Publications and Bibliography
Reference Guide to Publications
2006
Leaning, Brian; Watson, Tessa
From the inside looking out – an Intensive Interaction group for people with profound and multiple learning disabilities Journal Article
In: British Journal of Learning Disabilities, vol. 34, no. 2, pp. 103-109, 2006, ISSN: 1468-3156.
@article{Leaning2006,
title = {From the inside looking out – an Intensive Interaction group for people with profound and multiple learning disabilities},
author = {Brian Leaning and Tessa Watson},
doi = { https://doi.org/10.1111/j.1468-3156.2005.00374.x},
issn = {1468-3156},
year = {2006},
date = {2006-06-01},
urldate = {2006-04-21},
journal = {British Journal of Learning Disabilities},
volume = {34},
number = {2},
pages = {103-109},
abstract = {This paper reported on a series of workshops in an adult learning disability day centre for groups of clients and carers. Intensive Interaction was used with five people with profound and multiple learning disabilities over 8 weeks, with the aims of developing: meaningful dialogue; the ability to relate and communicate with others; an awareness of themselves as separate; alternatives to self-stimulatory behaviour.
Method: The participants with profound and multiple learning difficulties (3 female and 2 male) were videoed for 50 minutes prior to the sessions as a baseline measure. All the participants were preverbal, all had very limited non-verbal communication, and all were said to avoid interaction. The video was analysed, using momentary time sampling techniques, to observe behaviours that were viewed as being important for either interaction or for avoidance of interaction, and 5 such behaviours were described: eye contact with others, object-orientated eye contact, self-stimulation (e.g. rocking, breath holding, face slapping), smiling and active avoidant behaviour (moving or turning away from others, covering the face to block the view of others).
After the assessment phase the group was run for eight weekly 50-minute sessions with two facilitators (a Music Therapist and a Clinical Psychologist).
Each session began and ended with 5 minutes of music to signify a transition in and out of the session. A box was placed in the middle of the room that contained a variety of sensory items (e.g. balls, silk materials, musical chimes) which were used in interactions. In each session each facilitator would engage with clients who indicated their wish, or readiness, to do so, often building a game from an action, facial expression or sound made by the client.
Each session was videotaped and each of the five behaviours measured for each individual. One follow-up session was conducted one month after the end of the last group. A researcher who was not involved in the group conducted all the video ratings and analysis. In both the baseline and follow-up sessions the participants were engaged in the group sessions with the members of staff from the day service. Four different types of groups were observed to measure the baseline and follow-up (music and movement, massage, communication, and news and views).
Results: Across the group there was an increased use of eye contact, to others and to objects, suggesting that the participants developed a greater interest in interacting than they had demonstrated during baseline or follow-up phases. An increased incidence in smiling throughout the group also pointed towards a higher level of enjoyment during interaction than at baseline or follow-up. A reduction in both self-stimulation and active avoidant behaviours suggested that the participants felt more comfortable interacting during these group sessions, and it was suggested that the facilitators were better able to build greater understanding of the participants. However, when the data was analysed from the follow-up session (one month after the final session), the frequency of behaviours shown by the participants reverted back to a rate similar to that of the baseline. This appears to indicate that the mechanisms learnt in the group were not, at that time, generalised to other areas of the participant’s lives.
Discussion: Through the analysis of the changes in positive and negative behaviours, this study suggests that there was an increase in the ability of all the participants to engage with the facilitators. Therefore, they concluded that this study supports the idea of FILO and the use of Intensive Interaction principles in working with people with profound intellectual disabilities.
It was the author’s belief that Intensive Interaction principles can be taught to staff (over a three to four session training course, with ongoing supervision), and that such training supports the government policy aim ‘to ensure that social and health care staff working with people with learning disabilities are appropriately skilled, trained and qualified’ (DoH 2001, p.26). },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper reported on a series of workshops in an adult learning disability day centre for groups of clients and carers. Intensive Interaction was used with five people with profound and multiple learning disabilities over 8 weeks, with the aims of developing: meaningful dialogue; the ability to relate and communicate with others; an awareness of themselves as separate; alternatives to self-stimulatory behaviour.
Method: The participants with profound and multiple learning difficulties (3 female and 2 male) were videoed for 50 minutes prior to the sessions as a baseline measure. All the participants were preverbal, all had very limited non-verbal communication, and all were said to avoid interaction. The video was analysed, using momentary time sampling techniques, to observe behaviours that were viewed as being important for either interaction or for avoidance of interaction, and 5 such behaviours were described: eye contact with others, object-orientated eye contact, self-stimulation (e.g. rocking, breath holding, face slapping), smiling and active avoidant behaviour (moving or turning away from others, covering the face to block the view of others).
After the assessment phase the group was run for eight weekly 50-minute sessions with two facilitators (a Music Therapist and a Clinical Psychologist).
Each session began and ended with 5 minutes of music to signify a transition in and out of the session. A box was placed in the middle of the room that contained a variety of sensory items (e.g. balls, silk materials, musical chimes) which were used in interactions. In each session each facilitator would engage with clients who indicated their wish, or readiness, to do so, often building a game from an action, facial expression or sound made by the client.
Each session was videotaped and each of the five behaviours measured for each individual. One follow-up session was conducted one month after the end of the last group. A researcher who was not involved in the group conducted all the video ratings and analysis. In both the baseline and follow-up sessions the participants were engaged in the group sessions with the members of staff from the day service. Four different types of groups were observed to measure the baseline and follow-up (music and movement, massage, communication, and news and views).
Results: Across the group there was an increased use of eye contact, to others and to objects, suggesting that the participants developed a greater interest in interacting than they had demonstrated during baseline or follow-up phases. An increased incidence in smiling throughout the group also pointed towards a higher level of enjoyment during interaction than at baseline or follow-up. A reduction in both self-stimulation and active avoidant behaviours suggested that the participants felt more comfortable interacting during these group sessions, and it was suggested that the facilitators were better able to build greater understanding of the participants. However, when the data was analysed from the follow-up session (one month after the final session), the frequency of behaviours shown by the participants reverted back to a rate similar to that of the baseline. This appears to indicate that the mechanisms learnt in the group were not, at that time, generalised to other areas of the participant’s lives.
Discussion: Through the analysis of the changes in positive and negative behaviours, this study suggests that there was an increase in the ability of all the participants to engage with the facilitators. Therefore, they concluded that this study supports the idea of FILO and the use of Intensive Interaction principles in working with people with profound intellectual disabilities.
It was the author’s belief that Intensive Interaction principles can be taught to staff (over a three to four session training course, with ongoing supervision), and that such training supports the government policy aim ‘to ensure that social and health care staff working with people with learning disabilities are appropriately skilled, trained and qualified’ (DoH 2001, p.26).
Method: The participants with profound and multiple learning difficulties (3 female and 2 male) were videoed for 50 minutes prior to the sessions as a baseline measure. All the participants were preverbal, all had very limited non-verbal communication, and all were said to avoid interaction. The video was analysed, using momentary time sampling techniques, to observe behaviours that were viewed as being important for either interaction or for avoidance of interaction, and 5 such behaviours were described: eye contact with others, object-orientated eye contact, self-stimulation (e.g. rocking, breath holding, face slapping), smiling and active avoidant behaviour (moving or turning away from others, covering the face to block the view of others).
After the assessment phase the group was run for eight weekly 50-minute sessions with two facilitators (a Music Therapist and a Clinical Psychologist).
Each session began and ended with 5 minutes of music to signify a transition in and out of the session. A box was placed in the middle of the room that contained a variety of sensory items (e.g. balls, silk materials, musical chimes) which were used in interactions. In each session each facilitator would engage with clients who indicated their wish, or readiness, to do so, often building a game from an action, facial expression or sound made by the client.
Each session was videotaped and each of the five behaviours measured for each individual. One follow-up session was conducted one month after the end of the last group. A researcher who was not involved in the group conducted all the video ratings and analysis. In both the baseline and follow-up sessions the participants were engaged in the group sessions with the members of staff from the day service. Four different types of groups were observed to measure the baseline and follow-up (music and movement, massage, communication, and news and views).
Results: Across the group there was an increased use of eye contact, to others and to objects, suggesting that the participants developed a greater interest in interacting than they had demonstrated during baseline or follow-up phases. An increased incidence in smiling throughout the group also pointed towards a higher level of enjoyment during interaction than at baseline or follow-up. A reduction in both self-stimulation and active avoidant behaviours suggested that the participants felt more comfortable interacting during these group sessions, and it was suggested that the facilitators were better able to build greater understanding of the participants. However, when the data was analysed from the follow-up session (one month after the final session), the frequency of behaviours shown by the participants reverted back to a rate similar to that of the baseline. This appears to indicate that the mechanisms learnt in the group were not, at that time, generalised to other areas of the participant’s lives.
Discussion: Through the analysis of the changes in positive and negative behaviours, this study suggests that there was an increase in the ability of all the participants to engage with the facilitators. Therefore, they concluded that this study supports the idea of FILO and the use of Intensive Interaction principles in working with people with profound intellectual disabilities.
It was the author’s belief that Intensive Interaction principles can be taught to staff (over a three to four session training course, with ongoing supervision), and that such training supports the government policy aim ‘to ensure that social and health care staff working with people with learning disabilities are appropriately skilled, trained and qualified’ (DoH 2001, p.26).
Firth, Graham
Intensive Interaction: a Research Review Journal Article
In: Mental Health & Learning Disabilities Research and Practice, vol. 3, no. 1, pp. 53-58, 2006, ISSN: 5920-3153.
@article{Firth2006,
title = {Intensive Interaction: a Research Review},
author = {Graham Firth},
url = {https://www.mhldrp.org.uk/article/id/368/},
doi = {https://doi.org/10.5920/mhldrp.2006.3153},
issn = {5920-3153},
year = {2006},
date = {2006-04-18},
journal = {Mental Health & Learning Disabilities Research and Practice},
volume = {3},
number = {1},
pages = {53-58},
abstract = {Intensive Interaction is a socially interactive approach to supporting and developing the pre verbal communication and sociability of people with severe or profound learning disabilities, or severe autism. Developed in the 1980’s from the psychological model of ‘augmented mothering’ the approach currently has an increasing number of proponents who make claims for increased social responsiveness due to the use of the approach. This short paper aims to evaluate some of the evidential claims of consequential increased social responses from people with severe and profound and multiple learning disabilities due to the use of Intensive Interaction techniques. Thus the paper presents a review of findings presented in relevant research papers which have been published in generally recognised academic journals. From this review the author concludes that although expanding, the current body of research has been limited in scope and scale, and has generally been conducted by a small number of Intensive Interaction practitioners and advocates. However, increased client social responsiveness was consistently reported across the research projects reviewed. In conclusion, this paper advocates for further systematic research into the approach by the wider research community to further develop the evidential base of the approach.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Intensive Interaction is a socially interactive approach to supporting and developing the pre verbal communication and sociability of people with severe or profound learning disabilities, or severe autism. Developed in the 1980’s from the psychological model of ‘augmented mothering’ the approach currently has an increasing number of proponents who make claims for increased social responsiveness due to the use of the approach. This short paper aims to evaluate some of the evidential claims of consequential increased social responses from people with severe and profound and multiple learning disabilities due to the use of Intensive Interaction techniques. Thus the paper presents a review of findings presented in relevant research papers which have been published in generally recognised academic journals. From this review the author concludes that although expanding, the current body of research has been limited in scope and scale, and has generally been conducted by a small number of Intensive Interaction practitioners and advocates. However, increased client social responsiveness was consistently reported across the research projects reviewed. In conclusion, this paper advocates for further systematic research into the approach by the wider research community to further develop the evidential base of the approach.
Forster, S; Taylor, M
Using Intensive Interaction - A case study Journal Article
In: Acquiring Knowledge in Speech, Language & Hearing, vol. 8, no. 1, pp. 12-15, 2006.
@article{Forster2006,
title = {Using Intensive Interaction - A case study},
author = {S Forster and M Taylor
},
year = {2006},
date = {2006-01-01},
journal = {Acquiring Knowledge in Speech, Language & Hearing},
volume = {8},
number = {1},
pages = {12-15},
abstract = {This study focused on Cameron, a young man with a profound intellectual disability, severe vision impairment and a physical disability, who attended a small day service five days a week. The study was conducted over 6 months with 9 DSWs participating, two being interviewed regarding their reflections on the intervention.
Design: Data were gathered both retrospectively and prospectively. Multiple sources of data (reports, assessments, observation, reflections by participants, and interviews) were collated to compare to the pre-intervention data. 50 interaction reflection forms were completed by DSWs immediately following an I.I. session. Follow-up data included a re-administered Triple C (completed by the service speech pathologist with two DSWs), videoed observations of interactions with Cameron, and two semi-structured interviews with DSWs (which were transcribed, and thematically analysed and coded).
Results: In 2002 (before the I.I. intervention), Cameron’s communication was assessed as consistent with the pre-intentional reflexive communication stage (stage 1 - Bloomberg & West, 1999), with some skills in the reactive stage. This indicated that Cameron was showing minimal reactions to people, activities and objects, and his responses were mainly reflexive. Cameron also showed very few person engagements, a few engagements with objects (e.g. sucking objects) and was largely involved in self-engagement behaviours.
In mid 2004, the service received a consultation on Intensive Interaction, and the manager of the service and the service speech pathologist supported the establishment of daily interaction sessions for Cameron. These one-to-one sessions varied from 15 minutes to 2 hours (occasionally occurring twice a day) and following the interaction, staff completed the interaction reflection forms. A content analysis was completed on the 50 reflection sheets, with the following findings being of particular note:
There was a change in the interactions occurring separate from other clients, to interactions occurring in the same rooms as other clients, often on the periphery of established programs like art or music;
New skills were recorded e.g. increased eye contact, searching for his interaction partner’s hand;
There was a shift from negative ascription of behaviour to seeing the behaviour as communicating a need, and problem solving to address that need,
Some staff reported using the same techniques continuously, whereas other staff reported trying out new techniques to extend the interactions.
Six months later the Triple C was re-administered and Cameron’s recorded skills had increased to being consistent with the pre-intentional reactive stage of communication (stage 2). Behaviours observed in 2005, but not in 2002 included smiling, reacting to the voices of particular staff and beginning to show anticipation – although it was noted that any new observations might have indicated that Cameron’s communication skills had improved, and/or that his DSW’s were more observant of his interactive behaviours.
The two DWSs interviewed were also video recorded in 5 minutes of Intensive Interaction with Cameron. The videos were reviewed and written observations made (i.e. video interactions were not coded, but used to provide general descriptions of behaviours). The observations showed that the DWSs showed positive regard towards Cameron through their words to him and their physical positioning (e.g. sitting with their face close and body oriented towards Cameron). They used techniques such as burst-pause, whereby they would rock or pat Cameron and then pause to see his response, and they imitated Cameron’s sounds to capture his interest. They also just sat with their hand on his chest or legs, making small movements to signal their presence.
The results of the Triple C and reflections by staff utilising Intensive interaction indicated that improvements in individuals’ communication skills and positive staff perceptions were seen in this case study. The staff reported positively on the use of Intensive Interaction, though challenges of gaining resources for staff availability and ongoing training were acknowledged.
Conclusions: The analysis of the data gathered suggests that improvements did occur both in Cameron’s communication skills, and in the perceptions of staff following the intervention. The promising results of this case study indicate the potential usefulness of Intensive Interaction for people with PID. Also indicated was the need for more rigorous research to demonstrate the efficacy of using Intensive Interaction as a means of increasing communication interactions between with adults who have PID and their significant communication partners. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This study focused on Cameron, a young man with a profound intellectual disability, severe vision impairment and a physical disability, who attended a small day service five days a week. The study was conducted over 6 months with 9 DSWs participating, two being interviewed regarding their reflections on the intervention.
