Reducing Stereotyped Behaviour: an experimental analysis of Intensive Interaction

 Jones, R. & Williams, H. (1998) International Journal of Practical Approaches to Disability, 22 (2/3), 21-25.

This research study investigated the effects of an Intensive Interactionintervention in comparison to the effects of a proximity-only intervention. The focus of the study was on the decrease of stereotyped behaviour as opposed to any effects on social behaviour.

Stereotyped behaviour, such as body rocking, hand gazing and head swaying, is frequently reported in people with severe and profound learning disabilities. Previous studies demonstrated that naturally occurring interactions with staff could reduce stereotyped behaviour (Brusca et al, 1989; Lovell et al 1998; Ephraim, 1982).

The Participant: The participant, Larry, was a 35-year-old man with a severe intellectual disability. He lived in a residential hospital setting, did not use expressive language and had limited eyesight. Larry’s stereotyped behaviour consisted of flapping both of his hands at high frequency.

Method & Findings: The researchers conducted two single subject experiments.

The first experiment used a proximity-only treatment in order to compare the Intensive Interactionintervention with the effects of an alternative intervention. Larry was observed in his normal environment during a baseline period in order to gain evidence on the normal levels of incidence of his stereotyped behaviour. At the intervention phase staff were asked to sit near Larry (i.e. proximity-only sessions) or sit near him and imitate his left hand stereotyped behaviour (i.e. Intensive Interaction). The results of this experiment suggested that Larry’s stereotyped behaviour was ‘consistently slightly lower in the interaction conditions’ than in the proximity only sessions (and when compared to his baseline behaviour).

In the second experiment again a member of staff sat near Larry, or sat near and copied his hand flapping with both his hands. From this experiment, it appeared that ‘interaction had a reductive effect’ on Larry’s hand-flapping when compared to both his baseline behaviour, and when engaged in the proximity only sessions.

Some Discussion: Overall, despite the positive and seemingly supportive evidence listed above, the effects were small and so not viewed by the authors as unambiguously demonstrating that Intensive Interactionis an effective intervention for reducing stereotypic behaviour. However, the authors stress that stereotyped behaviour is very difficult to reduce, and many other studies have also been unable to provide evidence of effective reduction whilst using a variety of other interventions.

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