Can adults on the autism spectrum be affected positively by the use of intensive interaction in supported living services?

Fraser, C. (2011) Good Autism Practice, 12 (2), 37-42.

The case study: Derek was a 67 year old man with a diagnosis of autism and epilepsy. He lived in a supported living home (for 9 years) and sometimes displayed challenging behaviours e.g. incontinence; shouting; repetitiveness; withdrawing to his room; switching lights on & off; pulling his finger nails off. In order to judge the effectiveness of Intensive Interaction, CF (the author, a residential manager) noted the frequency of these behaviours during and after an Intensive Interaction intervention.

Results and evaluation: When first using Intensive Interaction CF felt that Derek wasn’t showing any interest in her, preferring to seek out his support worker. After a few sessions the first shared interaction was a sigh, with a loud ‘blowing out’ sound. Derek did this and CF echoed it, and then Derek gave a very brief sideways glance towards CF. As the sessions progressed one day as CF arrived Derek immediately sighed: it felt like they now had a meaningful way to say “Hello”.

During session 3 Derek used CF’s name, and when CF arrived for session 5, Derek’s support worker went to his room and said: “Derek, Catherine is here”, at which point Derek said “Catherine” and smiled and jumped up from his bed. During session 8 Derek used sustained eye contact for the first time.

To increase the reliability of the findings CF met with Derek’s support team and asked them for their observations. One comment was that Derek had started asking when CF would next come. Other changes agreed by the team members were:

  • Derek had started spending more time in the lounge than his bedroom.
  • Derek had started interacting more with his fellow service-users.
  • Derek had stopped flicking lights on and off.
  • The time Derek spent listening to music through headphones had reduced.
  • Derek appeared more patient, and did not invade other people’s personal space as much as he did before.

Generally the observations from the staff team showed an increase in sociability and a decrease in behaviours that challenged (see Table 1: the frequency of Derek’s challenging behaviours decreased post-Intensive Interaction).

Table 1: Frequency with which behaviours were observed by staff over a five moth period
Behaviour displayedFrequency per month
Repetitive behaviour202115121211
Agitated behaviour442001

Concluding comments: When evaluating this study CF stated that this research should consider any other factors which may have affected Derek’s behaviour, but noted that there were no changes in the level of Derek’s support, or in the number of family visits and no significant changes to his health. CF also noted that there was no control or comparison data, making it impossible to conclude that the changes were directly due to the Intensive Interaction, but CF states that this might well have been the case, and that there was no evidence to suggest that the Intensive Interaction caused any regression in his emotional state or behaviour.

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