Design: Data were gathered both retrospectively and prospectively. Multiple sources of data (reports, assessments, observation, reflections by participants, and interviews) were collated to compare to the pre-intervention data. 50 interaction reflection forms were completed by DSWs immediately following an I.I. session. Follow-up data included a re-administered Triple C (completed by the service speech pathologist with two DSWs), videoed observations of interactions with Cameron, and two semi-structured interviews with DSWs (which were transcribed, and thematically analysed and coded).
Results: In 2002 (before the I.I. intervention), Cameron’s communication was assessed as consistent with the pre-intentional reflexive communication stage (stage 1 - Bloomberg & West, 1999), with some skills in the reactive stage. This indicated that Cameron was showing minimal reactions to people, activities and objects, and his responses were mainly reflexive. Cameron also showed very few person engagements, a few engagements with objects (e.g. sucking objects) and was largely involved in self-engagement behaviours.
In mid 2004, the service received a consultation on Intensive Interaction, and the manager of the service and the service speech pathologist supported the establishment of daily interaction sessions for Cameron. These one-to-one sessions varied from 15 minutes to 2 hours (occasionally occurring twice a day) and following the interaction, staff completed the interaction reflection forms. A content analysis was completed on the 50 reflection sheets, with the following findings being of particular note:
There was a change in the interactions occurring separate from other clients, to interactions occurring in the same rooms as other clients, often on the periphery of established programs like art or music;
New skills were recorded e.g. increased eye contact, searching for his interaction partner’s hand;
There was a shift from negative ascription of behaviour to seeing the behaviour as communicating a need, and problem solving to address that need,
Some staff reported using the same techniques continuously, whereas other staff reported trying out new techniques to extend the interactions.
Six months later the Triple C was re-administered and Cameron’s recorded skills had increased to being consistent with the pre-intentional reactive stage of communication (stage 2). Behaviours observed in 2005, but not in 2002 included smiling, reacting to the voices of particular staff and beginning to show anticipation – although it was noted that any new observations might have indicated that Cameron’s communication skills had improved, and/or that his DSW’s were more observant of his interactive behaviours.
The two DWSs interviewed were also video recorded in 5 minutes of Intensive Interaction with Cameron. The videos were reviewed and written observations made (i.e. video interactions were not coded, but used to provide general descriptions of behaviours). The observations showed that the DWSs showed positive regard towards Cameron through their words to him and their physical positioning (e.g. sitting with their face close and body oriented towards Cameron). They used techniques such as burst-pause, whereby they would rock or pat Cameron and then pause to see his response, and they imitated Cameron’s sounds to capture his interest. They also just sat with their hand on his chest or legs, making small movements to signal their presence.
The results of the Triple C and reflections by staff utilising Intensive interaction indicated that improvements in individuals’ communication skills and positive staff perceptions were seen in this case study. The staff reported positively on the use of Intensive Interaction, though challenges of gaining resources for staff availability and ongoing training were acknowledged.
Conclusions: The analysis of the data gathered suggests that improvements did occur both in Cameron’s communication skills, and in the perceptions of staff following the intervention. The promising results of this case study indicate the potential usefulness of Intensive Interaction for people with PID. Also indicated was the need for more rigorous research to demonstrate the efficacy of using Intensive Interaction as a means of increasing communication interactions between with adults who have PID and their significant communication partners.
Design: Data were gathered both retrospectively and prospectively. Multiple sources of data (reports, assessments, observation, reflections by participants, and interviews) were collated to compare to the pre-intervention data. 50 interaction reflection forms were completed by DSWs immediately following an I.I. session. Follow-up data included a re-administered Triple C (completed by the service speech pathologist with two DSWs), videoed observations of interactions with Cameron, and two semi-structured interviews with DSWs (which were transcribed, and thematically analysed and coded).
Results: In 2002 (before the I.I. intervention), Cameron’s communication was assessed as consistent with the pre-intentional reflexive communication stage (stage 1 - Bloomberg & West, 1999), with some skills in the reactive stage. This indicated that Cameron was showing minimal reactions to people, activities and objects, and his responses were mainly reflexive. Cameron also showed very few person engagements, a few engagements with objects (e.g. sucking objects) and was largely involved in self-engagement behaviours.
In mid 2004, the service received a consultation on Intensive Interaction, and the manager of the service and the service speech pathologist supported the establishment of daily interaction sessions for Cameron. These one-to-one sessions varied from 15 minutes to 2 hours (occasionally occurring twice a day) and following the interaction, staff completed the interaction reflection forms. A content analysis was completed on the 50 reflection sheets, with the following findings being of particular note:
There was a change in the interactions occurring separate from other clients, to interactions occurring in the same rooms as other clients, often on the periphery of established programs like art or music;
New skills were recorded e.g. increased eye contact, searching for his interaction partner’s hand;
There was a shift from negative ascription of behaviour to seeing the behaviour as communicating a need, and problem solving to address that need,
Some staff reported using the same techniques continuously, whereas other staff reported trying out new techniques to extend the interactions.
Six months later the Triple C was re-administered and Cameron’s recorded skills had increased to being consistent with the pre-intentional reactive stage of communication (stage 2). Behaviours observed in 2005, but not in 2002 included smiling, reacting to the voices of particular staff and beginning to show anticipation – although it was noted that any new observations might have indicated that Cameron’s communication skills had improved, and/or that his DSW’s were more observant of his interactive behaviours.
The two DWSs interviewed were also video recorded in 5 minutes of Intensive Interaction with Cameron. The videos were reviewed and written observations made (i.e. video interactions were not coded, but used to provide general descriptions of behaviours). The observations showed that the DWSs showed positive regard towards Cameron through their words to him and their physical positioning (e.g. sitting with their face close and body oriented towards Cameron). They used techniques such as burst-pause, whereby they would rock or pat Cameron and then pause to see his response, and they imitated Cameron’s sounds to capture his interest. They also just sat with their hand on his chest or legs, making small movements to signal their presence.
The results of the Triple C and reflections by staff utilising Intensive interaction indicated that improvements in individuals’ communication skills and positive staff perceptions were seen in this case study. The staff reported positively on the use of Intensive Interaction, though challenges of gaining resources for staff availability and ongoing training were acknowledged.
Conclusions: The analysis of the data gathered suggests that improvements did occur both in Cameron’s communication skills, and in the perceptions of staff following the intervention. The promising results of this case study indicate the potential usefulness of Intensive Interaction for people with PID. Also indicated was the need for more rigorous research to demonstrate the efficacy of using Intensive Interaction as a means of increasing communication interactions between with adults who have PID and their significant communication partners.
2005
Kellett, Mary
Catherine’s Legacy: social communication development for individuals with profound learning difficulties and fragile life expectancies Journal Article
In: British Journal of Special Education, vol. 32, no. 3, pp. 116 – 121, 2005, ISSN: 0952-3383.
@article{Kellett2005,
title = {Catherine’s Legacy: social communication development for individuals with profound learning difficulties and fragile life expectancies},
author = {Mary Kellett},
url = {https://doi.org/10.1111/j.0952-3383.2005.00383.x},
doi = {10.1111/j.0952-3383.2005.00383.x},
issn = {0952-3383},
year = {2005},
date = {2005-09-01},
urldate = {2005-08-31},
journal = {British Journal of Special Education},
volume = {32},
number = {3},
pages = {116 – 121},
abstract = {This paper summarises case study evidence of how an 11-year-old girl’s quality of life was transformed by the adoption of Intensive Interaction. Despite the objective research perspective of such a paper, published as it was in such a highly regarded academic journal, what emerges is a very emotive and powerful story about one young girl’s dramatic social development in the last few months of her short life.
In this paper Dr Kellett, of the Children’s Research Centre at the Open University, also explores the methodological and ethical considerations concerning research with children with the most profound disabilities and fragile life expectancies, and the likely implications that individual life experiences may have for policy and practice in this area.
The Participant: Catherine, the focus of this paper, was 11 years old and at home with her family. She had profound learning disabilities compounded by quadriplegia, perceptual impairments and severe and frequent muscle spasms and seizures. She was physically very frail and suffered frequent infections and illnesses.
The Method: prior to the Intensive Interaction intervention at her school, Catherine was perceived by staff as being entirely passive, making no eye contact or vocalisations. Once the Intensive Interaction sessions commenced and a limited amount of video footage was gathered and analysed, dramatic developments were observed in two particular areas, those of eye contact and the ability to attend to joint focus activities.
The Results: Catherine’s engagement in eye contact was seen by the researchers as ‘a tremendously important development’ as it had changed from ‘zero incidences’ prior to the use of Intensive Interaction. Also noted were new behaviours that developed shortly before Catherine died, one being a ‘turn-taking’ vocalisation activity using ‘tutting’ sounds based around Catherine constantly blowing saliva bubbles, which developed into a ‘raspberry blowing’ game, and it was during this activity that staff felt they were ‘really connecting’ with her. The video on which the observations were based are described as ‘alive with smiles, eye contact, warm physical interaction and the sound of Catherine using her tongue in a ‘tutting’ sound as part of a playful imitative game’.
Also reported were the development of similar interactive communication within Catherine’s family and the generalisation of new found communication outside of the research scenario. Catherine’s mother started to use the approach after watching some of the research sessions, and was reported to particularly enjoy the ‘tutting’ and ‘bubble blowing’ games with Catherine. During these times Catherine’s mother was happily ‘rewarded with smiles and eye contact’ and she also described the joy of the family in being able to finally connect with Catherine. She also very movingly stated that the ‘last few months were their happiest times together’.
Some Discussion: As Dr Kellett concludes, Catherine’s study ‘adds to our knowledge and understanding of communication development for individuals who are similarly frail and profoundly impaired’, and she goes on to state that ‘Catherine is no longer with us but she has left a rich legacy behind her’.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper summarises case study evidence of how an 11-year-old girl’s quality of life was transformed by the adoption of Intensive Interaction. Despite the objective research perspective of such a paper, published as it was in such a highly regarded academic journal, what emerges is a very emotive and powerful story about one young girl’s dramatic social development in the last few months of her short life.
In this paper Dr Kellett, of the Children’s Research Centre at the Open University, also explores the methodological and ethical considerations concerning research with children with the most profound disabilities and fragile life expectancies, and the likely implications that individual life experiences may have for policy and practice in this area.
The Participant: Catherine, the focus of this paper, was 11 years old and at home with her family. She had profound learning disabilities compounded by quadriplegia, perceptual impairments and severe and frequent muscle spasms and seizures. She was physically very frail and suffered frequent infections and illnesses.
The Method: prior to the Intensive Interaction intervention at her school, Catherine was perceived by staff as being entirely passive, making no eye contact or vocalisations. Once the Intensive Interaction sessions commenced and a limited amount of video footage was gathered and analysed, dramatic developments were observed in two particular areas, those of eye contact and the ability to attend to joint focus activities.
The Results: Catherine’s engagement in eye contact was seen by the researchers as ‘a tremendously important development’ as it had changed from ‘zero incidences’ prior to the use of Intensive Interaction. Also noted were new behaviours that developed shortly before Catherine died, one being a ‘turn-taking’ vocalisation activity using ‘tutting’ sounds based around Catherine constantly blowing saliva bubbles, which developed into a ‘raspberry blowing’ game, and it was during this activity that staff felt they were ‘really connecting’ with her. The video on which the observations were based are described as ‘alive with smiles, eye contact, warm physical interaction and the sound of Catherine using her tongue in a ‘tutting’ sound as part of a playful imitative game’.
Also reported were the development of similar interactive communication within Catherine’s family and the generalisation of new found communication outside of the research scenario. Catherine’s mother started to use the approach after watching some of the research sessions, and was reported to particularly enjoy the ‘tutting’ and ‘bubble blowing’ games with Catherine. During these times Catherine’s mother was happily ‘rewarded with smiles and eye contact’ and she also described the joy of the family in being able to finally connect with Catherine. She also very movingly stated that the ‘last few months were their happiest times together’.
Some Discussion: As Dr Kellett concludes, Catherine’s study ‘adds to our knowledge and understanding of communication development for individuals who are similarly frail and profoundly impaired’, and she goes on to state that ‘Catherine is no longer with us but she has left a rich legacy behind her’.
In this paper Dr Kellett, of the Children’s Research Centre at the Open University, also explores the methodological and ethical considerations concerning research with children with the most profound disabilities and fragile life expectancies, and the likely implications that individual life experiences may have for policy and practice in this area.
The Participant: Catherine, the focus of this paper, was 11 years old and at home with her family. She had profound learning disabilities compounded by quadriplegia, perceptual impairments and severe and frequent muscle spasms and seizures. She was physically very frail and suffered frequent infections and illnesses.
The Method: prior to the Intensive Interaction intervention at her school, Catherine was perceived by staff as being entirely passive, making no eye contact or vocalisations. Once the Intensive Interaction sessions commenced and a limited amount of video footage was gathered and analysed, dramatic developments were observed in two particular areas, those of eye contact and the ability to attend to joint focus activities.
The Results: Catherine’s engagement in eye contact was seen by the researchers as ‘a tremendously important development’ as it had changed from ‘zero incidences’ prior to the use of Intensive Interaction. Also noted were new behaviours that developed shortly before Catherine died, one being a ‘turn-taking’ vocalisation activity using ‘tutting’ sounds based around Catherine constantly blowing saliva bubbles, which developed into a ‘raspberry blowing’ game, and it was during this activity that staff felt they were ‘really connecting’ with her. The video on which the observations were based are described as ‘alive with smiles, eye contact, warm physical interaction and the sound of Catherine using her tongue in a ‘tutting’ sound as part of a playful imitative game’.
Also reported were the development of similar interactive communication within Catherine’s family and the generalisation of new found communication outside of the research scenario. Catherine’s mother started to use the approach after watching some of the research sessions, and was reported to particularly enjoy the ‘tutting’ and ‘bubble blowing’ games with Catherine. During these times Catherine’s mother was happily ‘rewarded with smiles and eye contact’ and she also described the joy of the family in being able to finally connect with Catherine. She also very movingly stated that the ‘last few months were their happiest times together’.
Some Discussion: As Dr Kellett concludes, Catherine’s study ‘adds to our knowledge and understanding of communication development for individuals who are similarly frail and profoundly impaired’, and she goes on to state that ‘Catherine is no longer with us but she has left a rich legacy behind her’.
2004
Culham, Andrew
Getting in Touch with our Feminine Sides? Men's Difficulties and Concerns with Doing Intensive Interaction Journal Article
In: British Journal of Special Education, vol. 31, no. 2, pp. 81-88, 2004, ISSN: 0952-3383.
@article{Culham2004,
title = {Getting in Touch with our Feminine Sides? Men's Difficulties and Concerns with Doing Intensive Interaction},
author = {Andrew Culham},
doi = { https://doi.org/10.1111/j.0952-3383.2004.00333.x},
issn = {0952-3383},
year = {2004},
date = {2004-06-01},
urldate = {2004-05-28},
journal = {British Journal of Special Education},
volume = {31},
number = {2},
pages = {81-88},
abstract = {Methodology: This research addressed a number of issues faced by male practitioners using Intensive Interaction (I.I.) Using both questionnaires and interviews, data was gathered from over 35 practitioners, including F.E. lecturers, teachers, day-centre staff, psychologists, and speech & language therapists. Over half of the practitioners questioned had between 2 to over 10 years experienced in I.I. (the others having only limited experience of the approach).
General Results: The majority of practitioners reported using I.I. with students/clients with severe and profound learning disability, and a minority reported used the approach with a other groups of people such as those with sensory disabilities, emotional and behavioural difficulties, neurological difficulties, retirement home residents, clients with autism and people who were electively mute. The majority of respondents reported using I.I. as a ‘vehicle’ to support various sessions across the curriculum. Many noted that I.I. worked very well in supporting curriculum areas such as independence skills, sensory activities, and basic skills. The remaining practitioners, including psychologists, day-centre staff, residential support workers and parents, used I.I. as a communication tool with their clients.
