Intensive Interaction: human connection and social inclusion

What is it?

Intensive interaction is a social communication approach developed by Dr Dave Hewett OBE and Professor Melanie Nind. It was then researched and developed by staff at Harperbury Hospital School in Hertfordshire who were working with students with severe learning disabilities and autism who appeared socially withdrawn.

The approach focuses on human connection and social inclusion, supporting those with social communication difficulties to engage with another person and to use and learn the fundamentals of communication. It can be particularly effective to use with children and young people who are non-speaking or minimally speaking.

What are the fundamentals of communication?

• Sharing personal space

• The ability to give attention and share attention with another person

• Understanding and using eye contact, facial expressions and body language, touch and gesture

• Learning to take turns in exchanges of behaviour

• Understanding and using vocalisations

• Play, fun and enjoyment from being in the company of another person

Why is Intensive Interaction helpful?

For children with social communication difficulties, being in the company of other people may be challenging, as people can be unpredictable, and don’t always do the same thing or act or respond in the way they might expect. They may feel more comfortable in playing in their own way with a favoured toy or object as they may view that item as safe, reliable, predictable and offering a chance for success in a way that people might not for them.

Intensive interaction aims to break down these barriers and can provide a way to for the company of another person to be enjoyed and to provide opportunities to take the lead in interactions.

How does it work?

The approach works well when the child is joined at a time when they are relaxed and calm. The adult should be relaxed and unhurried in their movements, they should get into a position that makes them look available and non-imposing, ideally at the child’s eye level or below (this can be empowering for a child who spends a lot of time in their day looking up at adults). The adult then gently joins in or imitates the child’s behaviour, this may be;

• Noises (grunting, lip smacking, vocalisation, babble)

• Actions (tapping, flapping, clapping, rocking, moving the curtains)

• Facial expressions (smiling, grimacing, blinking, eye contact)

• Physical contact (patting, tapping, reaching out to be held)

  
  

By meeting and joining the child at their communication level, this can help to shift the child’s attention from their inner world into the outer world. As the child begins to realise that the actions or sounds they make affect what adults do, it can help to increase their confidence towards communicating in their own way.

Top tips!

It is important to always follow the child’s lead and not try to force an interaction; the aim is for the child to have the time and space to take the lead in an interaction. When the child loses interest then stop and join them again at another time.

The number of intensive interaction sessions with a child may well be dictated by the staffing availability in your school, however a session a day would work well. The length of a session is determined by the child’s engagement.

Intensive Interaction in practice

Intensive interaction can be so powerful in helping the child recognise that their actions can cause a reaction in others. When recently working with a little boy in one of Applied Psychologies settings, I began to imitate his jumping actions, and it was amazing to see him realise that his actions were causing me to react. As a result, he started to change the way he jumped, such as bending down lower or lifting his hands up to see if there would be a response. The joy on his face seeing these actions being repeated back to him was a step forward in his development.

When recently working in a school demonstrating intensive interaction with a young girl a member of staff commented, ‘that’s the most I’ve seen her communicate’. The ways she communicated during the session included, vocalisations, some two word phrases, handing objects to adults and taking them back, leading adults by the hand, showing joint attention and smiling. The school are now keen to integrate intensive interaction into their daily practice for this girl and for a number of other pupils.

Want to know more?

Alex Marris our Interaction and Communication Advisory Teacher can support schools and staff with introducing the use of intensive interaction in their setting along with ways to record and monitor the sessions. To book for in person visits within Humberside email info@appliedpsychologies.com or for those further afield, email us or ask your EP about her online clinics.

Further reading and information about academic research can be found on the Intensive Interaction Institute’s website www.intensiveinteraction.org