How Rapidly Does Intensive Interaction Promote Social Engagement for Adults with Profound Learning Disabilities?

Zeedyk, S, Caldwell, P. & Davies, C. (2009) European Journal of Special Needs Education, 24 (2), 119-137.

This study investigated levels of engagement in individuals with profound learning disabilities participating in their first Intensive Interaction session. The authors had 2 aims: to determine how quickly observable increases in engagement behaviours take place, and to look at individual differences in patterns of change across the sample.

Method: The authors used an observational, multiple-case design to look at levels of social engagement in 10 individuals with profound learning disabilities (6 female, 4 male, aged late teens to early 60s) participating in their first Intensive Interaction session. No formal diagnoses were available; however, informal reports indicated diagnoses of autism, cerebral palsy and global intellectual delay. Randomly selected videotaped material, from an archive of Phoebe Caldwell, was analysed using micro-analytic techniques.

The Intensive Interaction sessions analysed took place in residential or day centres and lasted between 30 minutes and several hours. This study focused on the initial period of the interactions i.e. between when the session began and when the first break in interaction occurred, these sections ranging from 3 to 14 minutes. Coding look to code 3 key behavioural indicators of clients’ interest in their interaction partner:

  • eye gaze to partner ([a] away from partner, [b] toward partner’s body, [c] toward partner’s face);
  • bodily orientation to partner ([a] away from partner, [b] toward partner, [c] facing partner directly); and,
  • proximity to partner ([a] far/beyond touching distance, [b] close/within touching distance, [c] touching).

The emotional valenceof client’s actions was also coded as either: (a) neutral/negative; (b) positive; or (c) very positive. Inter-rater reliability of coding was assessed via a second blind coder; the mean intra-class correlation was 0.89, indicating acceptable levels of reliability. 

Findings: Data analysis began by dividing the interaction sessions into quarters. Next, an ‘Engagement Index Score’ (EIS) ranging from 0 -100 was calculated for each of the 3 key social behaviours to represent the extent to which a participant was socially engaged in that quarter; an EIS score of ‘0’ signifying that the participant had spent the entire time at the lowest level of engagement for that social behaviour, and a score of ‘100’, meaning that the participant was constantly at the highest level of engagement.

It was found that EIS scores generally increased from section one to section four. 9 out of 10 participants showed increased eye gaze, 8 out of 9 showed an increase in proximity to partner, and 6 out of 8 displayed increased orientation to their partner. Emotional valence also increased in 9 out of 10 participants.

The EIS scores were also depicted graphically for each participant across each quarter of the Intensive Interaction session, revealing that the overall pattern of increasing engagement was subject to considerable variation. However this secondary analysis also showed that all the participants showed increases in at least some measures and that the majority (7/10) showed increases for all 4 measures.

Discussion: This study has shown that Intensive Interaction is an effective tool in promoting social engagement with key social behaviours showing increases in the first Intensive Interaction session. The authors also relate their findings to the existing literature, suggesting that further work may be done to investigate exactly what conditions are necessary for improvements in engagement and why Intensive Interaction seems to be particularly useful in creating these conditions.

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