Some respondents identified a difficulty with the lack of clear criteria or standards in I.I. Some respondents found it difficult to reverse the traditional didactic teaching methods of their initial training, and found communication with the student as ‘an equal’ difficult. Some respondents regarded the development of professional and practical skills through the use of I.I. as a primary benefit. Reported gains included improvements in communication styles, teamwork and collaboration; greater knowledge of students; and curriculum development. Many of the respondents felt that they needed more training and guidance with the practical skills of I.I., and some observed that too much time was spent intellectualising the approach and not enough time developing practical, classroom-based skills.
One teacher noted that parents are very supportive and are often astounded at I.I.’s results: ‘It works… parents, many of whom like to become involved with developing their child’s communication, can see it work for their children.’ A third of those questioned regarded ‘developing relationships’ as a distinct benefit of I.I. At least half of these respondents enjoyed the freedom that I.I. afforded them – an F.E. lecturer remarked: ‘I.I. allows me to engage with my students in a way that is uncharacteristic of my normal teaching practice, to sit back and enjoy the ride.’
For some it was the creation of ‘communication opportunities’ that was the most rewarding aspect of using I.I. with people with learning disabilities: ‘For the first time, I am able to enjoy another human being’s company for its own sake.’ However, a third of respondents indicated a concern with the negative perceptions and attitudes held by ‘mainstream’ staff, from various agencies, with regard to the value and appropriateness of I.I.. One practitioner remarked: ‘I find the reaction of others, who do not understand the individual and the procedure of communicating with them, difficult. Some people are unable to see the depth of both the students and I.I. and pass a judgement of failure or irrelevance.’
Results pertaining to being a male practitioner: Half of the respondents reported that the issues of touch, working with female students and the fear of allegations of sexual assault have prevented them from doing I.I. One practitioner noted: ‘My practice of I.I. is limited due to my fears and unease of working with female clients at the house.’ Another respondent noted that his team has had numerous staff development sessions regarding physical touch and gaining permission to touch, which had assisted male members of the team to be more comfortable around students/clients: ‘The whole business about touch… male practitioners need to feel reasonably secure, that they know what the boundaries are and that they know what the establishment rules are on permission.’
Another issue arising concerned support: the level and success of support was seen as dependent upon individual teams, personalities and managers. A respondent noted the difficulties around peer support: ‘I feel slightly uncomfortable in certain situations because of the male/female divide … but I try not to let this affect my practice.’ Managerial support of I.I. practitioners was also a concern: whilst some celebrated their manager’s proactive work and support, many questioned their manager’s understanding of I.I. Lack of support from line managers and senior members caused some staff distress, alienation and in some instances ridicule. One therapist reported that ‘Some senior managers can be dismissive of what we do.’
The male practitioners revealed that, on average, only 20% of the team they worked with were male. Also, one respondent noted that many of his female colleagues looked to him to take responsibility for discipline and restraint, possibly because of his gender.
Conclusions: Although it isn’t always clear what difficulties relate specifically to maleness, and what difficulties exist for practitioners of either gender, this research clearly illustrates the need of male practitioners for further support and development in the area of I.I.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Methodology: This research addressed a number of issues faced by male practitioners using Intensive Interaction (I.I.) Using both questionnaires and interviews, data was gathered from over 35 practitioners, including F.E. lecturers, teachers, day-centre staff, psychologists, and speech & language therapists. Over half of the practitioners questioned had between 2 to over 10 years experienced in I.I. (the others having only limited experience of the approach).
General Results: The majority of practitioners reported using I.I. with students/clients with severe and profound learning disability, and a minority reported used the approach with a other groups of people such as those with sensory disabilities, emotional and behavioural difficulties, neurological difficulties, retirement home residents, clients with autism and people who were electively mute. The majority of respondents reported using I.I. as a ‘vehicle’ to support various sessions across the curriculum. Many noted that I.I. worked very well in supporting curriculum areas such as independence skills, sensory activities, and basic skills. The remaining practitioners, including psychologists, day-centre staff, residential support workers and parents, used I.I. as a communication tool with their clients.
Some respondents identified a difficulty with the lack of clear criteria or standards in I.I. Some respondents found it difficult to reverse the traditional didactic teaching methods of their initial training, and found communication with the student as ‘an equal’ difficult. Some respondents regarded the development of professional and practical skills through the use of I.I. as a primary benefit. Reported gains included improvements in communication styles, teamwork and collaboration; greater knowledge of students; and curriculum development. Many of the respondents felt that they needed more training and guidance with the practical skills of I.I., and some observed that too much time was spent intellectualising the approach and not enough time developing practical, classroom-based skills.
One teacher noted that parents are very supportive and are often astounded at I.I.’s results: ‘It works… parents, many of whom like to become involved with developing their child’s communication, can see it work for their children.’ A third of those questioned regarded ‘developing relationships’ as a distinct benefit of I.I. At least half of these respondents enjoyed the freedom that I.I. afforded them – an F.E. lecturer remarked: ‘I.I. allows me to engage with my students in a way that is uncharacteristic of my normal teaching practice, to sit back and enjoy the ride.’
For some it was the creation of ‘communication opportunities’ that was the most rewarding aspect of using I.I. with people with learning disabilities: ‘For the first time, I am able to enjoy another human being’s company for its own sake.’ However, a third of respondents indicated a concern with the negative perceptions and attitudes held by ‘mainstream’ staff, from various agencies, with regard to the value and appropriateness of I.I.. One practitioner remarked: ‘I find the reaction of others, who do not understand the individual and the procedure of communicating with them, difficult. Some people are unable to see the depth of both the students and I.I. and pass a judgement of failure or irrelevance.’
Results pertaining to being a male practitioner: Half of the respondents reported that the issues of touch, working with female students and the fear of allegations of sexual assault have prevented them from doing I.I. One practitioner noted: ‘My practice of I.I. is limited due to my fears and unease of working with female clients at the house.’ Another respondent noted that his team has had numerous staff development sessions regarding physical touch and gaining permission to touch, which had assisted male members of the team to be more comfortable around students/clients: ‘The whole business about touch… male practitioners need to feel reasonably secure, that they know what the boundaries are and that they know what the establishment rules are on permission.’
Another issue arising concerned support: the level and success of support was seen as dependent upon individual teams, personalities and managers. A respondent noted the difficulties around peer support: ‘I feel slightly uncomfortable in certain situations because of the male/female divide … but I try not to let this affect my practice.’ Managerial support of I.I. practitioners was also a concern: whilst some celebrated their manager’s proactive work and support, many questioned their manager’s understanding of I.I. Lack of support from line managers and senior members caused some staff distress, alienation and in some instances ridicule. One therapist reported that ‘Some senior managers can be dismissive of what we do.’
The male practitioners revealed that, on average, only 20% of the team they worked with were male. Also, one respondent noted that many of his female colleagues looked to him to take responsibility for discipline and restraint, possibly because of his gender.
Conclusions: Although it isn’t always clear what difficulties relate specifically to maleness, and what difficulties exist for practitioners of either gender, this research clearly illustrates the need of male practitioners for further support and development in the area of I.I.
General Results: The majority of practitioners reported using I.I. with students/clients with severe and profound learning disability, and a minority reported used the approach with a other groups of people such as those with sensory disabilities, emotional and behavioural difficulties, neurological difficulties, retirement home residents, clients with autism and people who were electively mute. The majority of respondents reported using I.I. as a ‘vehicle’ to support various sessions across the curriculum. Many noted that I.I. worked very well in supporting curriculum areas such as independence skills, sensory activities, and basic skills. The remaining practitioners, including psychologists, day-centre staff, residential support workers and parents, used I.I. as a communication tool with their clients.
Some respondents identified a difficulty with the lack of clear criteria or standards in I.I. Some respondents found it difficult to reverse the traditional didactic teaching methods of their initial training, and found communication with the student as ‘an equal’ difficult. Some respondents regarded the development of professional and practical skills through the use of I.I. as a primary benefit. Reported gains included improvements in communication styles, teamwork and collaboration; greater knowledge of students; and curriculum development. Many of the respondents felt that they needed more training and guidance with the practical skills of I.I., and some observed that too much time was spent intellectualising the approach and not enough time developing practical, classroom-based skills.
One teacher noted that parents are very supportive and are often astounded at I.I.’s results: ‘It works… parents, many of whom like to become involved with developing their child’s communication, can see it work for their children.’ A third of those questioned regarded ‘developing relationships’ as a distinct benefit of I.I. At least half of these respondents enjoyed the freedom that I.I. afforded them – an F.E. lecturer remarked: ‘I.I. allows me to engage with my students in a way that is uncharacteristic of my normal teaching practice, to sit back and enjoy the ride.’
For some it was the creation of ‘communication opportunities’ that was the most rewarding aspect of using I.I. with people with learning disabilities: ‘For the first time, I am able to enjoy another human being’s company for its own sake.’ However, a third of respondents indicated a concern with the negative perceptions and attitudes held by ‘mainstream’ staff, from various agencies, with regard to the value and appropriateness of I.I.. One practitioner remarked: ‘I find the reaction of others, who do not understand the individual and the procedure of communicating with them, difficult. Some people are unable to see the depth of both the students and I.I. and pass a judgement of failure or irrelevance.’
Results pertaining to being a male practitioner: Half of the respondents reported that the issues of touch, working with female students and the fear of allegations of sexual assault have prevented them from doing I.I. One practitioner noted: ‘My practice of I.I. is limited due to my fears and unease of working with female clients at the house.’ Another respondent noted that his team has had numerous staff development sessions regarding physical touch and gaining permission to touch, which had assisted male members of the team to be more comfortable around students/clients: ‘The whole business about touch… male practitioners need to feel reasonably secure, that they know what the boundaries are and that they know what the establishment rules are on permission.’
Another issue arising concerned support: the level and success of support was seen as dependent upon individual teams, personalities and managers. A respondent noted the difficulties around peer support: ‘I feel slightly uncomfortable in certain situations because of the male/female divide … but I try not to let this affect my practice.’ Managerial support of I.I. practitioners was also a concern: whilst some celebrated their manager’s proactive work and support, many questioned their manager’s understanding of I.I. Lack of support from line managers and senior members caused some staff distress, alienation and in some instances ridicule. One therapist reported that ‘Some senior managers can be dismissive of what we do.’
The male practitioners revealed that, on average, only 20% of the team they worked with were male. Also, one respondent noted that many of his female colleagues looked to him to take responsibility for discipline and restraint, possibly because of his gender.
Conclusions: Although it isn’t always clear what difficulties relate specifically to maleness, and what difficulties exist for practitioners of either gender, this research clearly illustrates the need of male practitioners for further support and development in the area of I.I.
Kellett, Mary
Intensive Interaction in the inclusive classroom: using interactive pedagogy to connect with students who are hardest to reach Journal Article
In: Westminster Studies in Education, vol. 27, no. 2, pp. 175-188, 2004, ISSN: 1470-1359.
@article{Kellett2004,
title = {Intensive Interaction in the inclusive classroom: using interactive pedagogy to connect with students who are hardest to reach},
author = {Mary Kellett},
url = {https://doi.org/10.1080/0140672040270207},
doi = {10.1080/0140672040270207},
issn = {1470-1359},
year = {2004},
date = {2004-01-01},
urldate = {2010-12-02},
journal = {Westminster Studies in Education},
volume = {27},
number = {2},
pages = {175-188},
abstract = {In this paper Kellet looks at the pedagogical role of I.I. for students with severe and complex learning difficulties. She begins with an overview of the theoretical context of ‘interactive pedagogy’, and describes how I.I. can support sociability and communication development for the pupils who are the hardest to reach, with one case study (Finn) being used as an exemplar. Kellet gives some context as to how interactive pedagogies developed in response to ‘a growing disquiet that behaviourist styles of teaching did not promote real learning’.
Kellet states how I.I. ‘focusses on making the curriculum fit the student rather than the other way round’, and that the responsive nature of I.I. begins by ‘respecting whatever stage that individual is at in her or his development and celebrating what she or he is capable of doing’, with I.I. providing a ‘first point of connection which is at the heart of inclusive ideology’.
The case study: Finn was aged 6 and had severe learning difficulties. He was ‘passive’, with staff finding it difficult to engage him in any form of social interaction. He often lay on the floor or had his head down on a table, spending much of his time chewing his clothing, or other items he could get. A teacher and 2 TA assistants worked as a team in Finn’s class: none had any previous I.I. experience. All 3 attended a one day of I.I. training and were keen to try the approach.
Baseline data was collected for 6 weeks prior to any I.I., after which Finn had a daily I.I. session of 15-20 minutes with a TA. However, after 3 months the class teacher changed and the I.I. sessions become less regular as the new teacher increasingly prioritised other activities. At weekly intervals (later reduced to fortnightly) over a 1 year period, 5 minute video observations of Finn were made during the I.I. sessions, and at other times, across both the baseline and I.I. intervention phases.
From the video data, eye contact, looking at/towards the face of the interactive partner, smiling, vocalisation, and ‘engagement’ (i.e. ‘a state of absorbed intellectual or emotional arousal and connectedness’) were coded, analysed and changed into %s for ease of comparison - with inter-observer agreement = 96.1%, and intra- observer agreement = 96.3%.
Findings: During the baseline phase the incidence of Finn looking at or towards the face of his interactive partner averaged only 5%. This changed rapidly once the I.I. sessions began and increased to a mean of 31% over the intervention phase. Similar progress was made in Finn’s ability to make social physical contact, increasing from a baseline mean of 2.5% to a mean of 28.2% in the intervention phase. The incidence of Finn making eye contact before I.I. started was virtually non-existent, but progress shown in this area was seen to be ‘extremely encouraging, given that eye contact is such an important element in sociability and communication’.
Increases in Finn’s ability to attend to a joint focus and his levels of ‘engagement’ demonstrated how positively Finn responded to the I.I. approach. A mean score of 14% in the baseline phase for joint focus increased to a mean of 67% in the intervention phase, with two high peaks of 93%. The data for engagement was also seen to represent ‘important evidence of sustained and absorbed social interaction’: a baseline mean of 2% changed rapidly once the I.I. started with a ‘steadily rising incidence marred only by regressions related to the loss of continuity of vacation periods’.
The importance of teamwork: Kellet argues that from of this research we should understand that ‘for interactive pedagogy such as Intensive interaction to be implemented with optimal outcomes then effective teamwork is essential’. Visible, tangible support for needs to be evident at the managerial level from the earliest possible stage, and also that senior management should be involved in 'I.I. workshops alongside staff who intend to practise’ with such training ideally done ‘as a whole-school exercise on a nominated training day, with senior managers visibly participating’.
Some final reflections: according to Kellet, ‘for those students who have not yet learned the fundamentals of early social communication, developing sociability and communication is an essential first step in their learning. Without it learning cannot become meaningful’. She then goes on to state that I.I. is one approach within an ‘umbrella of interactive pedagogies’ that has been shown to be particularly successful. This paper finally argues the case for its wider adoption in inclusive mainstream schools.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
In this paper Kellet looks at the pedagogical role of I.I. for students with severe and complex learning difficulties. She begins with an overview of the theoretical context of ‘interactive pedagogy’, and describes how I.I. can support sociability and communication development for the pupils who are the hardest to reach, with one case study (Finn) being used as an exemplar. Kellet gives some context as to how interactive pedagogies developed in response to ‘a growing disquiet that behaviourist styles of teaching did not promote real learning’.
Kellet states how I.I. ‘focusses on making the curriculum fit the student rather than the other way round’, and that the responsive nature of I.I. begins by ‘respecting whatever stage that individual is at in her or his development and celebrating what she or he is capable of doing’, with I.I. providing a ‘first point of connection which is at the heart of inclusive ideology’.
