Tuesday 28 November 2017

Intensive interaction: learning to enjoy each others company

According to the British Institute of Learning Disabilities (BILD):

'Intensive Interaction is a practical approach to interacting with people .... who do not find it easy communicating or being social ... It helps them develop their communication abilities.'
I really like this approach, which was developed by Dave Hewett and Melanie Nind, in the 1980s. I enjoy using it with those trickier-to-engage individuals.
We use Intensive Interaction to help us develop more successful and meaningful communication when working alongside people with severe or profound and multiple learning disabilities and/or autism, whatever their age.

Hewett and Hind talk about how learning to become better communicators ourselves, we can support the children we care for, or work with, to develop their own confidence and competence as communicators. This is enabled by the child's learning of the Fundamentals of Communication:

              Learning how to be with another person

              Learning Joint focus' and how to have activities with another person

              Learning to attend and concentrate

              Use and understanding of non-verbal communication: body language and gesture

              Use and understanding of eye contacts

              Use and understanding of facial expressions

              Turn taking: taking turns in exchanges of behaviour

              Use and understanding of vocalisations

              Sharing personal space and ...

              Use and understanding of touch.

Intensive Interaction is about creating mutual pleasure:

              During Intensive Interaction we (parents, carers and support staff) adjust our behaviours so that we become more interesting and socially engaging for the child.

              Intensive Interaction flows naturally in time, with rhythms and pauses.

              During Intensive Interaction we respond to a child's behaviours as if they are intentional communications (even if they aren't!).

              During Intensive Interaction we use 'contingent responding ' i.e.  we follow a child's lead and share control of an interaction with them.
              we generally use Intensive Interaction when we want to promote sustained and sociable communication with children (or adults) with a learning need and/or autism, whatever their age or level of disability or development.

              Intensive Interaction is also good for parents, carers and support staff -  it provides a practical way of developing good communication practices, and it can also help develop better relationships between us and the children we care for or work with.

How do we do Intensive Interaction?:

·         Sharing Personal Space: this is the process of being physically close to someone, but in a way, that doesn't make them feel uncomfortable or awkward e.g. by sitting, standing, or even lying close to someone.

      Eye Contact: this is an important means of communication for giving and receiving social acknowledgement. We can give and receive eye contact in a number of ways e.g. looking at and away from each other; playing hide-and-appear games; exchanging eye contact in a mirror; etc.

      Exchanging Facial Expressions: this is done by using facial expressions to socially engage with someone e.g. using clear and sustained smiles; pulling playful faces at each other; using dramatised winks; raising our eye brows; etc.

      Physical Contact: using sensitive and non-directive physical contact can help build mutual trust, and this can be achieved by: sensitively rubbing someone's arm; gently patting their back; holding hands; rhythmically squeezing hands; clapping hands or hand-over-hand games; walking arm-in-arm; tickling; touching foreheads; rubbing noses; etc.

      Vocal Echoing: echoing a child's sounds or vocalisations (even if they are not actually words or phrases) can develop into conversation-like sequences e.g. echoing back a child's vocal sounds, echoing back a child's breathing sounds, or their coughs and sneezes; echoing a sound made by a child's activity or a sound made by a child's body; etc.

      Behavioural Mirroring: mirroring some aspects of a child's physical movements or behaviour can develop into turn-taking sequences that are, or can become, communicative e.g. mirroring aspects of a child's movements or activity; mirroring a child's facial expressions; etc.

      Joint-Focus Activity: a joint-focus activity is when parents, carers or support staff, and the child they are supporting, focus their attention on the same activity or object e.g. jointly looking at things in the environment (i.e. following a child's visual focus); giving a running commentary on a child's actions; looking at pictures or photographs together; actively listening to music together; etc. I think my most (embarrasing but) significant moment was lying on the floor in Matalan in Burton, staring at the heating pipes above with a lovely lad called John, while people stepped over us muttering! I was able to share in his interest, add language and gain John's respect in one easy move.

      Joint Action:  this is just doing things together, not to, not for, but with!
e.g. physically exploring objects together; physically playing together with a ball or a balloon, or water and sponges; making sounds together on the same musical instrument; etc. I especially like to make gloop to share with a child to explore how it rolls but then drips through fingers. The surprise is easy to share.

      Burst-Pause Sequences: a burst-pause sequence is when an action is preceded by a pause, leaving a gap to develop anticipation and expectancy, and so making things more fun e.g.  playing ‘peek-a-boo ' from under a parachute or from behind a cushion; playing 'catch’ together with a '1-2-3 go' countdown to each turn; etc. I like using rhymes for this with younger children. I use the they like best

      Turn Taking: this is when two people engage together in an activity with both people taking separate roles or turns, thus sequencing their actions
e.g.  taking turns to make noises both vocally or physically; taking turns to make movements; passing facial signals back and forth; physically passing things back and forth e.g. balls, or rubber rings or beanbags; deliberately taking turns to bang a drum; etc. I really enjoyed stamping in a puddle the other day with a  child who took turns, this was the first time I had known him to take turns

See more in The Intensive Interaction Handbook Book by Dave Hewett, Graham Firth, Mark Barber, and Tandy Harrison, available from Amazon

Sunday 5 November 2017

How should we interact with a child with SM in early years and primary?

Look out for one on secondary coming soon based upon our survey of young people which will be in the Royal College of SLTs Bulletin soon.

We have more short videos and how-to's in the parent hub. Let us know what you would like us to cover next.