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Background Developed in 1994 by Dave Hewett and Melanie Nind.
Client-led
‘Entering their world’
Process-focused not task-focused
Assumes communicative intent
Primarily uses NVC to establish contact
Aims (Firth & Barber, 2011)
Genuine and participatory social inclusion
Communicative skills acquisition or development
Therapeutic support
“A way of finding a connection with someone who is difficult to reach, then building a more equitable and inclusive relationship with them”
Intensive Interaction in
Dementia (Ellis & Astell, 2008)
Single Case Study – termed ‘Adaptive Interaction’
Observation – explore current communication context, identify key features.
Standard Interaction (baseline) – 10 minutes, closed questions followed by 20 sec. pause.
I.I. – 10 minutes, attended to and responded to verbal and non-verbal behaviours, either direct reflection, or reproducing rhythm in some way.
My Study
3 Participants
Information gathering – life history, baseline observation, rating of communication skills
4 sessions over the course of a week
5 minutes Standard Interaction followed by 10 minutes Intensive Interaction
2 sessions were ‘Augmented’ with biographically relevant joint-focus items.
Data Collection
Holden Communication Scale
D = 46/48, F = 26/48, K = 43/48
Positive Response Schedule (Perrin, 1997)
Passive Observer recording events and thoughts
Reflective Diary after each session
Holden Communication
Scale Response
Interest in past events
Pleasure
Humour
Names
General Orientation
General Knowledge
Ability to join in games etc
Speech
Attempts at communication
Interest and response to objects
Success in communication
Positive Response
Schedule Deliberate Body Movement
Deliberate Head Movement
Vocalisation
Looks at Environment
Looks at Carer
Initiates Interaction
Engagement
Happy
Sad
Fear
Results – D
Results – D
Results - F
Results - F
Results - K
Results - K
Reflections & Conclusions
Increasing rapport over time, but not strong enough effect to show in quantitative results
Physically and emotionally demanding
Differences between conditions are enhanced when social interaction items are extracted.
Reflections & Conclusions Joint-focus items work for some people – 1-2 items per session?
Best for those scoring over about 38/48 on
HCS
Post-study – further developments for D & K
Some issues with staff understanding
Reflexivity and peer support is vital
What Next?
Further investigation of benefits over time – longitudinal study
Determine appropriate cut-off point on HCS (or similar)
Encouraging all staff to engage
References Caldwell, P. (2007) From isolation to intimacy: Making friends without words. London: Jessica Kingsley Publishers.
Caldwell, P. (2006) Speaking the other’s language: Imitation as a gateway to relationship. Infant and Child Development, 15, pp. 25-282.
Ellis, M.P. and Astell, A.J. (2008) A new approach to communicating with people with advanced dementia: A case study of adaptive interaction (Chapter 8). In Zeedyk, M.S (Ed.), Promoting social interaction for individuals with communicative impairments: Making contact. London: Jessica Kingsley Publishers.
Ellis, M. and Astell, A. (2010) Communication and personhood in advanced dementia. Healthcare Counselling and Psychotherapy Journal, 10 (3), pp. 32-35.
Firth, G. (2008) A dual aspect process model of Intensive Interaction. British Journal of Learning Disability, 37, pp. 43-49.
Firth, G. and Barber, M. (2011) Using Intensive Interaction with a person with a social or communicative impairment. London: Jessica Kingsley Publishers.
Nind and Hewett (1994) Access to Communication: Developing the Basics of Communication with People with Severe Learning Difficulties Through Intensive Interaction (1st edition). London: David Fulton.
Perrin, T., May, H. and Anderson, E. (2008) Wellbeing in dementia: An occupational approach for therapists and carers (2nd edition). London: Churchill Livingstone.
Perrin, T. (1997) The Positive Response Schedule for Severe Dementia. Aging and Mental Health, 1(2), 184-191.