The case study: Finn was aged 6 and had severe learning difficulties. He was ‘passive’, with staff finding it difficult to engage him in any form of social interaction. He often lay on the floor or had his head down on a table, spending much of his time chewing his clothing, or other items he could get. A teacher and 2 TA assistants worked as a team in Finn’s class: none had any previous I.I. experience. All 3 attended a one day of I.I. training and were keen to try the approach.
Baseline data was collected for 6 weeks prior to any I.I., after which Finn had a daily I.I. session of 15-20 minutes with a TA. However, after 3 months the class teacher changed and the I.I. sessions become less regular as the new teacher increasingly prioritised other activities. At weekly intervals (later reduced to fortnightly) over a 1 year period, 5 minute video observations of Finn were made during the I.I. sessions, and at other times, across both the baseline and I.I. intervention phases.
From the video data, eye contact, looking at/towards the face of the interactive partner, smiling, vocalisation, and ‘engagement’ (i.e. ‘a state of absorbed intellectual or emotional arousal and connectedness’) were coded, analysed and changed into %s for ease of comparison - with inter-observer agreement = 96.1%, and intra- observer agreement = 96.3%.
Findings: During the baseline phase the incidence of Finn looking at or towards the face of his interactive partner averaged only 5%. This changed rapidly once the I.I. sessions began and increased to a mean of 31% over the intervention phase. Similar progress was made in Finn’s ability to make social physical contact, increasing from a baseline mean of 2.5% to a mean of 28.2% in the intervention phase. The incidence of Finn making eye contact before I.I. started was virtually non-existent, but progress shown in this area was seen to be ‘extremely encouraging, given that eye contact is such an important element in sociability and communication’.
Increases in Finn’s ability to attend to a joint focus and his levels of ‘engagement’ demonstrated how positively Finn responded to the I.I. approach. A mean score of 14% in the baseline phase for joint focus increased to a mean of 67% in the intervention phase, with two high peaks of 93%. The data for engagement was also seen to represent ‘important evidence of sustained and absorbed social interaction’: a baseline mean of 2% changed rapidly once the I.I. started with a ‘steadily rising incidence marred only by regressions related to the loss of continuity of vacation periods’.
The importance of teamwork: Kellet argues that from of this research we should understand that ‘for interactive pedagogy such as Intensive interaction to be implemented with optimal outcomes then effective teamwork is essential’. Visible, tangible support for needs to be evident at the managerial level from the earliest possible stage, and also that senior management should be involved in 'I.I. workshops alongside staff who intend to practise’ with such training ideally done ‘as a whole-school exercise on a nominated training day, with senior managers visibly participating’.
Some final reflections: according to Kellet, ‘for those students who have not yet learned the fundamentals of early social communication, developing sociability and communication is an essential first step in their learning. Without it learning cannot become meaningful’. She then goes on to state that I.I. is one approach within an ‘umbrella of interactive pedagogies’ that has been shown to be particularly successful. This paper finally argues the case for its wider adoption in inclusive mainstream schools.
Kellet states how I.I. ‘focusses on making the curriculum fit the student rather than the other way round’, and that the responsive nature of I.I. begins by ‘respecting whatever stage that individual is at in her or his development and celebrating what she or he is capable of doing’, with I.I. providing a ‘first point of connection which is at the heart of inclusive ideology’.
The case study: Finn was aged 6 and had severe learning difficulties. He was ‘passive’, with staff finding it difficult to engage him in any form of social interaction. He often lay on the floor or had his head down on a table, spending much of his time chewing his clothing, or other items he could get. A teacher and 2 TA assistants worked as a team in Finn’s class: none had any previous I.I. experience. All 3 attended a one day of I.I. training and were keen to try the approach.
Baseline data was collected for 6 weeks prior to any I.I., after which Finn had a daily I.I. session of 15-20 minutes with a TA. However, after 3 months the class teacher changed and the I.I. sessions become less regular as the new teacher increasingly prioritised other activities. At weekly intervals (later reduced to fortnightly) over a 1 year period, 5 minute video observations of Finn were made during the I.I. sessions, and at other times, across both the baseline and I.I. intervention phases.
From the video data, eye contact, looking at/towards the face of the interactive partner, smiling, vocalisation, and ‘engagement’ (i.e. ‘a state of absorbed intellectual or emotional arousal and connectedness’) were coded, analysed and changed into %s for ease of comparison - with inter-observer agreement = 96.1%, and intra- observer agreement = 96.3%.
Findings: During the baseline phase the incidence of Finn looking at or towards the face of his interactive partner averaged only 5%. This changed rapidly once the I.I. sessions began and increased to a mean of 31% over the intervention phase. Similar progress was made in Finn’s ability to make social physical contact, increasing from a baseline mean of 2.5% to a mean of 28.2% in the intervention phase. The incidence of Finn making eye contact before I.I. started was virtually non-existent, but progress shown in this area was seen to be ‘extremely encouraging, given that eye contact is such an important element in sociability and communication’.
Increases in Finn’s ability to attend to a joint focus and his levels of ‘engagement’ demonstrated how positively Finn responded to the I.I. approach. A mean score of 14% in the baseline phase for joint focus increased to a mean of 67% in the intervention phase, with two high peaks of 93%. The data for engagement was also seen to represent ‘important evidence of sustained and absorbed social interaction’: a baseline mean of 2% changed rapidly once the I.I. started with a ‘steadily rising incidence marred only by regressions related to the loss of continuity of vacation periods’.
The importance of teamwork: Kellet argues that from of this research we should understand that ‘for interactive pedagogy such as Intensive interaction to be implemented with optimal outcomes then effective teamwork is essential’. Visible, tangible support for needs to be evident at the managerial level from the earliest possible stage, and also that senior management should be involved in 'I.I. workshops alongside staff who intend to practise’ with such training ideally done ‘as a whole-school exercise on a nominated training day, with senior managers visibly participating’.
Some final reflections: according to Kellet, ‘for those students who have not yet learned the fundamentals of early social communication, developing sociability and communication is an essential first step in their learning. Without it learning cannot become meaningful’. She then goes on to state that I.I. is one approach within an ‘umbrella of interactive pedagogies’ that has been shown to be particularly successful. This paper finally argues the case for its wider adoption in inclusive mainstream schools.
2003
Kellett, Mary
In: Journal of Research in Special Educational Needs, vol. 3, no. 1, pp. 18–34, 2003, ISSN: 1471-3802.
@article{Kellett2003,
title = {Jacob’s journey: developing sociability and communication in a young boy with severe and complex learning disabilities using the Intensive Interaction teaching approach},
author = {Mary Kellett},
url = {https://doi.org/10.1111/j.1471-3802.2003.00181.x},
doi = {10.1111/j.1471-3802.2003.00181.x},
issn = {1471-3802},
year = {2003},
date = {2003-03-01},
urldate = {2004-01-26},
journal = {Journal of Research in Special Educational Needs},
volume = {3},
number = {1},
pages = {18–34},
abstract = {This paper reports on the use of Intensive Interaction with Jacob, an 8 years old boy with severe learning difficulties. A multiple-method methodology was used, with the findings showing substantial progress in sociability and communication: Jacob’s stereotyped behaviour was also observed to substantially reduce.
Methodology: a multiple baseline interrupted time series methodology was used, with 6 children (across 3 special schools) given different baseline and staggered intervention phase starts. Video data was gathered alongside 2 assessment schedules (see below). Jacob was filmed over a 5 week baseline and a 42 week intervention phase, and various social behaviours were coded. Also a teacher’s log was kept alongside sessional I.I. reflection sheets.
Jacob’s profile: Jacob had severe learning difficulties (he was pre-verbal) and also epilepsy and physical impairments. He was unable to weight-bear or sit for long periods, and would often become distressed and was prone to self-injury e.g. banging his head or elbow. He was reported to spend most of his time in social isolation, engaged in various forms of stereotyped activity.
The Intensive Interaction sessions: a teaching assistant, Emma, volunteered to work with Jacob with the support of the class teacher. Initially Emma had to work hard to gain Jacob’s attention, and she decided to work with Jacob out of his wheelchair. She sat Jacob face to face on her knee, and responded to any of his actions (even burps & sneezes) with an imitation or a positive comment. Jacob continued to engage in his rocking activity when on Emma’s knee, but she turned it into a game: rocking rhythmically with him and singing ‘Row, row, row the boat.’ Jacob loved this - indicating his pleasure with smiles. Soon Jacob was initiating the game, taking hold of Emma’s hands and starting the rocking himself. Other games were introduced e.g. the teasing rhyme ‘if you see the crocodile, don’t forget to scream’, with Emma and Jacob both ‘screaming’ together. As time went by Jacob became more interested in his interaction with Emma, and he would scrutinise her face and engage in eye contact and, on occasions, even stroke her hand or face.
The findings:
• In the baseline phase the percentage incidence of Jacob not interacting averaged 82.9%, but there was an immediate and substantial change once Intensive Interaction sessions began (the average incidence of no interactive behaviours fell to 11.6% in the intervention phase).
• As soon as the Intensive Interaction started Jacob began to look at or towards Emma’s face, with a surge to 75.7% incidence after week 1 of the I.I. sessions. There was also a second surge to 85% at week 26, after an 11 week gap in the I.I when Emma was ill*. Despite this setback the average incidence of looking at or towards Emma’s face went from 8.4% at baseline, to 48% in the intervention phase.
• Another early and sustained development was the ability to attend to a joint focus, with this increasing from an average of 3.7% at baseline to an average of 65.5% during the Intensive Interaction.
• Two other behaviours that emerged were eye contact and social physical contact e.g. the touching of a hand or a hug, with both these behaviours being completely absent from Jacob’s communicative repertoire before the onset of Intensive Interaction.
• Jacob’s engagement (i.e. a state when Jacob was completely absorbed in his interaction with Emma) showed average incidence figures of 46.4% during the intervention phase compared with 2.6% at baseline.
Observation data from the video was triangulated by the two assessment schedules: Kiernan & Reid’s Pre-Verbal Communication Assessment Schedule and Brazelton’s Cuddliness Scale – these schedules showed no progress in the five weeks of baseline. Jacob was able to achieve 14.3% of the pre-verbal communication descriptors during baseline, but at the end of the study this figure had risen to 56.6%.
Jacob’s baseline scores on the Brazelton’s Cuddliness Scale (a measure of physical sociability) showed him as responding passively to social physical contact - ‘neither actively resisting nor participating’. But after 5 weeks of Intensive Interaction, this had moved up to point 5 on the scale - ‘usually relaxes and moulds when first held’. At the end Jacob progressed even further where he, himself, was initiating the social physical contact.
Staff and researcher observations: Discussions with staff showed unanimous acknowledgement of the immense progress Jacob had made since starting out on his Intensive Interaction journey: his self-injurious behaviours had all but vanished; his stereotypical behaviours had greatly reduced; he was much more alert and aware of his peers and environment; he was able to participate in group activities.
Staff were also of the opinion that Jacob had become a much happier child. He had progressed from being a ‘hard to reach’ child, who spent the majority of his time in self-injurious stereotypy, to a happy, socially interactive child who could participate in joint activities, engage in purposeful social interaction and was beginning to use some formal communication skills.
(*unfortunately Emma was off work for 3 months, and the effects of this are referred to in the analysis of the data).},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper reports on the use of Intensive Interaction with Jacob, an 8 years old boy with severe learning difficulties. A multiple-method methodology was used, with the findings showing substantial progress in sociability and communication: Jacob’s stereotyped behaviour was also observed to substantially reduce.
Methodology: a multiple baseline interrupted time series methodology was used, with 6 children (across 3 special schools) given different baseline and staggered intervention phase starts. Video data was gathered alongside 2 assessment schedules (see below). Jacob was filmed over a 5 week baseline and a 42 week intervention phase, and various social behaviours were coded. Also a teacher’s log was kept alongside sessional I.I. reflection sheets.
Jacob’s profile: Jacob had severe learning difficulties (he was pre-verbal) and also epilepsy and physical impairments. He was unable to weight-bear or sit for long periods, and would often become distressed and was prone to self-injury e.g. banging his head or elbow. He was reported to spend most of his time in social isolation, engaged in various forms of stereotyped activity.
The Intensive Interaction sessions: a teaching assistant, Emma, volunteered to work with Jacob with the support of the class teacher. Initially Emma had to work hard to gain Jacob’s attention, and she decided to work with Jacob out of his wheelchair. She sat Jacob face to face on her knee, and responded to any of his actions (even burps & sneezes) with an imitation or a positive comment. Jacob continued to engage in his rocking activity when on Emma’s knee, but she turned it into a game: rocking rhythmically with him and singing ‘Row, row, row the boat.’ Jacob loved this - indicating his pleasure with smiles. Soon Jacob was initiating the game, taking hold of Emma’s hands and starting the rocking himself. Other games were introduced e.g. the teasing rhyme ‘if you see the crocodile, don’t forget to scream’, with Emma and Jacob both ‘screaming’ together. As time went by Jacob became more interested in his interaction with Emma, and he would scrutinise her face and engage in eye contact and, on occasions, even stroke her hand or face.
The findings:
• In the baseline phase the percentage incidence of Jacob not interacting averaged 82.9%, but there was an immediate and substantial change once Intensive Interaction sessions began (the average incidence of no interactive behaviours fell to 11.6% in the intervention phase).
• As soon as the Intensive Interaction started Jacob began to look at or towards Emma’s face, with a surge to 75.7% incidence after week 1 of the I.I. sessions. There was also a second surge to 85% at week 26, after an 11 week gap in the I.I when Emma was ill*. Despite this setback the average incidence of looking at or towards Emma’s face went from 8.4% at baseline, to 48% in the intervention phase.
• Another early and sustained development was the ability to attend to a joint focus, with this increasing from an average of 3.7% at baseline to an average of 65.5% during the Intensive Interaction.
• Two other behaviours that emerged were eye contact and social physical contact e.g. the touching of a hand or a hug, with both these behaviours being completely absent from Jacob’s communicative repertoire before the onset of Intensive Interaction.
• Jacob’s engagement (i.e. a state when Jacob was completely absorbed in his interaction with Emma) showed average incidence figures of 46.4% during the intervention phase compared with 2.6% at baseline.
Observation data from the video was triangulated by the two assessment schedules: Kiernan & Reid’s Pre-Verbal Communication Assessment Schedule and Brazelton’s Cuddliness Scale – these schedules showed no progress in the five weeks of baseline. Jacob was able to achieve 14.3% of the pre-verbal communication descriptors during baseline, but at the end of the study this figure had risen to 56.6%.
Jacob’s baseline scores on the Brazelton’s Cuddliness Scale (a measure of physical sociability) showed him as responding passively to social physical contact - ‘neither actively resisting nor participating’. But after 5 weeks of Intensive Interaction, this had moved up to point 5 on the scale - ‘usually relaxes and moulds when first held’. At the end Jacob progressed even further where he, himself, was initiating the social physical contact.
Staff and researcher observations: Discussions with staff showed unanimous acknowledgement of the immense progress Jacob had made since starting out on his Intensive Interaction journey: his self-injurious behaviours had all but vanished; his stereotypical behaviours had greatly reduced; he was much more alert and aware of his peers and environment; he was able to participate in group activities.
Staff were also of the opinion that Jacob had become a much happier child. He had progressed from being a ‘hard to reach’ child, who spent the majority of his time in self-injurious stereotypy, to a happy, socially interactive child who could participate in joint activities, engage in purposeful social interaction and was beginning to use some formal communication skills.
(*unfortunately Emma was off work for 3 months, and the effects of this are referred to in the analysis of the data).
