A Practical Guide to Intensive Interaction

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Follows a three day intervention using Intensive Interaction to get in touch with a young man with very severe autism, using his body language, followed by discussions with Care Staff.

I knew Bob, a priest who approached his ministry with energy and creativity, from his Brixton days, where his gifts and potential were sharply focused.Williams , D. (1993) ‘My experience with Autism, Emotion and Behaviour’Documentary with Connie Chung, USA

The potential benefits associated with intensive interaction are thrilling to many who use the approach, including a large body of unheralded individuals who work directly with the clients. This is especially so if you consider that there are very few alternative approaches that can be used with people with severe or profound and multiple learning disabilities, sensory impairments and ‘challenging behaviours’. While II is by no means a ‘magic wand’, its reflective nature, relative simplicity, and evidence-based philosophy and methods are very interesting. I?believe the approach deserves more interest from psychology. This is increasingly true as intensive interaction is being used on an ever widening number of people with different communication problems. Psychology can assist the debate on what intensive interaction is and how it works, and so further its potential use as an educational, therapeutic and social approach. At the broadest level, intensive interaction is consistent with three major schools of psychological thought – humanistic psychology, attachment theory and positive psychology. All these approaches share a core tenet that positive human relationships are crucial to our sense of self-worth, ability to realise our potential, and our psychological well-being. In retirement, Bob found time to pursue several interests, including his life-long love of ornithology. He vociferously spoke out against injustice and he faithfully supported local parishes in their day-to-day worship life. That mixture of prophet, speaking out in God’s name, and faithful pastor have been marks of his whole ministry. He was a man of passion, love, and prayer. Intensive interaction is an approach for enhancing the communication abilities of children and adults who have severe sensory problems, severe learning difficulties or autism. According to Nind and Hewett (1994), intensive interaction employs the ‘fundamentals of communication’ to build social interactivity. These ‘fundamentals’ include:And as Pranve’s parents become more proficient in using his body language to communicate with him, his behaviour becomes less stressed and he is able to return on a part-time basis to the day centre from which he had been excluded. Two months later his mother tells me that while he has the odd off-day, on the whole they could now interact with him and manage his behaviour. And he is calmer. Dr Peter Coia, a clinical psychologist from Wakefield, has proposed a neural mechanism that goes some way to explaining the responses produced by intensive interaction. A mirror neuron is a neuron that fires both when an animal acts, and when the animal observes the same action performed by another. In humans, brain activity consistent with mirror neurons has been found in the pre-motor cortex and the inferior parietal cortex (Iacoboni et al., 1999). Coia believes that mirror neurons might play a very important role in language acquisition via behavioural and vocal imitation –?they enable all of us to recognise and pay attention to our own behaviour when it is mirrored by someone else (Coia, 2008). As Pranve becomes more relaxed his brain finds it easier to organise his muscular responses and he says clearly, ‘Where’s Charlene? ‘instead of muttering the rhythm and then goes on to astonish his family by introducing the nursery rhyme.

Pranve constantly rubs his hands together - a very common way that people on the spectrum self-confirm. He carries a ball of strings underneath his armpit and spends time pulling these out and sorting them. Iacoboni, M., Woods, R.P., Brass, M. et al. (1999). Cortical mechanisms of human imitation. Science, 286, 5449. Some supporters will raise the objection that they feel silly engaging in behaviour that they may view as childish, or as age inappropriate for their partner. If we feel silly it is because we are centred on ourselves and not in our partner: we need to shift our attention to building a relationship through signals that their brain can take on board and process, rather than trying to frogmarch them into a world that is at best confusing and may present as terrifying. (Jolliffe et al 1992).We need to ask ourselves: ‘What is it that improves the quality of my partner’s life? Nind, M. (1996) ‘Efficacy of Intensive Interaction: Developing sociability and communication in people with severe and complex learning difficulties using an approach based on the caregiver-infant interaction’. European Journal of Special educational Needs 11, 1, 48-66Past records stated that Susan liked drawing, so we took paper and crayons to our sessions. Susan immediately engaged with us, requesting that we draw particular objects such as flowers, faces and cars. Susan also made attempts to involve the direct care staff in interaction: she would hold up the pictures to them and invite them to ‘look at that’ with a beaming smile (she also interacted with us in this way). The activity expanded into sharing songs when Susan started to sing ‘Round and round the garden’ as we drew flowers, and her expressed vocabulary expanded as the sessions progressed. For example, she requested ‘more petals’ on a ‘sunflower’.