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Intensive Interaction

 Intensive Interaction in action

'Intensive Interaction is a practical approach to interacting with people with severe or profound and multiple learning disabilities and/or autism. There is nothing difficult or expert about Intensive Interaction, it is a very practical approach to communication and socialising with people who do not find it easy communicating or being social.'

'The approach helps the person with learning difficulties and their communication partner to relate better to each other and enjoy each other's company more. It helps them develop their communication abilities. In Intensive interaction the carer, support worker, speech and language therapist or teacher works at being a better communication partner and so supports the person with learning disabilities develop confidence and competence as a communicator'.

'The approach was developed by teachers Dave Hewett and Melanie Nind in the 1980’s. The approach can be used as a way of teaching fundamental communication, as a means of relationship building, or simply as a way of pleasurably spending time with people'.      

 (Extracts from the Brisitsh Institute of Learning Disabilities 'Intensive Interaction Factsheet')

 Who is Intensive Interaction for?

It is intended that Intensive Interaction will address the needs of:

• People who are pre-verbal, with few or limited communicative behaviours.
• People who are extremely socially withdrawn, and do not positively interact with other people.
• People who display various stereotyped or self-stimulatory behaviours that exclude the participation of other people.

Do you have to be an expert or can anyone do it?

There is nothing difficult or expert about Intensive Interaction. It is a very practical approach to communication and socialising that employs natural and easily recognisable techniques. It is theoretically simple and was developed from a model of ‘infant/caregiver interactions’, and therefore it involves the kind of activities through which sociability and communication normally develop in infancy.

It is a fun process and can be used as a way of teaching fundamental communication, as a means of relationship building, or simply as a way of pleasurably spending time with people. The nature and intensity of the activities might vary between noisy rough and tumble activities, intense mutual face-to-face studying or simply quietly sitting together in close physical proximity.

By using the various activities as a catalyst for social interaction we hope to facilitate a progression from passivity or social non-engagement, through turn-taking and contingent action, to the eventual initiation and leading of interactive games.

When we adopt Intensive Interaction as an approach we go about things in a particular way - we adopt a particular interactive style. We try to develop a calm, accepting atmosphere, recognising that the motivation for each participant to socially interact with us has to be right - any interactive activity has to be within their realm of interest.

We adjust our interpersonal behaviours, trying to make ourselves more interesting by perhaps altering our voice or body language. We may also follow our client’s lead - responding to the things they do, involving ourselves in their activity in a way that does not make any demands on them that they cannot cope with. We use timing and rhythm in the interactions, making them mutually enjoyable - adding anticipation and drama to hold the person's attention. We try to create the feeling of taking turns. We communicate that we value them and enjoy being with them.

We use sensitive observation to judge how well an interaction is going. We respond quickly to any feedback, interpreting it so that we can keep the interaction positive and enjoyable for both partners. We collectively reflect on the interactions, and think about how we can enhance and extend them.

If we do all these things with Intensity, Sensitivity and Perseverance then can we claim to be using Intensive Interaction.

What are the potential outcomes?

The body of evidence concerning the responses of people with severe or profound learning disabilities to Intensive Interaction is currently unambiguously supportive. There are repeated claims of novel or increased socially interactive behaviours. Such positive developments are reported as greater use of eye contact; increased toleration of, or engagement in, physical contact activities; additional episodes of sustained joint attention; increased use of potentially communicative vocalisations; and an increased regard for facial signalling. There was also evidence of greater initiation of social interaction by some of the research participants.

 Valuing People Now (VPN)

According to the strategy document ‘Valuing People Now: ‘Making it happen for everyone’ (DoH, 2009) the UK Government’s vision is that all people with learning disabilities ‘are supported to become empowered citizens’. This document, a follow up to the original 'Valuing People' Document (2001), explicitly states that, for people with complex needs, where social inclusion is concerned:

1.6 addressing the issues for people with complex needs is really about embedding the principles of personalisation within all aspects of planning, commissioning and delivery of support services. It is also about recognising that the very particular support needs of an individual will mean very individualised support packages, including systems for facilitating meaningful two-way communication.

Page 38 of the document is then completely given over to an exposition of Intensive Interaction, with some historical background, comments on the strategies involved, and a brief passage on the possible beneficial outcomes.  It goes on to state that people with learning disabilities should be enabled and supported to ‘develop and use appropriate communication systems where people have little or no verbal communication’ (p.39).

 

Intensive Interaction Training in Leeds
The NHS Foundation Modular Intensive Interaction training course is open to anyone in Leeds who cares for, or works to support people with severe or profound intellectual disabilities and/or autism. To apply for the course please print off and then complete the form attached below via the link, and return it to the address indicated on the back of the leaflet - once a date has been set for a particular Module, we will contact you to offer you a place.  