Methodology: a multiple baseline interrupted time series methodology was used, with 6 children (across 3 special schools) given different baseline and staggered intervention phase starts. Video data was gathered alongside 2 assessment schedules (see below). Jacob was filmed over a 5 week baseline and a 42 week intervention phase, and various social behaviours were coded. Also a teacher’s log was kept alongside sessional I.I. reflection sheets.
Jacob’s profile: Jacob had severe learning difficulties (he was pre-verbal) and also epilepsy and physical impairments. He was unable to weight-bear or sit for long periods, and would often become distressed and was prone to self-injury e.g. banging his head or elbow. He was reported to spend most of his time in social isolation, engaged in various forms of stereotyped activity.
The Intensive Interaction sessions: a teaching assistant, Emma, volunteered to work with Jacob with the support of the class teacher. Initially Emma had to work hard to gain Jacob’s attention, and she decided to work with Jacob out of his wheelchair. She sat Jacob face to face on her knee, and responded to any of his actions (even burps & sneezes) with an imitation or a positive comment. Jacob continued to engage in his rocking activity when on Emma’s knee, but she turned it into a game: rocking rhythmically with him and singing ‘Row, row, row the boat.’ Jacob loved this - indicating his pleasure with smiles. Soon Jacob was initiating the game, taking hold of Emma’s hands and starting the rocking himself. Other games were introduced e.g. the teasing rhyme ‘if you see the crocodile, don’t forget to scream’, with Emma and Jacob both ‘screaming’ together. As time went by Jacob became more interested in his interaction with Emma, and he would scrutinise her face and engage in eye contact and, on occasions, even stroke her hand or face.
The findings:
• In the baseline phase the percentage incidence of Jacob not interacting averaged 82.9%, but there was an immediate and substantial change once Intensive Interaction sessions began (the average incidence of no interactive behaviours fell to 11.6% in the intervention phase).
• As soon as the Intensive Interaction started Jacob began to look at or towards Emma’s face, with a surge to 75.7% incidence after week 1 of the I.I. sessions. There was also a second surge to 85% at week 26, after an 11 week gap in the I.I when Emma was ill*. Despite this setback the average incidence of looking at or towards Emma’s face went from 8.4% at baseline, to 48% in the intervention phase.
• Another early and sustained development was the ability to attend to a joint focus, with this increasing from an average of 3.7% at baseline to an average of 65.5% during the Intensive Interaction.
• Two other behaviours that emerged were eye contact and social physical contact e.g. the touching of a hand or a hug, with both these behaviours being completely absent from Jacob’s communicative repertoire before the onset of Intensive Interaction.
• Jacob’s engagement (i.e. a state when Jacob was completely absorbed in his interaction with Emma) showed average incidence figures of 46.4% during the intervention phase compared with 2.6% at baseline.
Observation data from the video was triangulated by the two assessment schedules: Kiernan & Reid’s Pre-Verbal Communication Assessment Schedule and Brazelton’s Cuddliness Scale – these schedules showed no progress in the five weeks of baseline. Jacob was able to achieve 14.3% of the pre-verbal communication descriptors during baseline, but at the end of the study this figure had risen to 56.6%.
Jacob’s baseline scores on the Brazelton’s Cuddliness Scale (a measure of physical sociability) showed him as responding passively to social physical contact - ‘neither actively resisting nor participating’. But after 5 weeks of Intensive Interaction, this had moved up to point 5 on the scale - ‘usually relaxes and moulds when first held’. At the end Jacob progressed even further where he, himself, was initiating the social physical contact.
Staff and researcher observations: Discussions with staff showed unanimous acknowledgement of the immense progress Jacob had made since starting out on his Intensive Interaction journey: his self-injurious behaviours had all but vanished; his stereotypical behaviours had greatly reduced; he was much more alert and aware of his peers and environment; he was able to participate in group activities.
Staff were also of the opinion that Jacob had become a much happier child. He had progressed from being a ‘hard to reach’ child, who spent the majority of his time in self-injurious stereotypy, to a happy, socially interactive child who could participate in joint activities, engage in purposeful social interaction and was beginning to use some formal communication skills.
(*unfortunately Emma was off work for 3 months, and the effects of this are referred to in the analysis of the data).
2002
Nind, Melanie; Cochrane, Steve
Inclusive curricula? Pupils on the margins of special schools Journal Article
In: International Journal of Inclusive Education, vol. 6, no. 2, pp. 185-198, 2002, ISSN: 1360-3110.
@article{Nind2002,
title = {Inclusive curricula? Pupils on the margins of special schools},
author = {Melanie Nind and Steve Cochrane },
url = {https://www.tandfonline.com/doi/pdf/10.1080/13603110110067217?needAccess=true},
doi = {https://doi.org/10.1080/13603110110067217},
issn = {1360-3110},
year = {2002},
date = {2002-11-10},
journal = {International Journal of Inclusive Education},
volume = {6},
number = {2},
pages = {185-198},
abstract = {This paper discusses an inclusion initiative and action research project involving the special schools and services of an education administration (Local Education Authority) in the UK. The project is concerned with the classroom contexts and dynamics that create difficulty. It is not intended to produce incremental change along a developmental path, but rather to stimulate transformation of thinking within the schools. The focus is on pupils who provide the greatest challenge to the routine confidence and competence of teachers. The local education administration aims to avoid placement of these pupils out of the locality in specialist provision elsewhere in the country by developing appropriate curricula, pedagogy and support locally. The part of the project reported here makes use of Intensive Interaction, an interactive approach that emphasizes the quality of teacher-learner interaction, as a vehicle for reviewing and transforming practice. The emphasis is on intuitive teaching combined with critical reflection and collaborative problem-solving, rather than on the notion of specialist ‘experts’. The planning, action and developments of the initial year of the project are reported and themes related to the challenge of inclusion are discussed.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper discusses an inclusion initiative and action research project involving the special schools and services of an education administration (Local Education Authority) in the UK. The project is concerned with the classroom contexts and dynamics that create difficulty. It is not intended to produce incremental change along a developmental path, but rather to stimulate transformation of thinking within the schools. The focus is on pupils who provide the greatest challenge to the routine confidence and competence of teachers. The local education administration aims to avoid placement of these pupils out of the locality in specialist provision elsewhere in the country by developing appropriate curricula, pedagogy and support locally. The part of the project reported here makes use of Intensive Interaction, an interactive approach that emphasizes the quality of teacher-learner interaction, as a vehicle for reviewing and transforming practice. The emphasis is on intuitive teaching combined with critical reflection and collaborative problem-solving, rather than on the notion of specialist ‘experts’. The planning, action and developments of the initial year of the project are reported and themes related to the challenge of inclusion are discussed.
Nind, Melanie; Kellett, Mary
Responding to learners with severe learning difficulties and stereotyped behaviour: challenges for an inclusive era Journal Article
In: European Journal of Special Needs Education, vol. 17, no. 3, pp. 265-82, 2002, ISSN: 0885-6250.
@article{Nind2002b,
title = {Responding to learners with severe learning difficulties and stereotyped behaviour: challenges for an inclusive era},
author = {Melanie Nind and Mary Kellett},
url = {https://www.tandfonline.com/doi/pdf/10.1080/08856250210162167?needAccess=true},
doi = {https://doi.org/10.1080/08856250210162167},
issn = {0885-6250},
year = {2002},
date = {2002-10-15},
journal = {European Journal of Special Needs Education},
volume = {17},
number = {3},
pages = {265-82},
abstract = {Traditionally, professionals working with individuals with severe learning difficulties who demonstrate stereotyped behaviours, such as rocking and hand-flapping, have viewed such behaviours as undesirable, inappropriate and in need of reduction or elimination. This perspective is influenced by notions of readying those individuals for mixed settings, educating, training or modifying them to help gain their acceptance. Intensive Interaction is an alternative approach for working with individuals with complex difficulties that responds positively to them and their stereotyped behaviours, sometimes using these as a point of connection. Intensive Interaction sets out to enhance social and communication abilities and not to reduce stereotyped behaviours. However, findings from two studies of Intensive Interaction that show some reduction in stereotyped behaviours are reported and discussed. The authors consider the way in which more inclusive thinking connects with changes in thinking about stereotyped behaviour and the individuals who engage in them.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Traditionally, professionals working with individuals with severe learning difficulties who demonstrate stereotyped behaviours, such as rocking and hand-flapping, have viewed such behaviours as undesirable, inappropriate and in need of reduction or elimination. This perspective is influenced by notions of readying those individuals for mixed settings, educating, training or modifying them to help gain their acceptance. Intensive Interaction is an alternative approach for working with individuals with complex difficulties that responds positively to them and their stereotyped behaviours, sometimes using these as a point of connection. Intensive Interaction sets out to enhance social and communication abilities and not to reduce stereotyped behaviours. However, findings from two studies of Intensive Interaction that show some reduction in stereotyped behaviours are reported and discussed. The authors consider the way in which more inclusive thinking connects with changes in thinking about stereotyped behaviour and the individuals who engage in them.
2001
Elgie, Sarah; Maguire, Nick
Intensive interaction with a woman with profound and multiple disabilities: a case study Journal Article
In: Tizard Learning Disability Review, vol. 6, no. 3, pp. 18-24, 2001, ISSN: 1359-5474.
@article{Elgie2001,
title = {Intensive interaction with a woman with profound and multiple disabilities: a case study},
author = {Sarah Elgie and Nick Maguire},
doi = {https://doi.org/10.1108/13595474200100024},
issn = {1359-5474},
year = {2001},
date = {2001-07-01},
journal = {Tizard Learning Disability Review},
volume = {6},
number = {3},
pages = {18-24},
abstract = {The Participant: This study reports on the use of Intensive Interaction with a remote and withdrawn 39-year-old woman, Anna, who engaged in serious self-injurious behaviour (SIB). Anna was a blind woman with profound learning disabilities who had lived all her life within the care system. She was ‘extremely emotionally and socially isolated’ and had ‘effectively cut herself off from the outside world’. She was reported as having no verbal skills and ‘used very limited non-verbal communication’.
Anna had engaged in serious self-injurious behaviour since childhood ‘to the extent that her face and eyes had become extremely disfigured’. To protect her from damaging her face and eyes further she wore plastic arm splints for 25 minutes in every hour.
Prior to the intervention, baseline measures of Anna’s self-injurious behaviours were collated for six months prior to the start of Intensive Interaction. When Anna’s splints were removed she immediately started to self-injure, by eye gouging or pressing her fingers under her collarbone. During the intervention Anna was seen three times a week in her room for 16 weeks by both therapists (a psychologist and an assistant psychologist, named as the authors above), and this was carried out whilst her arms were splinted. The sessions of Intensive Interaction contained physical contact (esp. hand holding), vocal commentary with intonation and sensitively timed vocal imitation. These sessions lasted up to 25 minutes.
The Results: There was ‘an obvious increase in the amount of hand contact’ spontaneous initiated by Anna after the Intensive Interaction began. This was in contrast to her behaviour prior to the Intensive Interaction intervention when no spontaneous reaching out by Anna had been observed, despite the fact that Anna had been receiving the same amount of individual time with a therapist in the six months before the intervention (when the first author was unsuccessfully attempting to engage her in a behavioural program involving reward and tactile stimulation). This new behaviour was seen to be ‘an exciting and striking response to Intensive Interaction’.
The results also showed that Anna made more vocalisations during the Intensive Interaction sessions than when she was alone. According to the authors, ‘the decrease in vocalisation when Anna was alone suggests that Anna’s noises were attempts to communicate with and respond to the therapists’ interactions in a dialogue type fashion’.
However, also included in the findings was the assertion that ‘there was no appreciable change’ in the presentation of the Anna’s SIB (self-injurious behaviour) over time; this was indicated by the authors as being ‘expected at this early stage of intervention, given that she had used self-injurious forms of stimulation for most of her life’.
Some Discussion: Generally, the authors concluded that this study provided further evidence of the effectiveness of Intensive Interaction in ‘the development of social and communicative skills’. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The Participant: This study reports on the use of Intensive Interaction with a remote and withdrawn 39-year-old woman, Anna, who engaged in serious self-injurious behaviour (SIB). Anna was a blind woman with profound learning disabilities who had lived all her life within the care system. She was ‘extremely emotionally and socially isolated’ and had ‘effectively cut herself off from the outside world’. She was reported as having no verbal skills and ‘used very limited non-verbal communication’.
Anna had engaged in serious self-injurious behaviour since childhood ‘to the extent that her face and eyes had become extremely disfigured’. To protect her from damaging her face and eyes further she wore plastic arm splints for 25 minutes in every hour.
Prior to the intervention, baseline measures of Anna’s self-injurious behaviours were collated for six months prior to the start of Intensive Interaction. When Anna’s splints were removed she immediately started to self-injure, by eye gouging or pressing her fingers under her collarbone. During the intervention Anna was seen three times a week in her room for 16 weeks by both therapists (a psychologist and an assistant psychologist, named as the authors above), and this was carried out whilst her arms were splinted. The sessions of Intensive Interaction contained physical contact (esp. hand holding), vocal commentary with intonation and sensitively timed vocal imitation. These sessions lasted up to 25 minutes.
The Results: There was ‘an obvious increase in the amount of hand contact’ spontaneous initiated by Anna after the Intensive Interaction began. This was in contrast to her behaviour prior to the Intensive Interaction intervention when no spontaneous reaching out by Anna had been observed, despite the fact that Anna had been receiving the same amount of individual time with a therapist in the six months before the intervention (when the first author was unsuccessfully attempting to engage her in a behavioural program involving reward and tactile stimulation). This new behaviour was seen to be ‘an exciting and striking response to Intensive Interaction’.
The results also showed that Anna made more vocalisations during the Intensive Interaction sessions than when she was alone. According to the authors, ‘the decrease in vocalisation when Anna was alone suggests that Anna’s noises were attempts to communicate with and respond to the therapists’ interactions in a dialogue type fashion’.
However, also included in the findings was the assertion that ‘there was no appreciable change’ in the presentation of the Anna’s SIB (self-injurious behaviour) over time; this was indicated by the authors as being ‘expected at this early stage of intervention, given that she had used self-injurious forms of stimulation for most of her life’.
Some Discussion: Generally, the authors concluded that this study provided further evidence of the effectiveness of Intensive Interaction in ‘the development of social and communicative skills’.
Anna had engaged in serious self-injurious behaviour since childhood ‘to the extent that her face and eyes had become extremely disfigured’. To protect her from damaging her face and eyes further she wore plastic arm splints for 25 minutes in every hour.
Prior to the intervention, baseline measures of Anna’s self-injurious behaviours were collated for six months prior to the start of Intensive Interaction. When Anna’s splints were removed she immediately started to self-injure, by eye gouging or pressing her fingers under her collarbone. During the intervention Anna was seen three times a week in her room for 16 weeks by both therapists (a psychologist and an assistant psychologist, named as the authors above), and this was carried out whilst her arms were splinted. The sessions of Intensive Interaction contained physical contact (esp. hand holding), vocal commentary with intonation and sensitively timed vocal imitation. These sessions lasted up to 25 minutes.
The Results: There was ‘an obvious increase in the amount of hand contact’ spontaneous initiated by Anna after the Intensive Interaction began. This was in contrast to her behaviour prior to the Intensive Interaction intervention when no spontaneous reaching out by Anna had been observed, despite the fact that Anna had been receiving the same amount of individual time with a therapist in the six months before the intervention (when the first author was unsuccessfully attempting to engage her in a behavioural program involving reward and tactile stimulation). This new behaviour was seen to be ‘an exciting and striking response to Intensive Interaction’.
The results also showed that Anna made more vocalisations during the Intensive Interaction sessions than when she was alone. According to the authors, ‘the decrease in vocalisation when Anna was alone suggests that Anna’s noises were attempts to communicate with and respond to the therapists’ interactions in a dialogue type fashion’.
