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The Preschool Autism Communication Therapy (PACT) is the only treatment method for early autism that has been shown to have a long-term effect on autism symptom developmental outcomes into middle childhood. It has also enabled the mechanism through which these effects are produced to be identified. The PACT model is designed on the basis of developmental and transactional principles applied to autism, to form a relatively low-intensity naturalistic intervention that can be flexibly applied at home or in a medical environment. It works by parents, caregivers, or teachers using video-feedback methods to enhance recognition and responsiveness to child communication and optimize the child’s social communication development. There have to date been five replication studies of the core effect of this intervention on parent-child interaction, and four on the effect on child symptom outcomes. PACT has been subjected to the longest post-intervention follow-up to date in the field, showing sustained effects on child development. An adaptation has been shown to be effective in low- and medium-income country settings, and a related pre-emptive intervention effective with infants at risk of autism. Training on the PACT model is available through a mixture of online e-learning, face-to-face training, and supervised practice teaching (http://research.bmh.manchester.ac.uk/pact/TrainingPACT/).