ࡱ> q` 0+bjbjqPqP D::"(((((((<8$<jHH^^^=??????$(h^c("c((^^x(^(^==q((x^< `SsF=0sgxxJ(xH hTUBccgX<<< <<<<<<((((((  British Institute of Learning Disabilities Campion House Green Street Kidderminster DY10 1JL Telephone 01562 723010 enquiries@bild.org.uk www.bild.org.uk Factsheet partnership boards Summary Intensive Interaction is a practical approach to interacting with people with learning disabilities who do not find it easy communicating or being social. The approach helps the person with learning difficulties and their communication partner to relate better to each other and enjoy each other's company more. It helps them develop their communication abilities. In Intensive interaction the carer, support worker, speech and language therapist or teacher works on being a better communication partner and so supports the person with learning disabilities develop confidence and competence as a communicator. Intensive interaction is a fun process. The communication partner is guided by what we know about how communication ordinarily develops for young children. S/he applies this knowledge in a way that is sensitive and respectful to the person with learning disability, whatever their age. General Introduction: Why Intensive Interaction? Intensive interaction was first developed because a group of staff was having difficulty getting to know their students. The students, with learning disabilities, lived in a long stay hospital (Harperbury) and did not have any speech or sign language communication. They did not welcome attempts by the staff to do things with them, often turning away or pushing others away. The staff felt that it was pointless to try to teach the students without first getting to know them - learning how to get communication and social relationship started. Intensive Interaction is the name they gave to the approach they developed together over time and which is now used widely in education and adult services (see Nind & Hewett, 1994, Access to Communication). The approach of Intensive Interaction was inspired by the ideas of psychologist, Gary Ephraim. He argued that adults with learning disabilities needed to learn fundamental communication and social abilities in a naturalistic way, through the kind of interactive play that babies and parents do. This means the people won't develop isolated skills that they have difficulty using in different situations. Instead they are highly motivated to practice and develop their communication abilities because this is enjoyable and meaningful. What is Intensive Interaction? Intensive Interaction can be used as a way of teaching or simply as a way of being with people. It enables us to focus on the quality of our everyday interactions. When we adopt Intensive Interaction as an approach we go about things in a particular way - we adopt a particular interactive style. In our interactions with communication partners with learning disabilities we: Adjust our interpersonal behaviours - perhaps altering our voice or gaze or body language. This is to make us less threatening and more interesting. Take the other person's lead - respond to things they do. This can be by commenting on their actions, joining in with them, playfully imitating them. By responding instead of leading we don't make demands on the person that they cannot cope with. Instead we communicate that we value them and enjoy being with them. We allow them to chance to explore with making things happen and to take the lead. The 'topic of conversation' is within their realm of interest. Treat the things the person does as if this is communication. We read social meaning into actions even when this meaning isn't yet clear. In this way the person is responded to as a communicator and gets to know what this feels like and involves. The communication partner 'tunes in' to the possible intent of various actions and expressions, so that eventually the partners are negotiating. For example, when I dip my head I want a break, when I vocalize I'm seeing if I can get a response, and when I look at you I'm saying I want more. Use sensitive observation to judge how well the interaction is going. We respond quickly to any feedback, interpreting it so that we can keep the interaction positive and enjoyable for both partners. We also get other colleagues or friends to observe us interacting and use video recordings if possible. In this way we don't just use our intuitive skills as communicators, but we reflect on how we can enhance these and we problem-solve with others, so that interactions don't 'get stuck'. Use timing and rhythm in the interactions. This can make them like games - with anticipation and drama to hold the person's attention. Rhythm and repetition help the person with learning disabilities to predict what will happen next and to get more involved. We can create the feeling of taking turns. Have fun. Intensive Interaction sessions should be enjoyable and often playful. When and Where? Using the Intensive Interaction approach means using the interactive style described above. We can do this at any time and in any place. It is most effective, though, when we do two things together. First, when we seize opportunities as they arise - during care tasks, quiet moments, when the person with learning disabilities is in the mood for being social. Second, when we plan to set aside some time each day when there is nothing else to be done or to distract us from giving our full attention to having a quality interaction. And then giving quality time to reflecting on the interaction. Who? Intensive Interaction has been developed for people whose learning disabilities are more severe or complex. It is particularly useful when communicating and relating is made more difficult by additional physical or sensory impairments or autism. It is an approach used by a wide range of professionals, care staff, and also families and friends. We recommend working in teams to give better support. When Intensive Interaction is used with older children and adults with learning difficulties, the practitioners need to feel comfortable with the issues of age-appropriateness that may arise. The approach may involve the communication partners behaving in ways not typical for persons their age. This can feel like going against principles of normalization. However, adjusting your way of interacting to maximize the chances of the person with learning disabilities finding this meaningful and enjoyable is very respectful. Learning to 'listen' so sensitively gives them the chance to have a say that they are unlikely to have otherwise. Being playful does not have to mean losing dignity. Research Intensive Interaction is based on research showing the style of interaction that is connected with effective learning for infants (in Western culture). The use of this style in Intensive Interaction with people with learning disabilities has been positively evaluated. Nind's (1996) study showed that the participants developed behaviours that helped to sustain interactions (looking, smiling, vocalizing), developed their ability to be engaged in interaction and learned to initiate social contact. They made advances in their ability to communicate needs and preferences, their vocal imitation, and communication through sounds and gestures. In some cases, stereotyped behaviour reduced. There are also a number of published case studies illustrating the progress that children and adults have made. These also show benefits for the interactive partners. Useful Reading Nind, M. & Hewett, D. (2001) A Practical Guide to Intensive Interaction. Kidderminster: BILD publications. (The most accessible text, a handbook with guidance on getting starting and keeping going.) Samuel, J. (2001) 'Intensive Interaction'. Clinical Psychology Forum, 148, 22-25. (Summary of the contribution of Intensive Interaction to provision for adults in Oxfordshire NHS Learning Disability Trust small group homes.) Hewett, D. & Nind, M. (Eds) (1998) Interaction in Action: Reflections on the use of Intensive Interaction. London: David Fulton. (Accounts of using Intensive Interaction by teachers, social workers, parents, psychologists and occupational teherapists, working with people across all ages, plus discussion of issues and recent research.) Nind, M. (1996) 'Efficacy of Intensive Interaction', European Journal of Special Needs Education, 11, 1, 48-66. (Research evidence for the effectiveness of Intensive Interaction.) Nind, M. & Hewett, D. (1994) Access to Communication: Developing the basics of communication with people with severe learning difficulties through Intensive Interaction. London: David Fulton. (A detailed explanation of the background, theoretical underpinnings and practical aspects of Intensive Interaction.) BILD has made every effort to ensure the accuracy of the information contained within its factsheets, but cannot be held liable for any actions taken based on the information provided.      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