However, also included in the findings was the assertion that ‘there was no appreciable change’ in the presentation of the Anna’s SIB (self-injurious behaviour) over time; this was indicated by the authors as being ‘expected at this early stage of intervention, given that she had used self-injurious forms of stimulation for most of her life’.
Some Discussion: Generally, the authors concluded that this study provided further evidence of the effectiveness of Intensive Interaction in ‘the development of social and communicative skills’.
Samuel, Judith
Intensive Interaction in context Journal Article
In: Tizard Learning Disability Review, vol. 6, no. 3, pp. 25-30, 2001, ISSN: 1359-5474.
@article{Samuel2001,
title = {Intensive Interaction in context},
author = {Judith Samuel},
url = {https://www.emerald.com/insight/content/doi/10.1108/13595474200100025/full/html},
doi = {https://doi.org/10.1108/13595474200100025},
issn = {1359-5474},
year = {2001},
date = {2001-07-01},
journal = {Tizard Learning Disability Review},
volume = {6},
number = {3},
pages = {25-30},
abstract = {Initially called ‘augmented mothering’, intensive interaction was pioneered by a clinical psychologist (Ephraim, 1982) working in an institutional setting. Interest spread to a nearby school at Harperbury Hospital (Nind & Hewett, 1988). Here the applications of programmes for teaching discrimination and self-help skills and reduction of problem behaviours were not making an impact , and staff were concerned to find alternative ways to meet fundamental learning needs. Intensive interaction became the term that stuck for the new approach (Nind & Hewett, 1994) with the most recent definition being;
‘The specific interactive approach…to facilitating the development of social and communication abilities in people with SLD based on the model of care-giver infant interaction’(Nind & Hewett, 2001 pvi).
In their single case experimental study with Anna, Elgie and Maguire describe the model behind intensive interaction and outline what can impede the quality of interaction between people with profound learning disability (PLD) and their carers.
},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Initially called ‘augmented mothering’, intensive interaction was pioneered by a clinical psychologist (Ephraim, 1982) working in an institutional setting. Interest spread to a nearby school at Harperbury Hospital (Nind & Hewett, 1988). Here the applications of programmes for teaching discrimination and self-help skills and reduction of problem behaviours were not making an impact , and staff were concerned to find alternative ways to meet fundamental learning needs. Intensive interaction became the term that stuck for the new approach (Nind & Hewett, 1994) with the most recent definition being;
‘The specific interactive approach…to facilitating the development of social and communication abilities in people with SLD based on the model of care-giver infant interaction’(Nind & Hewett, 2001 pvi).
In their single case experimental study with Anna, Elgie and Maguire describe the model behind intensive interaction and outline what can impede the quality of interaction between people with profound learning disability (PLD) and their carers.
‘The specific interactive approach…to facilitating the development of social and communication abilities in people with SLD based on the model of care-giver infant interaction’(Nind & Hewett, 2001 pvi).
In their single case experimental study with Anna, Elgie and Maguire describe the model behind intensive interaction and outline what can impede the quality of interaction between people with profound learning disability (PLD) and their carers.
Nind, Melanie; Kellett, Mary; Hopkins, Vicky
Teachers’ talk styles: communicating with learners with severe and complex learning difficulties Journal Article
In: Child Language and Therapy, vol. 17, no. 2, pp. 143-159, 2001, ISSN: 0265-6590.
@article{Nind2001,
title = {Teachers’ talk styles: communicating with learners with severe and complex learning difficulties},
author = {Melanie Nind and Mary Kellett and Vicky Hopkins},
url = {https://doi.org/10.1177/026565900101700204},
doi = {10.1177/026565900101700204},
issn = {0265-6590},
year = {2001},
date = {2001-06-01},
urldate = {2001-06-01},
journal = {Child Language and Therapy},
volume = {17},
number = {2},
pages = {143-159},
abstract = {Some Background: the authors of this paper argue that the communication difficulties experienced by those with severe or profound learning disabilities have been typically attributed entirely to the learning disabled person, and therefore interventions are usually aimed at enhancing their communicative abilities. In this paper, Intensive Interaction is conceptualised as ‘transactional’ in nature, and as such difficulties are seen as arising from both sides of the communication process.
The authors note that research studies indicate that parents of disabled children tend to adopt a more directive approach to communication, whereas in contrast, mothers of typically developing children adopt a less directive style of interaction labelled ‘Motherese’, which uses slow, simple language with an exaggerated use of pitch. It is suggested that ‘Motherese’ is designed to maximise the engagement level and understanding of the child. ‘Motherese’ is also noted to employ vocalisations in unison with the child, use imitations of vocal pitch, rhythm and duration and promote the use of turn-taking, techniques similar to those used in Intensive Interaction.
The Method: This study examined the interactive talk of teachers engaging in Intensive Interaction, and the degree to which ‘Motherese’ was used to engage their learners. 4 teachers were each asked to submit 2 video clips of them practising Intensive Interaction with a partner. These videos were rated for evidence of ‘Motherese’, with the authors also identifying if some particular features of ‘Motherese’ were more common than others.
The Results: the results showed that in all of the 8 videos ‘Motherese’ was demonstrated, although the amount used varied considerably between participants. No particular feature of ‘Motherese’ was found to be evident in all of the videos, suggesting that the use of the Motherese style is individual to each interactor.
The teachers who were identified as most successfully engaging their interactive partners were noted to employ a wide range of elements of ‘Motherese’ in their interactive repertoires (although these elements were not used on every occasion). ‘Contingent Vocalisation’ or ‘joining-in’ was identified as a core feature of ‘Motherese’, and it was indicated as being more naturally used than other aspects.
Some Discussion: This research found ‘Motherese’ to be an important component in the more successful interactions observed between teachers and learners with severe or complex learning difficulties. From this the authors concluded that the differentiated interactive styles highlighted were evidence that the teachers were influenced by their interactive partners, and modified their own interactive approaches accordingly. The authors believe that such a finding implies that the source of any identified communicative difficulty does not lie entirely with the learning disabled person. Instead they identify a shared or ‘transactional’ model as a more accurate representation of the communication difficulties experienced by people with severe or profound learning disabilities.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Some Background: the authors of this paper argue that the communication difficulties experienced by those with severe or profound learning disabilities have been typically attributed entirely to the learning disabled person, and therefore interventions are usually aimed at enhancing their communicative abilities. In this paper, Intensive Interaction is conceptualised as ‘transactional’ in nature, and as such difficulties are seen as arising from both sides of the communication process.
The authors note that research studies indicate that parents of disabled children tend to adopt a more directive approach to communication, whereas in contrast, mothers of typically developing children adopt a less directive style of interaction labelled ‘Motherese’, which uses slow, simple language with an exaggerated use of pitch. It is suggested that ‘Motherese’ is designed to maximise the engagement level and understanding of the child. ‘Motherese’ is also noted to employ vocalisations in unison with the child, use imitations of vocal pitch, rhythm and duration and promote the use of turn-taking, techniques similar to those used in Intensive Interaction.
The Method: This study examined the interactive talk of teachers engaging in Intensive Interaction, and the degree to which ‘Motherese’ was used to engage their learners. 4 teachers were each asked to submit 2 video clips of them practising Intensive Interaction with a partner. These videos were rated for evidence of ‘Motherese’, with the authors also identifying if some particular features of ‘Motherese’ were more common than others.
The Results: the results showed that in all of the 8 videos ‘Motherese’ was demonstrated, although the amount used varied considerably between participants. No particular feature of ‘Motherese’ was found to be evident in all of the videos, suggesting that the use of the Motherese style is individual to each interactor.
The teachers who were identified as most successfully engaging their interactive partners were noted to employ a wide range of elements of ‘Motherese’ in their interactive repertoires (although these elements were not used on every occasion). ‘Contingent Vocalisation’ or ‘joining-in’ was identified as a core feature of ‘Motherese’, and it was indicated as being more naturally used than other aspects.
Some Discussion: This research found ‘Motherese’ to be an important component in the more successful interactions observed between teachers and learners with severe or complex learning difficulties. From this the authors concluded that the differentiated interactive styles highlighted were evidence that the teachers were influenced by their interactive partners, and modified their own interactive approaches accordingly. The authors believe that such a finding implies that the source of any identified communicative difficulty does not lie entirely with the learning disabled person. Instead they identify a shared or ‘transactional’ model as a more accurate representation of the communication difficulties experienced by people with severe or profound learning disabilities.
The authors note that research studies indicate that parents of disabled children tend to adopt a more directive approach to communication, whereas in contrast, mothers of typically developing children adopt a less directive style of interaction labelled ‘Motherese’, which uses slow, simple language with an exaggerated use of pitch. It is suggested that ‘Motherese’ is designed to maximise the engagement level and understanding of the child. ‘Motherese’ is also noted to employ vocalisations in unison with the child, use imitations of vocal pitch, rhythm and duration and promote the use of turn-taking, techniques similar to those used in Intensive Interaction.
The Method: This study examined the interactive talk of teachers engaging in Intensive Interaction, and the degree to which ‘Motherese’ was used to engage their learners. 4 teachers were each asked to submit 2 video clips of them practising Intensive Interaction with a partner. These videos were rated for evidence of ‘Motherese’, with the authors also identifying if some particular features of ‘Motherese’ were more common than others.
The Results: the results showed that in all of the 8 videos ‘Motherese’ was demonstrated, although the amount used varied considerably between participants. No particular feature of ‘Motherese’ was found to be evident in all of the videos, suggesting that the use of the Motherese style is individual to each interactor.
The teachers who were identified as most successfully engaging their interactive partners were noted to employ a wide range of elements of ‘Motherese’ in their interactive repertoires (although these elements were not used on every occasion). ‘Contingent Vocalisation’ or ‘joining-in’ was identified as a core feature of ‘Motherese’, and it was indicated as being more naturally used than other aspects.
Some Discussion: This research found ‘Motherese’ to be an important component in the more successful interactions observed between teachers and learners with severe or complex learning difficulties. From this the authors concluded that the differentiated interactive styles highlighted were evidence that the teachers were influenced by their interactive partners, and modified their own interactive approaches accordingly. The authors believe that such a finding implies that the source of any identified communicative difficulty does not lie entirely with the learning disabled person. Instead they identify a shared or ‘transactional’ model as a more accurate representation of the communication difficulties experienced by people with severe or profound learning disabilities.
Cameron, L; Bell, D
Enhanced Interaction Training Journal Article
In: Working with People who have a Learning Disability, vol. 18, no. 3, pp. 8-15, 2001.
@article{Cameron2001,
title = {Enhanced Interaction Training},
author = {L Cameron and D Bell},
year = {2001},
date = {2001-01-01},
journal = {Working with People who have a Learning Disability},
volume = {18},
number = {3},
pages = {8-15},
abstract = {This article focused on a multidisciplinary intervention to introduce staff to Intensive Interaction and support them in using it with their own clients.
An Introduction: It has been estimated that 50% of people with learning disabilities have significant communication problems (Scottish Executive Review of Services, 2000). However, the diagnosis of a communication problem often masks the other (i.e. the learning disability), and staff working with learning disabled people are typically poor at communicating within their client’s level of understanding (Bradshaw, 2001). It is suggested by Bott et al (1997) that a person’s level of communication difficulties is also highly related to the frequency of their challenging behaviour.
The Initial Clinical Approach: A young man with a severe communication disorder, severe learning disability and serious challenging behaviour was referred to the authors. He communicated only through vocalisations and a few repetitive words. The authors observed and assessed the client in his normal environment and found staff to be over-estimating his level of verbal comprehension and also the level of intent behind his actions. His attempts to communicate non-verbally were not being observed or responded to. The authors designed a programme aimed at improving staff observation and non-verbal communication. They used sensory objects to promote Intensive Interaction with the client.
The Intensive Interaction sessions resulted in increased eye contact, increased initiation of communication, more frequent vocalisations, and repetitive words said with a more communicative context. There was no challenging behaviour within the sessions. The staff, however, did not accept the progress. They were happy that the client could now express pleasure through clapping, but thought that it would be seen negatively in public. The authors felt that in order for this approach to be clinically effective it would require further commitment from staff.
The Revised Clinical Approach: It was decided that the carer attitude to the client, to the possibility of progress, and to the demands that would result from changing the client’s communicative behaviour would need to be addressed. The authors then saw a non-verbal young woman with self-injurious behaviour. There were six sessions of Intensive Interaction in the client’s home where one author would interact with the client whilst the staff member watched. These sessions were video-recorded and reviewed. The staff member then gradually took over the interactive role.
The Results: Due to the Intensive Interaction intervention, the client made significant communicative changes and the staff member showed an improved ability to match their communication to the client. The improvements included increased responsiveness to non-verbal cues, reduced use of verbal language and an increase in the time given for a response. These gains lasted for over a year.},
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}
This article focused on a multidisciplinary intervention to introduce staff to Intensive Interaction and support them in using it with their own clients.
An Introduction: It has been estimated that 50% of people with learning disabilities have significant communication problems (Scottish Executive Review of Services, 2000). However, the diagnosis of a communication problem often masks the other (i.e. the learning disability), and staff working with learning disabled people are typically poor at communicating within their client’s level of understanding (Bradshaw, 2001). It is suggested by Bott et al (1997) that a person’s level of communication difficulties is also highly related to the frequency of their challenging behaviour.
The Initial Clinical Approach: A young man with a severe communication disorder, severe learning disability and serious challenging behaviour was referred to the authors. He communicated only through vocalisations and a few repetitive words. The authors observed and assessed the client in his normal environment and found staff to be over-estimating his level of verbal comprehension and also the level of intent behind his actions. His attempts to communicate non-verbally were not being observed or responded to. The authors designed a programme aimed at improving staff observation and non-verbal communication. They used sensory objects to promote Intensive Interaction with the client.
The Intensive Interaction sessions resulted in increased eye contact, increased initiation of communication, more frequent vocalisations, and repetitive words said with a more communicative context. There was no challenging behaviour within the sessions. The staff, however, did not accept the progress. They were happy that the client could now express pleasure through clapping, but thought that it would be seen negatively in public. The authors felt that in order for this approach to be clinically effective it would require further commitment from staff.
The Revised Clinical Approach: It was decided that the carer attitude to the client, to the possibility of progress, and to the demands that would result from changing the client’s communicative behaviour would need to be addressed. The authors then saw a non-verbal young woman with self-injurious behaviour. There were six sessions of Intensive Interaction in the client’s home where one author would interact with the client whilst the staff member watched. These sessions were video-recorded and reviewed. The staff member then gradually took over the interactive role.
The Results: Due to the Intensive Interaction intervention, the client made significant communicative changes and the staff member showed an improved ability to match their communication to the client. The improvements included increased responsiveness to non-verbal cues, reduced use of verbal language and an increase in the time given for a response. These gains lasted for over a year.
An Introduction: It has been estimated that 50% of people with learning disabilities have significant communication problems (Scottish Executive Review of Services, 2000). However, the diagnosis of a communication problem often masks the other (i.e. the learning disability), and staff working with learning disabled people are typically poor at communicating within their client’s level of understanding (Bradshaw, 2001). It is suggested by Bott et al (1997) that a person’s level of communication difficulties is also highly related to the frequency of their challenging behaviour.
The Initial Clinical Approach: A young man with a severe communication disorder, severe learning disability and serious challenging behaviour was referred to the authors. He communicated only through vocalisations and a few repetitive words. The authors observed and assessed the client in his normal environment and found staff to be over-estimating his level of verbal comprehension and also the level of intent behind his actions. His attempts to communicate non-verbally were not being observed or responded to. The authors designed a programme aimed at improving staff observation and non-verbal communication. They used sensory objects to promote Intensive Interaction with the client.
