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About Intensive Interaction

Some background:

In the early years in my work - I am thinking about the nineteen-seventies - I was deeply troubled by my lack of knowledge. I was especially concerned that I did not know how to reach the people who were difficult to reach, the ones who were pre-verbal, who were not sophisticated communicators. I loved being with them, it was what I wanted to do, but I didn’t know what to do.

I was working with many people who did not speak and did not seem to understand speech. They would often be socially isolated, seeming to be mostly alone in their own world. Quite a few of them had diagnoses of autism. One young man would sit in a corner, flicking a piece of string over and over again - he didn’t like other people coming near him. Another was very active and physical, constantly on the move, leaping up and down, staring at his flapping fingers whilst making repetitive vocalisations. There was also a young woman who seemed to try very hard to communicate and make contact with other people, but all she seemed to do was to gaze at me and rock frenziedly whilst making a grunting noise, over and over. Another young woman was not particularly isolated, she would take hold of staff, pat their hands, try to climb on you, she would want a great deal of attention, but relating with her was a chaotic kind of experience and we used to ask her to stop. I worked with a little girl who seemed to have no sight. She sat cross-legged on a chair, rocking, with her fingers pressed to her eyes. She actually spoke most of the time, endlessly repeating phrases she had heard, much of it swearing. If you spoke to her, she did not respond, continuing her repetitive phrases.

Of course, we were determined, we would try and involve our students in activities. We tried hard to get them to sit at a table, to do a puzzle or work with a construction toy. We tried to help them to use some simple signs: ‘please’, ‘thankyou’, ‘drink’, ‘biscuit’. Self-care was a popular area of work. We tried to help our young people to learn to get dressed unassisted, to have some ‘independence’.

Naturally, our attempts to do these things often resulted in conflict; indeed, many of our students could easily turn to violence when things weren’t going right for them. I remember one bright day in 1979 when I had one of my deepest educational thoughts. I had spent ten minutes in a fairly physical struggle with a fifteen-year-old boy, trying to help him learn to button his jacket. At last, I let go of him and gazed out of the window, lost in thought. “I’m trying to help him learn to put on his jacket, but he can’t concentrate, can’t look in my face, he doesn’t want to be with me. What am I doing? I should be teaching him how to be with me.”

I didn’t know how to help him with this. The main thing that he needed to learn, the absolute priority for him, relating, communicating - I didn’t know anything about that. He was intelligent enough to learn the sign for ‘biscuit’ and use it manically when there were biscuits around, but he didn’t want to be with anybody.

I also think back to Trevor, an eighteen-year-old young man not in my class. I used to ‘play’ with him outside, during breaks. He would stare at his reflection in a window for many minutes, a finger jammed in each ear. I would stand alongside him doing the same thing. He accepted me doing this and amazingly, started to look in my eyes in the reflection. Eventually, he would turn and briefly look directly in my eyes. It wasn’t much, but it felt like true contact.

In 1983 I became headteacher of a school/education centre on the campus of a long-stay hospital near London. Nearly all of our students were capable of extremely ‘challenging behaviour’ that was often the reason for being admitted to the hospital. About seventy per cent of the students could be described as ‘difficult to reach’ or pre-verbal. The other thirty per cent covered the whole of the rest of the spectrum of human ability. Our students were also all sorts of ages. We had a small number of school age people, but increasingly during the nineteen-eighties, we were working with a group of people who had passed school-leaving age.

The staff group in that school increasingly developed in the following few years. The curriculum was still very much based on behavioural principles; there was an emphasis on teacher-controlled task-orientated activities. There was a great deal of failure in helping people to learn things. Many of the staff members were deeply unhappy about this. We started talking about our lack of ability. We agreed that we didn’t know much about the ‘main mission’ – helping so many of our students to communicate and relate more with the people around them. We started trying things out, experimenting with our students and ourselves. We were realising that being social was the priority, and that therefore the major teaching resource, or piece of equipment for the learning, this was us. Our classrooms started to ‘soften’ there was less emphasis on chairs and tables and the appearance of sofas and easy chairs, comfortable corners.

We had some contact with a psychologist called Geraint Ephraim. He had focused his PhD thesis (Ephraim, 1979) on the issues we were interested in and carried out exploration work with the staff of the school in another long-stay hospital. Geraint, sadly and quite recently, is no longer gracing the world with his humanity, humour, intelligence and lust for life.