 

The Leeds NHS Intensive Interaction Training Application Form

If you would like further information on Intensive Interaction training then please ring:

Graham Firth on (0113) 3055160

 


Other Intensive Interaction Documents available to Download (as pdf. documents)

II Newsletter Issue 47 (April 2014)

An Introduction to Intensive Interaction (2014)

Intensive Interaction - Published Research Summaries Document (2014)


 

Some Useful Web Links

The Official Intensive Interaction website

Dave Hewett Website


SOME FURTHER READING - influential research papers:

Some of the most informative and influential research papers with child participants are as follows:

  • Watson, J. & Knight, C. (1991) ‘An Evaluation of Intensive Interactive Teaching with Pupils with Very Severe Learning Difficulties’, Child Language Teaching and Therapy, 7 (3), 310-25.

  • Watson, J. & Fisher, A. (1997) ‘Evaluating the Effectiveness 0f Intensive Interaction Teaching with Pupils with Profound and Complex Learning Disabilities’, British Journal of Special Education, 24 (2), 80-87.

  • Kellett, M. (2000) ‘Sam’s Story: Evaluating Intensive Interaction in Terms of its Effect on the Social and Communicative ability of a Young Child With Severe Learning Difficulties’, Support for Learning, 15 (4), 165-171.

  • Kellett, M. (2005) ‘Catherine’s Legacy: social communication development for individuals with profound learning difficulties and fragile life expectancies’, British Journal of Special Education, 32 (3), 116-121.

  • Zeedyk, S., Davies, C., Parry, S. & Caldwell, P. (2009) ‘Fostering social engagement in Romanian children with communicative impairments: The experiences of newly trained practitioners of Intensive Interaction.’ British Journal of Learning Disabilities, 37 (3), 186-196

 Some of the most informative and influential research papers with adult participants are as follows:

  • Nind, M. (1996) ‘Efficacy of Intensive Interaction; Developing sociability and communication in people with severe and complex learning difficulties using an approach based on caregiver- infant interaction’, European Journal of Special Educational Needs, 11 (1), 48-66.

  • Lovell, D., Jones, S. and Ephraim, G. (1998) ‘The Effect of Intensive Interaction on the Sociability of a Man with Severe Intellectual Disabilities’, International Journal of Practical Approaches to Disability, 22 (2/3), 3-8.

  • Elgie, S. & Maguire, N. (2001) Intensive Interaction with a Woman with Multiple and Profound Disabilities; a case study’, Tizard Learning Disability Review, (6) 3, 18-24.

  • Leaning, B. and Watson T. (2006) ‘From the inside looking out – an Intensive Interaction group for people with profound and multiple learning disabilities’, British Journal of Learning Disabilities, 34, 103-109.

  • Firth, G., Elford, H., Leeming, C., & Crabbe, M. (2008) ‘Intensive Interaction as a Novel Approach in Social Care: Care Staff’s Views on the Practice Change Process’ in Journal of Applied Research in Intellectual Disabilities, 21, p.58-69.

  • Samuel, J., Nind, M., Volans, A. & Scriven, I. (2008) ‘An evaluation of Intensive Interaction in community living settings for adults with profound intellectual disabilities’, Journal of Intellectual Disabilities, 12, 111-126

  • Zeedyk, S., Caldwell, P. & Davies, C. (2009) ‘How rapidly does Intensive Interaction promote social engagement for adults with profound learning disabilities and communicative impairments?’ European Journal of Special Needs Education, 24 (2), 119–137

 SOME FURTHER READING - influential position papers:

  • Nind, M. (2000) ‘Teachers’ understanding of interactive approaches in special education’ International Journal of Disability, Development and Education, 47 (2), 184-199. 

  • Nind, M. & Powell, S. (2000) ‘Intensive Interaction and autism: some theoretical concerns’, Children and Society, 14 (2), 98-109.

  • Irvine, C. (2001) ‘On the floor and playing…’, Royal College of Speech and Language Therapy Bulletin, November, 9-11.

  • Kennedy, A. (2001) ‘Intensive Interaction’, Learning Disability Practice, 4 (3), 14-15.

  • Samuel, J.  (2001) ‘Intensive Interaction’, Clinical Psychology Forum, 148, 22-5.

  • Nind, M. & Thomas, G. (2005) ‘Reinstating the value of teachers’ tacit knowledge for the benefit of learners: using ‘Intensive Interaction',Journal of Research in Special Educational Needs, 5 (3), 97–100

  • Barber, M.  (2007) 'Imitation, interaction and dialogue using Intensive Interaction: tea party rules', Support for Learning, 22, (3), p.124-130 

  • Firth, G. (2008) ‘A Dual Aspect Process Model of Intensive Interaction’, British Journal of Leaning Disabilities, 37, p. p.43-49