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What is Intensive Interaction?


People with autism live in a sensory maelstrom (Ramachandran 2011). It is difficult for them to know what they are doing. Intensive Interaction allows us to put ourselves into their shoes and understand them better.

Developed in the 1980s, Dr. Dave Hewett Ph.D. the founder of Intensive Interaction Institute, describes Intensive Interaction as a play-based approach that works towards aiding the development of a child’s early pre-speech communication and social skills. These skills include the ability to imitate sounds, facial expressions, eye contact, and joint attention. Intensive Interaction also focuses on breaking the actions of repetitive or self-inflicting behavior.


Intensive Interaction, as the term suggests, is a two-way communication and is applicable to all environments. The approach is built on how we monitor and interpret the actions and babbles/sounds that a child produces and respond accordingly. It entails understanding how to respond to a child in diverse situations based on observing their tone, facial expression, and body language. In the process, this allows for bonding and for both child and interactor (the person that is interacting with the child, i.e., parent/guardian/behavioural therapist,etc. ) to enjoy the presence of one another more.


WHO IS INTENSIVE INTERACTION FOR?

Intensive Interaction is applicable to individuals of all ages, not just exclusively children. It is primarily for individuals that are yet able to communicate via speech and language. These include individuals with:

  • Severe and/or complex learning difficulties

  • Multi-sensory impairments

  • A diagnosis of autism spectrum disorder.

  • A range of self-stimulatory or socially isolating behaviours.

  • Challenging behaviors

  • Late-stage of dementia

Intensive Interaction is also for those that are very social by nature but still require developing social skills in:

  • Being able to practice and understanding eye contact and facial expressions

  • Sharing or being able to take turns in sequences of social behaviour.

  • The use of vocalisations

The approach can be utilise by all parties that are involved in supporting the child/adult and include:

  • Speech and language therapists

  • Occupational therapists

  • Family members and friends


HOW DOES INTENSIVE INTERACTION WORK?

Before any progress can be made with the child/adult, one must understand the principles of Intensive Interaction:

  • Set aside any preconceived ideas and focus solely on the individual you are supporting

  • Amend your behaviour or voice to be perceived as less threatening

  • Observe their body language and understand what it elicits

  • Treat all the actions of the individual you are supporting as if it is a form of communication

  • Instead of always imitating their actions exactly, adopt slight variations and have fun!

Intensive Interaction teaches the Fundamentals of Communication:

  • Learning how to have fun with others - how to play

  • Learning to offer & share attention with another - developing skills in joint activities

  • Learning how to take turns & share one’s personal space

  • Learning to use and recognise eye contact in daily social interactions

  • Learning about non-verbal communications such as facial expressions, & body language

  • Learning to regulate and control emotional responses & arousal levels


How Intensive Interaction can be conducted:

The Intensive Interaction guide first engages in play with the child, reciprocating what the child does by mimicking and including themselves into their interests.


For example, by imitating movements/gestures and facial expressions (e.g. banging toys; clapping hands) or imitating noises, if the child is making a noise, try and make the same noise. Wait for the child to do it again, and then repeat. This builds turn-taking.


Then transition into activities and games that explore and stimulate the use of communication skills. Try and make a game out of the actions and take turns! For example, the child bangs the object, then you bang the object and repeat the actions of the child again. Also try changing the sound/action slightly such as, if the child says “ah” you could say “ooh”. This helps to build shared attention, and encourages children to increase their range of sound production.


All interactions with the child keep at their pace and follow their interests. The guide would pause to observe what the child is doing before responding accordingly. The session will end once the child shows signs of exhaustion or discomfort in the form of whining or escape behavior such as running away or screaming.


At the beginning, the sessions may only last for a few minutes at most, but gradually as the child develops, the sessions will get longer.


There is no set time or schedule to practice this approach which can happen whenever the opportunity arises. For younger children, that may be several times a day. Intensive Interaction is usually incorporated naturally into the child’s daily activities at day care or if they are enrolled into a special needs school.


Written by Angelyn.


References


Hutchinson, N., & Bodicoat, A. (2015). The effectiveness of intensive interaction: A systematic literature review. Journal of Applied Research in Intellectual Disabilities, 28, 437-454. doi:10.1111/jar.12138.


Jones, K., & Howley, M. (2010). An investigation into an interaction programme for children on the autism spectrum: Outcomes for children, perception of schools and a model for training. Journal of Research in Special Educational Needs, 10(2), 115-123. doi: 10.1111/j.1471-3802.2010.01153.x.


Nind, M., & Powell, S. (2000). Intensive interaction and autism: Some theoretical concerns. Children and Society, 14(2), 98-109. doi: 10.1111/j.1099-0860.2000.tb00158.x.


Ramachandran, V.S. (2011) ‘The Tell-Tale Brain’ Harvard University Press

Tee, A., & Reed, P. (2017). Controlled study of the impact on child behaviour problems of intensive interaction for children with ASD. Journal of Research in Special Educational Needs, 17(3), 179-186. doi: 10.1111/1471-3802.12376.


Wong, C., Odom, S.L., Hume, K., Cox, A.W., Fettig, A., Kucharczyk, S., Brock, M.E., Plavnick, J.B., Fleury, V.P., & Schultz, T.R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(7), 1951-1966. doi: 10.1007/s10803-014-2351-z.


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