Intensive interaction

Intensive Interaction is an approach for teaching communication abilities to children and adults who have autism, severe learning difficulties and profound and multiple learning difficulties who are still at early stages of development. The approach focuses on teaching the Fundamentals of Communication – the communication concepts and performances that basically precede speech development, though it may include many people who have some speech and language development.

The Fundamentals of Communication are typically referred to as being attainments such as:
 * enjoying being with another person
 * developing the ability to attend to that person
 * concentration and attention span
 * learning to do sequences of activity with the other person
 * taking turns in exchanges of behaviour
 * sharing personal space
 * using and understanding eye contacts
 * using and understanding facial expressions
 * using and understanding physical contacts
 * using and understanding non-verbal communication
 * using vocalisations with meaning (for some, speech development)
 * learning to regulate and control arousal levels

Intensive Interaction was developed during the 1980s by teachers working in schools in long-stay hospitals in southern England. The development of the approach came about partly as a result of practitioners questing for effective teaching approaches and partly as a reaction to and move away from the dominance of behavioural psychology in the field. A psychologist, the late Geraint Ephraim, working at Leavesden Mental Hospital, propounded the original formulation of techniques known then as ‘Augmented Mothering’. The detailed development work carried out at Harperbury Hospital School resulted in the first research projects and publications by Melanie Nind and Dave Hewett.

The techniques of teaching borrow from understandings as to how infants in the first two years carry out the learning of these highly complicated, critical concepts and abilities. The mass of research on babies learning in interactions with adults that has arisen since the mid 1970s, allows some simple pedagogical insights. Babies gradually accrue these complex performances by taking part in many successive, cumulative interactions with the adults around them. The main learning motivation for both participants is the mutual enjoyment of the interaction. The natural adult style is to construct the interaction basically, mostly, by allowing the baby to lead with her behaviour, with the adult building the content and a flow by responding to the behaviour of the baby. It is usually observed that the most frequently seen adult response is to imitate what the baby does. Thus the teaching is highly responsive and by process, rather than directive and driving to an objective.

For the developers of Intensive Interaction, it seemed a logical step to borrow from these processes in order to ignite the communication learning of many people who can frequently be considered ‘communicatively difficult to reach’, often living with some, or extensive, social isolation. Thus, Intensive Interaction activities are literally highly interactive, with the teacher enjoyably working from the behaviour of the learner. The activities can operate at many levels of intensity; they can be active and physical, but also quietly intense and contemplative. For good progress to occur the activities should happen frequently, daily, day after day, with the repetition of successful activities within sessions providing the basis for the activities gradually expanding in duration, content, sophistication and complexity.

The gradual dissemination of Intensive Interaction since the late 1980s has been a completely practitioner-led initiative. Intensive Interaction is now common practice in special schools and adult services all over the United Kingdom. Interest worldwide is growing and developing. There are a range of books and other materials now available and a burgeoning community of Intensive Interaction practitioners.

Books
Zeedyk, M.S> (ed) (2008) Promoting social interaction for individuals with communicative impairments. London:Jessica Kingsley.

Papers

 * Firth, G., Elford, H., Crabbe, M. & Leeming C. (2007). Intensive interaction as a novel approach in social care. Care staffs views on the practice change process. Journal of Applied Research in Intellectual Disabilities, 21(1), 58-69