The Intensive Interaction sessions resulted in increased eye contact, increased initiation of communication, more frequent vocalisations, and repetitive words said with a more communicative context. There was no challenging behaviour within the sessions. The staff, however, did not accept the progress. They were happy that the client could now express pleasure through clapping, but thought that it would be seen negatively in public. The authors felt that in order for this approach to be clinically effective it would require further commitment from staff.
The Revised Clinical Approach: It was decided that the carer attitude to the client, to the possibility of progress, and to the demands that would result from changing the client’s communicative behaviour would need to be addressed. The authors then saw a non-verbal young woman with self-injurious behaviour. There were six sessions of Intensive Interaction in the client’s home where one author would interact with the client whilst the staff member watched. These sessions were video-recorded and reviewed. The staff member then gradually took over the interactive role.
The Results: Due to the Intensive Interaction intervention, the client made significant communicative changes and the staff member showed an improved ability to match their communication to the client. The improvements included increased responsiveness to non-verbal cues, reduced use of verbal language and an increase in the time given for a response. These gains lasted for over a year.
Kennedy, Adrian
Intensive interaction Journal Article
In: Learning Disability Practice, vol. 4, no. 3, pp. 14-17, 2001, ISSN: 7748-1461.
@article{Kennedy2001,
title = {Intensive interaction},
author = {Adrian Kennedy },
doi = {doi: 10.7748/ldp2001.09.4.3.14.c1461},
issn = {7748-1461},
year = {2001},
date = {2001-01-01},
journal = {Learning Disability Practice},
volume = {4},
number = {3},
pages = {14-17},
abstract = {Adrian Kennedy describes how intensive interaction can teach us a new way of communicating with people with profound learning disabilities
The term ‘intensive interaction’ refers to an approach to working with people with learning disabilities that was first used in an educational setting but is relevant to a wide range of services. This article examines how the approach was used in a residential care home.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Adrian Kennedy describes how intensive interaction can teach us a new way of communicating with people with profound learning disabilities
The term ‘intensive interaction’ refers to an approach to working with people with learning disabilities that was first used in an educational setting but is relevant to a wide range of services. This article examines how the approach was used in a residential care home.
The term ‘intensive interaction’ refers to an approach to working with people with learning disabilities that was first used in an educational setting but is relevant to a wide range of services. This article examines how the approach was used in a residential care home.
Samuel, Judith
Intensive Interaction Journal Article
In: Clinical Psychology Forum, vol. 148, pp. 22-5, 2001.
@article{Samuel2001b,
title = {Intensive Interaction},
author = {Judith Samuel},
year = {2001},
date = {2001-01-01},
journal = {Clinical Psychology Forum},
volume = {148},
pages = {22-5},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2000
Kellett, Mary
In: Support for Learning, vol. 15, no. 4, pp. 165- 171, 2000, ISSN: 1467-9604.
@article{Kellett2000,
title = {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},
author = {Mary Kellett},
url = {https://doi.org/10.1111/1467-9604.00170},
doi = {10.1111/1467-9604.00170},
issn = {1467-9604},
year = {2000},
date = {2000-11-01},
urldate = {2003-01-07},
journal = {Support for Learning},
volume = {15},
number = {4},
pages = {165- 171},
abstract = {This research paper concerns a single case study that was part of a larger, more comprehensive longitudinal study of the use of Intensive Interaction in the early education of children with severe learning disabilities.
Participant: Sam was a five year old boy at a community special school, and he was half way through his reception class year. His communication abilities were judged to be ‘at the very early pre-verbal stage’ and he was indicated by the school staff as living ‘in a world of his own’. He did not use any symbolic language or formal signs, made no eye contact with other people and appeared not to observe, nor respond to, other peoples’ facial signalling. He often engaged in self-stimulatory behaviour such as ‘finger play and repetitive jiggling’.
Method & Findings: Using a ‘multiple-baseline interrupted time series methodology’ combined with weekly systematic video-recorded observation over a period of one academic year, the author shows just how much progress Sam made after the initiation of daily 10 minute sessions of Intensive Interaction. Also employed for data generation were two published assessment measures; Kiernan and Reid’s Pre-Verbal Communication Schedule, and an adaptation of Brazelton’s Cuddliness Scale.
From this research the major claims made for Sam’s observed responses to the Intensive Interaction intervention included:
• ‘Huge steps’ forward for Sam in ‘Looking at or towards a partner’s face’
• ‘Modest progress’ in the incidence of ‘social physical contact’
• Sam’s ability to ‘attend to a joint focus or activity with the teacher… developed dramatically’
• ‘Clearly evident’ progression for Sam in the incidence of ‘eye contact’
• Sam’s vocalisations ‘changed considerably’ and he ‘began to use his vocalising ability to respond contingently and to initiate contact’
• A highly significant increase in the time Sam spent ‘engaged in social interaction’
Discussion: In conclusion, the author cautions against generalising too much from the findings of this single case study. However, with this study the author shows how slow progress can be made visible for one of her participating pupils in a non-comparative or judgemental way. Furthermore, although the paper carries a serious academic message, and delivers vitally important evidential backing for the use of Intensive Interaction, it does so in such an optimistic and engaging way that it would be difficult not to be uplifted and personally moved by reading it.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This research paper concerns a single case study that was part of a larger, more comprehensive longitudinal study of the use of Intensive Interaction in the early education of children with severe learning disabilities.
Participant: Sam was a five year old boy at a community special school, and he was half way through his reception class year. His communication abilities were judged to be ‘at the very early pre-verbal stage’ and he was indicated by the school staff as living ‘in a world of his own’. He did not use any symbolic language or formal signs, made no eye contact with other people and appeared not to observe, nor respond to, other peoples’ facial signalling. He often engaged in self-stimulatory behaviour such as ‘finger play and repetitive jiggling’.
Method & Findings: Using a ‘multiple-baseline interrupted time series methodology’ combined with weekly systematic video-recorded observation over a period of one academic year, the author shows just how much progress Sam made after the initiation of daily 10 minute sessions of Intensive Interaction. Also employed for data generation were two published assessment measures; Kiernan and Reid’s Pre-Verbal Communication Schedule, and an adaptation of Brazelton’s Cuddliness Scale.
From this research the major claims made for Sam’s observed responses to the Intensive Interaction intervention included:
• ‘Huge steps’ forward for Sam in ‘Looking at or towards a partner’s face’
• ‘Modest progress’ in the incidence of ‘social physical contact’
• Sam’s ability to ‘attend to a joint focus or activity with the teacher… developed dramatically’
• ‘Clearly evident’ progression for Sam in the incidence of ‘eye contact’
• Sam’s vocalisations ‘changed considerably’ and he ‘began to use his vocalising ability to respond contingently and to initiate contact’
• A highly significant increase in the time Sam spent ‘engaged in social interaction’
Discussion: In conclusion, the author cautions against generalising too much from the findings of this single case study. However, with this study the author shows how slow progress can be made visible for one of her participating pupils in a non-comparative or judgemental way. Furthermore, although the paper carries a serious academic message, and delivers vitally important evidential backing for the use of Intensive Interaction, it does so in such an optimistic and engaging way that it would be difficult not to be uplifted and personally moved by reading it.
Participant: Sam was a five year old boy at a community special school, and he was half way through his reception class year. His communication abilities were judged to be ‘at the very early pre-verbal stage’ and he was indicated by the school staff as living ‘in a world of his own’. He did not use any symbolic language or formal signs, made no eye contact with other people and appeared not to observe, nor respond to, other peoples’ facial signalling. He often engaged in self-stimulatory behaviour such as ‘finger play and repetitive jiggling’.
Method & Findings: Using a ‘multiple-baseline interrupted time series methodology’ combined with weekly systematic video-recorded observation over a period of one academic year, the author shows just how much progress Sam made after the initiation of daily 10 minute sessions of Intensive Interaction. Also employed for data generation were two published assessment measures; Kiernan and Reid’s Pre-Verbal Communication Schedule, and an adaptation of Brazelton’s Cuddliness Scale.
From this research the major claims made for Sam’s observed responses to the Intensive Interaction intervention included:
• ‘Huge steps’ forward for Sam in ‘Looking at or towards a partner’s face’
• ‘Modest progress’ in the incidence of ‘social physical contact’
• Sam’s ability to ‘attend to a joint focus or activity with the teacher… developed dramatically’
• ‘Clearly evident’ progression for Sam in the incidence of ‘eye contact’
• Sam’s vocalisations ‘changed considerably’ and he ‘began to use his vocalising ability to respond contingently and to initiate contact’
• A highly significant increase in the time Sam spent ‘engaged in social interaction’
Discussion: In conclusion, the author cautions against generalising too much from the findings of this single case study. However, with this study the author shows how slow progress can be made visible for one of her participating pupils in a non-comparative or judgemental way. Furthermore, although the paper carries a serious academic message, and delivers vitally important evidential backing for the use of Intensive Interaction, it does so in such an optimistic and engaging way that it would be difficult not to be uplifted and personally moved by reading it.
Nind, Melanie
Teachers’ understanding of interactive approaches in special education Journal Article
In: International Journal of Disability, Development and Education, vol. 47, no. 2, pp. 183-199, 2000.
@article{Nind2000,
title = {Teachers’ understanding of interactive approaches in special education},
author = {Melanie Nind},
url = {https://www.tandfonline.com/doi/abs/10.1080/713671111},
doi = {https://doi.org/10.1080/713671111},
year = {2000},
date = {2000-07-21},
journal = {International Journal of Disability, Development and Education},
volume = {47},
number = {2},
pages = {183-199},
abstract = {This paper considers the adoption of interactive approaches in the history of special education and addresses teachers’ use and conceptualisation of interactive approaches. Teachers in special schools and units in the United Kingdom were asked whether they used interactive approaches and, if so, what this meant in their context. Interactive approaches were reported to be used by two-thirds of the sample and what this meant to the 58 respondents, from different areas of special education, varied considerably. Their responses are compared with the central elements of interactive approaches in the literature. Areas of consensus are discussed and a relative lack of emphasis on process amongst the teachers is identified.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper considers the adoption of interactive approaches in the history of special education and addresses teachers’ use and conceptualisation of interactive approaches. Teachers in special schools and units in the United Kingdom were asked whether they used interactive approaches and, if so, what this meant in their context. Interactive approaches were reported to be used by two-thirds of the sample and what this meant to the 58 respondents, from different areas of special education, varied considerably. Their responses are compared with the central elements of interactive approaches in the literature. Areas of consensus are discussed and a relative lack of emphasis on process amongst the teachers is identified.
Nind, Melanie; Powell, Stuart
Intensive Interaction and autism: some theoretical concerns Journal Article
In: Children and Society, vol. 14, no. 2, pp. 98-109, 2000, ISSN: 1099-0860.
@article{Nind2000b,
title = {Intensive Interaction and autism: some theoretical concerns},
author = {Melanie Nind and Stuart Powell },
url = {https://www.researchgate.net/publication/229753063_Intensive_interaction_and_autism_Some_theoretical_concerns},
doi = { https://doi.org/10.1111/j.1099-0860.2000.tb00158.x},
issn = {1099-0860},
year = {2000},
date = {2000-03-10},
journal = {Children and Society},
volume = {14},
number = {2},
pages = {98-109},
abstract = {The authors consider the possible application of intensive interaction to children with autism. Intensive interaction is briefly described, and the question asked whether children with autism (and developmental delay) can gain from this exemplar of naturalistic, interactive approaches to facilitating sociability and communication. A theoretical approach is taken to unravel the difficulties faced by children with autism in developing sociability and communication, and the way in which intensive interaction functions. Five areas of possible mismatch between the particular difficulties/needs of these children and the method are identified and interrogated. The authors conclude that children with autism can be enabled to learn about interaction and communication through this naturalistic and supportive process. The need for empirical evidence to substantiate this position is highlighted. },
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The authors consider the possible application of intensive interaction to children with autism. Intensive interaction is briefly described, and the question asked whether children with autism (and developmental delay) can gain from this exemplar of naturalistic, interactive approaches to facilitating sociability and communication. A theoretical approach is taken to unravel the difficulties faced by children with autism in developing sociability and communication, and the way in which intensive interaction functions. Five areas of possible mismatch between the particular difficulties/needs of these children and the method are identified and interrogated. The authors conclude that children with autism can be enabled to learn about interaction and communication through this naturalistic and supportive process. The need for empirical evidence to substantiate this position is highlighted.
1999
Nind, Melanie
Intensive Interaction and autism: a useful approach? Journal Article
In: British Journal of Special Education, vol. 26, no. 2, pp. 96–102, 1999, ISSN: 1467-8527.
@article{Nind1999,
title = {Intensive Interaction and autism: a useful approach?},
author = {Melanie Nind },
doi = {https://doi.org/10.1111/1467-8527.t01-1-00114},
issn = {1467-8527},
year = {1999},
date = {1999-06-01},
urldate = {2003-01-06},
journal = {British Journal of Special Education},
volume = {26},
number = {2},
pages = {96–102},
abstract = {This article addressed the potential usefulness of Intensive Interaction (I.I.) for pupils whose learning disabilities are compounded by autism. It begins with a general outline of I.I., describing it as an approach to ‘communication’ suitable for children and young people with the most severe learning disabilities, who have not readily made relationships, established informal communication or who are unable to access the set curriculum.
Nind points out that there had been no focus on I.I. as an approach to meeting the specific difficulties and needs of learners with Autism Spectrum Disorders (ASD). She states that the need to address the relevance of I.I. for those individuals with a learning disability and autism as a separate group has arisen for two reasons: firstly the nature of the autistic condition - personal relatedness with others has been seen as a central impairment in the autistic condition; and secondly, much of the literature on autism emphasises an innate inability to learn from natural interactive processes.
Nind briefly discusses the range of intervention processes used with people with autism spectrum disorders, differentiating between ‘special’ and ‘naturalistic’ approaches. Whilst the challenging nature of many individuals with autism has encouraged a focus on ‘special’ intervention processes, such as TEACCH and Lovaas therapies, there are those who have recognised the benefits of a non-directive interactive style. The article goes on to say that naturalistic approaches do not dominate in the current climate however, where the focus remains on direct training and behavioural intervention. Nind recognises that not all practitioners in the field have shared the implicit assumption that those with learning disabilities and autism are part of the target group for I.I.
To argue the case for I.I. she draws on both theoretical and empirical perspectives. The premise that underlies I.I. is that learning to communicate is not like learning a basic skill, which can be task analysed, with constituent sub-skills taught separately in a structured programme. Becoming an intentional communicator involves learning about oneself and others, learning that we can have an effect on others and that we can share meaning (Harding, 1982). To be effective communicators, we have to want to communicate and have a concept of what communication is all about. Nind argues that the best and possibly only model we have which addresses the development of the desire to communicate with others is in caregiver-infant interaction. The only teaching approach based on this model is I.I.
The empirical evidence cited by Nind looked at the usefulness and appropriateness of I.I. for learners with autism. In this paper Nind considers a single case study, a series of narrative case studies and lastly questionnaire and interview data from teachers using I.I. The case study looked at an adult (Kris), who was diagnosed with autism at the age of four. I.I. was used with him over a 12-month period when he was 28, and any developments measured. Nind notes that there were specific new developments noticed in Kris, which she associates with the introduction of I.I. These included a greater interest in watching people and moulding and relaxing when cuddled.
The narrative case studies presented provide weak empirical evidence in that there were no structured observations, but they do complement the study of Kris with their rich descriptions and reflections. This section describes the attempts of staff and parents to use I.I. with two boys, both of whom are diagnosed with autism. Both accounts discuss how I.I. was introduced, and the resulting developments from using this approach. Such developments included giving sustained attention, initiating contact and allowing others to share in activities.