Melanie Nind arrived at the school in 1984. She was just qualified as a teacher and she arrived having carried out her own research study on communication with difficult to reach people. She was right on the ball with what we were trying to achieve and she was an energy centre of knowledge and ideas. Late in 1985 we were comfortable with the approach that we were developing and understanding in the school. We were at ease with going and joining the learner in ‘their world’ creating jointly focused activities by responding to what the learner was already doing, developing the interactions by repetition of known activities, following the learner’s lead and resisting the temptation to do the ‘teacherish’ thing and drive the activity along. By early 1987 Melanie and I had both registered to carry out PhD research projects which would be ‘live’ within our school and would be studying the development our approach: Intensive Interaction. We were also deep into reading the psychological research on how it is that all human beings learn the very complicated knowledge concerning how to be a communicator.

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How do people learn to become communicators?

When you think about what an infant learns during the first year, it is quite amazing. If everything is proceeding well, what they learn is incredibly complicated and they learn it very fast. This is especially true of communication knowledge and abilities. Within one year, they proceed from knowing very little, to being competent at giving attention to an adult for many minutes, taking part in increasingly complicated and sophisticated activities with adults, learning to use and understand eye contacts, use and understand facial expressions, indeed learning to ‘read another person’s face – look for the meaning in a face and understand something about the person’s thoughts and feelings at that moment; one year olds are competent at turn-taking – sophisticated exchanges of behaviour with another person, they learn to use and understand physical contacts, body language, gesture; they are using vocalisations meaningfully and understand a range of language. They do an enormous amount of learning on these abilities in one year.

The parents must be brilliant teachers. How do they do it? Well, they don’t have lesson plans for teaching communication, they don’t give the infant a series of tasks and they don’t direct and lead those activities where communication is learnt. They go and join the infant and hold themselves ready to select items of the infant’s behaviour to respond to, ‘chime in’ with, comment and elaborate upon. In the earliest stages, very simple turn-taking exchanges and episodes of attention are initiated simply by the parent responding to something the baby does – often by imitating pleasurably. The effect for the infant is that something simple, safe, secure, interesting and understandable is happening near them. They also realise that they can pleasurably experiment with ‘social cause and effect’: “I do something, and it causes somebody else to do something”. These episodes gradually, but quite quickly develop and lengthen, becoming increasingly sophisticated communication exchanges. An average three month old for instance, can be in a continuous communication exchange for a few minutes.

The style of the parent is interactive, not directive. The infant learns to interact by frequently being in pleasurable situations with someone who is interactive. In fact, the infant often, if not usually, has the sensation of leading the activities, being in control of them. Certainly, the adult usually gives up quickly when the infant has had enough.

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The approach

When we started in-depth reading of the research on infant communication development, we found it reinforced much that we had learnt already from our experimentations with communication teaching in our classrooms. We were already developing pleasurable one-to-one times with our difficult to reach students where the free-flow of the activity was highly interactive and giving us pleasing and encouraging results. We had evolved a technique where the member of staff creates meaningful interactions with the student by responding to the behaviour of the student. Other key aspects of the technique would be that the member of staff used imitation, vocalisations, sensitive use of timing and tempo, especially allowing the student to dictate the pace of the interaction, use of pauses and allowing the activity to finish when the student had enough. Generally there was a sensation that we creating pleasurable, successful communication situations, where we were making ourselves interesting and engaging to the students by joining them in their world and adopting a behaviour style they could understand and respond to.

We were rewarded: our students were starting to develop an obvious desire and willingness to be in these situations, to become engaged with us. During these activities they also started to display the growth of subtle and complicated abilities like true social engagement, use and understanding of eye contacts, facial expressions, turn-taking, and developing a range of vocalisations which became more meaningful.

Our academic reading helped us to develop the research projects we started in 1987. Around this time Melanie and I started writing articles for journals, describing our work. This gave rise to calls for us to speak at conferences and give training to other establishments all over the country. In 1994, Melanie and I tried to put everything we knew into our first book, ‘Access to Communication’. Our book was well-received and created even more interest.

Since that time, we have continued to publish and to disseminate. Intensive Interaction is now in widespread use throughout the UK, indeed, is recommended in the National Curriculum special needs guidelines. My own interest in this topic has never lessened. Human communication is simply a fascinating topic, but there is the added thrill of frequently having the experience of observing a young person who may be socially isolated, start to show interest in other people, to smile, meet eyes, reach out.

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