Efficacy of Intensive Interaction: Developing sociability and communication in people with severe and complex learning difficulties using an approach based on caregiver- infant interaction

Nind, M. (1996) European Journal of Special Educational Needs, 11 (1), 48-66.

The Participants: This research was carried out with six students who were resident at a long stay hospital and part time students at the hospital school. After a ‘base-line phase’ of up to 6 months, daily Intensive Interactionwas introduced in an intervention phase of between 12 and 18 months. Measurement of the students’ behaviour was done using specially constructed observation schedules and video analysis, with Kieran & Reid’s Pre-Verbal Communication Schedule and Brazelton’s Cuddliness Scale also used.

The Results: There was a greater frequency of initiation of social contact, or initiation of social contact as a new phenomenon for all six students. There was also an increase in responses to proximity or physical contact in all the students, such as ‘looking at the teachers face’ (3 students); ‘making eye contact’ (2 students); and ‘happy vocalisations’ (2 students). ‘Smiling in a response to a teacher’ also increased for all the students.

Each student developed some new interactive behaviour, and these included ‘looking at the teacher’s face’; ‘contingent smiling’; ‘nestling into the teacher’; ‘exploring the teacher’s face with hands’; ‘maintaining a state of joint focus’; ‘contingent vocalisation’, and ‘taking the hand of the teacher’.

All of the students made advances in their communication abilities measured on the Pre-Verbal Communication Schedule, with progress particularly evident in the areas of vocal imitation, communication through gesture, and through the use of sounds. All the students made advances in their reciprocation of warm physical contact as measured by the Cuddliness Scale. Also the incidence of ritualistic behaviours or ‘organised self-involvement’ decreased for four students.

Additionally it was noted that two students who had never been able to make eye contact before, began to do so. Also, two students whose whole behavioural repertoire had been dominated by ritualistic self-involved behaviours, paused from this in order to engage in interactive games. One student changed from being a person no one could relate to, to someone with whom all the staff enjoyed interactive games. Another student who was described as ‘mostly sleepy and unmotivated, became alert and responsive, vocalising and waving her arms with the excitement of an interactive game’.

The Conclusions Drawn: The conclusions of this research were that after Intensive Interaction was introduced, the six students made observable gains in terms of their social and communication abilities, with new interactive behaviours emerging as ritualistic behaviours decreased. It was also shown that there were no significant events concurrent with the onset of Intensive Interaction, and therefore no rival explanations for the developments being caused by anything other than the use of Intensive Interaction.