The last body of evidence that Nind looked at was a study that aimed to identify examples of good practice of I.I. This study provided data looking at the views of practitioners using this approach. Questionnaires were sent to a number of special schools and units in England, looking at the usefulness of using the approach. Results from these questionnaires identified benefits of using I.I. for both pupils and staff. Benefits for pupils included self-motivation, improved communication and the development of relationships. Benefits for staff included improved observation abilities and feeling more positive about the children. Follow-up interviews conducted with seven teachers offered rich observations to support the questionnaire data. Nind notes an interesting pattern that emerged from the findings. Staff did not seem to be concerned about the debate as to whether an interactive approach would make it harder for those with autism to learn. Instead, the decision to use I.I. was based on an assessment of the individual child and the perception of their needs, regardless of whether they had autism or a learning disability.
Finally Nind observes that despite the current emphasis in Special Education on the National Curriculum, interactive approaches continue to develop and be important both in the general field of learning disabilities and concerning individuals on the autistic spectrum. The article concludes that there is every reason for I.I. to be adopted as a useful and effective strategy for working with individuals whose learning disabilities are compounded by autism.
},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This article addressed the potential usefulness of Intensive Interaction (I.I.) for pupils whose learning disabilities are compounded by autism. It begins with a general outline of I.I., describing it as an approach to ‘communication’ suitable for children and young people with the most severe learning disabilities, who have not readily made relationships, established informal communication or who are unable to access the set curriculum.
Nind points out that there had been no focus on I.I. as an approach to meeting the specific difficulties and needs of learners with Autism Spectrum Disorders (ASD). She states that the need to address the relevance of I.I. for those individuals with a learning disability and autism as a separate group has arisen for two reasons: firstly the nature of the autistic condition - personal relatedness with others has been seen as a central impairment in the autistic condition; and secondly, much of the literature on autism emphasises an innate inability to learn from natural interactive processes.
Nind briefly discusses the range of intervention processes used with people with autism spectrum disorders, differentiating between ‘special’ and ‘naturalistic’ approaches. Whilst the challenging nature of many individuals with autism has encouraged a focus on ‘special’ intervention processes, such as TEACCH and Lovaas therapies, there are those who have recognised the benefits of a non-directive interactive style. The article goes on to say that naturalistic approaches do not dominate in the current climate however, where the focus remains on direct training and behavioural intervention. Nind recognises that not all practitioners in the field have shared the implicit assumption that those with learning disabilities and autism are part of the target group for I.I.
To argue the case for I.I. she draws on both theoretical and empirical perspectives. The premise that underlies I.I. is that learning to communicate is not like learning a basic skill, which can be task analysed, with constituent sub-skills taught separately in a structured programme. Becoming an intentional communicator involves learning about oneself and others, learning that we can have an effect on others and that we can share meaning (Harding, 1982). To be effective communicators, we have to want to communicate and have a concept of what communication is all about. Nind argues that the best and possibly only model we have which addresses the development of the desire to communicate with others is in caregiver-infant interaction. The only teaching approach based on this model is I.I.
The empirical evidence cited by Nind looked at the usefulness and appropriateness of I.I. for learners with autism. In this paper Nind considers a single case study, a series of narrative case studies and lastly questionnaire and interview data from teachers using I.I. The case study looked at an adult (Kris), who was diagnosed with autism at the age of four. I.I. was used with him over a 12-month period when he was 28, and any developments measured. Nind notes that there were specific new developments noticed in Kris, which she associates with the introduction of I.I. These included a greater interest in watching people and moulding and relaxing when cuddled.
The narrative case studies presented provide weak empirical evidence in that there were no structured observations, but they do complement the study of Kris with their rich descriptions and reflections. This section describes the attempts of staff and parents to use I.I. with two boys, both of whom are diagnosed with autism. Both accounts discuss how I.I. was introduced, and the resulting developments from using this approach. Such developments included giving sustained attention, initiating contact and allowing others to share in activities.
The last body of evidence that Nind looked at was a study that aimed to identify examples of good practice of I.I. This study provided data looking at the views of practitioners using this approach. Questionnaires were sent to a number of special schools and units in England, looking at the usefulness of using the approach. Results from these questionnaires identified benefits of using I.I. for both pupils and staff. Benefits for pupils included self-motivation, improved communication and the development of relationships. Benefits for staff included improved observation abilities and feeling more positive about the children. Follow-up interviews conducted with seven teachers offered rich observations to support the questionnaire data. Nind notes an interesting pattern that emerged from the findings. Staff did not seem to be concerned about the debate as to whether an interactive approach would make it harder for those with autism to learn. Instead, the decision to use I.I. was based on an assessment of the individual child and the perception of their needs, regardless of whether they had autism or a learning disability.
Finally Nind observes that despite the current emphasis in Special Education on the National Curriculum, interactive approaches continue to develop and be important both in the general field of learning disabilities and concerning individuals on the autistic spectrum. The article concludes that there is every reason for I.I. to be adopted as a useful and effective strategy for working with individuals whose learning disabilities are compounded by autism.
Nind points out that there had been no focus on I.I. as an approach to meeting the specific difficulties and needs of learners with Autism Spectrum Disorders (ASD). She states that the need to address the relevance of I.I. for those individuals with a learning disability and autism as a separate group has arisen for two reasons: firstly the nature of the autistic condition - personal relatedness with others has been seen as a central impairment in the autistic condition; and secondly, much of the literature on autism emphasises an innate inability to learn from natural interactive processes.
Nind briefly discusses the range of intervention processes used with people with autism spectrum disorders, differentiating between ‘special’ and ‘naturalistic’ approaches. Whilst the challenging nature of many individuals with autism has encouraged a focus on ‘special’ intervention processes, such as TEACCH and Lovaas therapies, there are those who have recognised the benefits of a non-directive interactive style. The article goes on to say that naturalistic approaches do not dominate in the current climate however, where the focus remains on direct training and behavioural intervention. Nind recognises that not all practitioners in the field have shared the implicit assumption that those with learning disabilities and autism are part of the target group for I.I.
To argue the case for I.I. she draws on both theoretical and empirical perspectives. The premise that underlies I.I. is that learning to communicate is not like learning a basic skill, which can be task analysed, with constituent sub-skills taught separately in a structured programme. Becoming an intentional communicator involves learning about oneself and others, learning that we can have an effect on others and that we can share meaning (Harding, 1982). To be effective communicators, we have to want to communicate and have a concept of what communication is all about. Nind argues that the best and possibly only model we have which addresses the development of the desire to communicate with others is in caregiver-infant interaction. The only teaching approach based on this model is I.I.
The empirical evidence cited by Nind looked at the usefulness and appropriateness of I.I. for learners with autism. In this paper Nind considers a single case study, a series of narrative case studies and lastly questionnaire and interview data from teachers using I.I. The case study looked at an adult (Kris), who was diagnosed with autism at the age of four. I.I. was used with him over a 12-month period when he was 28, and any developments measured. Nind notes that there were specific new developments noticed in Kris, which she associates with the introduction of I.I. These included a greater interest in watching people and moulding and relaxing when cuddled.
The narrative case studies presented provide weak empirical evidence in that there were no structured observations, but they do complement the study of Kris with their rich descriptions and reflections. This section describes the attempts of staff and parents to use I.I. with two boys, both of whom are diagnosed with autism. Both accounts discuss how I.I. was introduced, and the resulting developments from using this approach. Such developments included giving sustained attention, initiating contact and allowing others to share in activities.
The last body of evidence that Nind looked at was a study that aimed to identify examples of good practice of I.I. This study provided data looking at the views of practitioners using this approach. Questionnaires were sent to a number of special schools and units in England, looking at the usefulness of using the approach. Results from these questionnaires identified benefits of using I.I. for both pupils and staff. Benefits for pupils included self-motivation, improved communication and the development of relationships. Benefits for staff included improved observation abilities and feeling more positive about the children. Follow-up interviews conducted with seven teachers offered rich observations to support the questionnaire data. Nind notes an interesting pattern that emerged from the findings. Staff did not seem to be concerned about the debate as to whether an interactive approach would make it harder for those with autism to learn. Instead, the decision to use I.I. was based on an assessment of the individual child and the perception of their needs, regardless of whether they had autism or a learning disability.
Finally Nind observes that despite the current emphasis in Special Education on the National Curriculum, interactive approaches continue to develop and be important both in the general field of learning disabilities and concerning individuals on the autistic spectrum. The article concludes that there is every reason for I.I. to be adopted as a useful and effective strategy for working with individuals whose learning disabilities are compounded by autism.
1998
Lovell, D; Jones, S; Ephraim, G
The Effect of Intensive Interaction on the Sociability of a Man with Severe Intellectual Disabilities Journal Article
In: International Journal of Practical Approaches to Disability, vol. 22, no. 2/3, pp. 3-8, 1998.
@article{Lovell1998,
title = {The Effect of Intensive Interaction on the Sociability of a Man with Severe Intellectual Disabilities},
author = {D Lovell and S Jones and G Ephraim
},
year = {1998},
date = {1998-01-01},
journal = { International Journal of Practical Approaches to Disability},
volume = {22},
number = {2/3},
pages = {3-8},
abstract = {The Participant: This research was conducted to investigate whether a withdrawn, 53-year-old pre-verbal man (W.) with severe intellectual disabilities showed an increase in sociable behaviour in two differing conditions. In one, a clinical psychologist engaged in Intensive Interaction with the client; in the second, the same psychologist remained close to the client but did not interact with him (‘proximity sessions’). The research was conducted in a long stay hospital for people with severe/profound intellectual disabilities.
The Results: before the interventions, the client (W.) would hum to himself and sing without words. He spent most of his time sitting alone in a corner and did not initiate any physical contact. However, there was much more physical contact in the Intensive Interaction sessions, and in one session he squeezed the psychologist's hands as part of a game for 90% of the time. He also did make physical contact on a number of occasions during the proximity sessions. Before the interventions W. spent no more than 10% of any session looking at another person - in some proximity sessions there was an increased occurrence in looking behaviour; however, during the Intensive Interaction sessions more than 10% of every session was spent looking at somebody, and over 70% on two occasions.
During the course of the intervention, vocalisation (humming or wordless singing) appeared to increase in both the Intensive Interaction and the proximity sessions over the levels recorded previously. Also no episodes of joint attention were recorded prior to the interventions. There was one recorded instance of joint attention in the proximity sessions. Episodes of joint attention were, however, observed during the Intensive Interaction sessions, recording over 70% on two occasions. No smiling or laughing was recorded prior to the interventions. However, W. was noticed to smile and laugh during two proximity sessions, and more often during Intensive Interaction sessions.
W.'s tendency to look at a toy in his hand remained relatively stable prior to, and over the period including both the proximity sessions and the Intensive Interaction sessions. W. covered his face with his clothes for 25 to 50% of the time prior to the interventions. This behaviour was only briefly evident on one of the 17 intervention sessions (during a proximity session). There were no occurrences in the Intensive Interaction sessions.
Some Discussion: the results of this research indicated that during the Intensive Interaction sessions W. tended to initiate more physical contact; spend more time looking at people; demonstrate more joint attention, and smile/laugh and vocalise more than he did prior to the interventions. He showed no examples of covering his face during the Intensive Interaction sessions, although this had been a frequent behaviour previously. The increase in sociability appeared to generalise to the proximity sessions, although the changes were significantly less marked than during Intensive Interaction.
The nursing staff who regularly worked with W. also commented that during the interaction period W. appeared happier and more willing to interact than he had been before. His increased sociability also seemed to generalise from the Intensive Interaction setting to other contexts.},
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pubstate = {published},
tppubtype = {article}
}
The Participant: This research was conducted to investigate whether a withdrawn, 53-year-old pre-verbal man (W.) with severe intellectual disabilities showed an increase in sociable behaviour in two differing conditions. In one, a clinical psychologist engaged in Intensive Interaction with the client; in the second, the same psychologist remained close to the client but did not interact with him (‘proximity sessions’). The research was conducted in a long stay hospital for people with severe/profound intellectual disabilities.
The Results: before the interventions, the client (W.) would hum to himself and sing without words. He spent most of his time sitting alone in a corner and did not initiate any physical contact. However, there was much more physical contact in the Intensive Interaction sessions, and in one session he squeezed the psychologist's hands as part of a game for 90% of the time. He also did make physical contact on a number of occasions during the proximity sessions. Before the interventions W. spent no more than 10% of any session looking at another person - in some proximity sessions there was an increased occurrence in looking behaviour; however, during the Intensive Interaction sessions more than 10% of every session was spent looking at somebody, and over 70% on two occasions.
During the course of the intervention, vocalisation (humming or wordless singing) appeared to increase in both the Intensive Interaction and the proximity sessions over the levels recorded previously. Also no episodes of joint attention were recorded prior to the interventions. There was one recorded instance of joint attention in the proximity sessions. Episodes of joint attention were, however, observed during the Intensive Interaction sessions, recording over 70% on two occasions. No smiling or laughing was recorded prior to the interventions. However, W. was noticed to smile and laugh during two proximity sessions, and more often during Intensive Interaction sessions.
W.'s tendency to look at a toy in his hand remained relatively stable prior to, and over the period including both the proximity sessions and the Intensive Interaction sessions. W. covered his face with his clothes for 25 to 50% of the time prior to the interventions. This behaviour was only briefly evident on one of the 17 intervention sessions (during a proximity session). There were no occurrences in the Intensive Interaction sessions.
Some Discussion: the results of this research indicated that during the Intensive Interaction sessions W. tended to initiate more physical contact; spend more time looking at people; demonstrate more joint attention, and smile/laugh and vocalise more than he did prior to the interventions. He showed no examples of covering his face during the Intensive Interaction sessions, although this had been a frequent behaviour previously. The increase in sociability appeared to generalise to the proximity sessions, although the changes were significantly less marked than during Intensive Interaction.
The nursing staff who regularly worked with W. also commented that during the interaction period W. appeared happier and more willing to interact than he had been before. His increased sociability also seemed to generalise from the Intensive Interaction setting to other contexts.
The Results: before the interventions, the client (W.) would hum to himself and sing without words. He spent most of his time sitting alone in a corner and did not initiate any physical contact. However, there was much more physical contact in the Intensive Interaction sessions, and in one session he squeezed the psychologist's hands as part of a game for 90% of the time. He also did make physical contact on a number of occasions during the proximity sessions. Before the interventions W. spent no more than 10% of any session looking at another person - in some proximity sessions there was an increased occurrence in looking behaviour; however, during the Intensive Interaction sessions more than 10% of every session was spent looking at somebody, and over 70% on two occasions.
During the course of the intervention, vocalisation (humming or wordless singing) appeared to increase in both the Intensive Interaction and the proximity sessions over the levels recorded previously. Also no episodes of joint attention were recorded prior to the interventions. There was one recorded instance of joint attention in the proximity sessions. Episodes of joint attention were, however, observed during the Intensive Interaction sessions, recording over 70% on two occasions. No smiling or laughing was recorded prior to the interventions. However, W. was noticed to smile and laugh during two proximity sessions, and more often during Intensive Interaction sessions.
W.'s tendency to look at a toy in his hand remained relatively stable prior to, and over the period including both the proximity sessions and the Intensive Interaction sessions. W. covered his face with his clothes for 25 to 50% of the time prior to the interventions. This behaviour was only briefly evident on one of the 17 intervention sessions (during a proximity session). There were no occurrences in the Intensive Interaction sessions.
Some Discussion: the results of this research indicated that during the Intensive Interaction sessions W. tended to initiate more physical contact; spend more time looking at people; demonstrate more joint attention, and smile/laugh and vocalise more than he did prior to the interventions. He showed no examples of covering his face during the Intensive Interaction sessions, although this had been a frequent behaviour previously. The increase in sociability appeared to generalise to the proximity sessions, although the changes were significantly less marked than during Intensive Interaction.
The nursing staff who regularly worked with W. also commented that during the interaction period W. appeared happier and more willing to interact than he had been before. His increased sociability also seemed to generalise from the Intensive Interaction setting to other contexts.