, SAS has evolved and modernised. The SAS Small Group Program is now on it’s 3rd published edition (not including the original PhD research version) which is delivered through a digital health platform and no longer refers to older technology, past generation popular TV shows, unnecessary gendered pronouns or other references that have moved with the times.

The theoretical framework underpinning SAS combines the understanding of each child’s unique cognitive profile and learning style and respects neurodiversity. The framework incorporates therapeutic approaches (e.g. Cognitive Behaviour Therapy and Acceptance & Commitment Therapy) and behaviour change theory (e.g. self-determination, goal setting, real-life practice etc) to empower meaningful change for children and their families.

With all this in mind, SAS has evolved since this time to incorporate new research on best practice therapeutic approaches for teaching social and emotion goals as well as to be responsive to the on-the-ground feedback from our SAS Facilitators, children and families themselves. Our use of a co-design process for innovating SAS in an ever-changing world into the digital health platform it is today has been so valuable to continuing to make meaningful impact for children in exploring, expressing, and reaching their own goals, values, and needs!

The information below provides more detail on the SAS content and process that is led by trained SAS Facilitators.

The SAS Small Group Program includes professional training courses for the SAS Facilitators who lead the groups and also a short course for the SAS Assistants that may support the Facilitator. The SAS Facilitator materials then also include a SAS Facilitator Manual, Session Checklists, Handouts, software delivered games and content for children, parents, teachers, and other adults supporting the child. Social Science Translated provides implementation support and peer consultation to assist services roll out SAS and adapt to meet the needs of different families and communities they serve.

The program content itself is systematically updated to incorporate new research and best-practice evidence over time, the instructions in the SAS Facilitator Manual are updated to align with new session content and new tips and tricks for adapting for differing child and families needs.

Over the years, the program has had new content added or remove or adjusted because it was no longer currently relevant or prioritised. For example, in response to feedback from SAS Facilitators, families and children, the 2016 release of the 2nd Edition of SAS Small Group included new activities that covered:

• understanding friendship qualities and degrees of friendship,
• assisting children with different learning styles learn the D.E.C.O.D.E.R problem solving formula (i.e. Neural Network and scavenger hunt), and
• the ‘Home-School Diary’ was replaced with the much more fun Skill Tracker.

In 2020, the program was transformed to be delivered through the current digital health platform format (the 3rd Edition of SAS). During this change, the opportunity was taken to again update content and terminology, such as using neutral pronouns, and changing the “Helpful Thought Missile” concept to the “Helpful Thought Zapper” and generally removing weapon-type references previously incorporated into the espionage theme.

Across 2022-2023, the SAS Small Group Program took a targeted approach to updating specific areas of content and Facilitator guidance in response to feedback from the SAS Facilitator network and changing community sentiment, particularly in the autistic and autism communities. These changes included updating wording in SAS Skill Codes such as the Bully Guard Body Armour, the Play Code, and the Rap song previously called “Why people ‘dis you” (now called “The Way We Play”). The SAS Facilitators also now have specific reminders about how to adapt for differing profiles of children across the program and examples of adapted, alternative and extension activities are provided to ensure Facilitators who are using neurodivergent-affirming approaches have some ideas on how to work with children in their groups.

SAS Facilitation Teams are encouraged to:

• Ask families about their values and preferences for session process or content, and any additional supports they may need.
• Adapt and individualise the way they deliver SAS to meet family values and needs.
• Check their own biases are not too strongly influencing the way they respond to children or parents.
• Run specific activities exploring a child’s own preferences (e.g. in conversing or playing) and how to communicate them.

Our SAS Facilitators are professionals in their own right that we support and expect to flexibly apply the SAS content and structure to best match the needs of the children and families they work with. When delivering SAS, clinicians or educators are able to adjust and apply different variations to activities to best approach the goals of each unique child. The program is intended to teach new skills aligned with a child’s own goals, to provide the child and their adult supports with a diverse set of skills to prepare for life’s social-emotional challenges. This approach not only provides guidance on how to understand people who may think differently to them, but also to empower communicating their own social needs and goals that make for meaningful changes in families' lives.

To help illustrate these flexible options for clinician’s to choose from further, feel free to check out the content and instruction examples further down on this page or the recorded information session video also linked on this page.

Thank you for taking the time to learn about how SAS has evolved over the last 20+ years to prepare children for life’s social emotional challenges in a neurodiverse world!