Intensive Interaction: a growing body of published evidence

Intensive Interaction is clearly built upon genuinely socially inclusive and universal humanistic values; it is highly plausible in its developed practices and principles (they are based on the most successful communication development model that there is - the infant-caregiver model), and therefore it is clearly theoretically coherent. Oh, and it is also a pleasure to do! But also rightfully, in these days of 'evidence based practice', I think it useful for us all to know that the hard 'evidence' for the claimed outcomes of Intensive Interaction approach exists.

So, lets have a quick look at some of the most epistemologically (what a word that is!) 'robust' evidence: well, across the general body of research into Intensive Interaction (summaries of 36 research and academic papers are are included in our  Intensive Interaction: published research summaries 2018 document available on the 'Intensive Interaction Users' Facebook page) there are a number of common findings of increased or novel interactive responses found across the studies - this evidence coming from a reassuringly broad range of British, European and international academic and research journals that publish peer-reviewed papers on special education, learning disabilities, disability studies, autism, language therapy, nursing, dementia and psychology. 

Listed below are some of these ‘external’, observable and therefore measurable interactive outcomes associated with Intensive Interaction interventions when compared to initial baseline measures. 

So from a number of Intensive Interaction research papers we get epistemologically (there it is again!) robust evidence of:

• increased social anticipation, initiation and/or engagement (Nind, 1996; Watson & Fisher, 1997; Kellett, 2000; Cameron & Bell, 2001; Kellett, 2003, 2004; Forster & Taylor, 2006; Anderson, 2006; Barber, 2008; Samuel et al, 2008; Zeedyk et al, 2009a; Zeedyk et al, 2009b; Jones & Howley, 2010; Fraser, 2011; Argyropoulou & Papoudi, 2012; Harris & Wolverson, 2014; Rayner et al, 2016; Calveley, 2017).

• increased toleration of, or responsiveness to physical proximity (Nind, 1996; Firth et al, 2008; Zeedyk et al, 2009a; Zeedyk et al, 2009b; Fraser, 2011; Harris & Wolverson, 2014; Calveley, 2017).

• increased levels of contingent smiling (Nind, 1996; Lovell et al, 1998; Leaning & Watson, 2006; Barber, 2008; Zeedyk et al, 2009a; Argyropoulou & Papoudi, 2012; Calveley, 2017).

• increased levels of eye contact or looking at another person’s face (Watson & Knight, 1991; Nind, 1996; Lovell et al, 1998; Kellett, 2000; Cameron & Bell, 2001; Kellett, 2003, 2004, 2005; Leaning & Watson, 2006; Forster & Taylor, 2006; Barber, 2008; Samuel et al, 2008; Zeedyk et al, 2009a; Zeedyk et al, 2009b; Fraser, 2011; Argyropoulou & Papoudi, 2012; Harris & Wolverson, 2014).

• increased use of vocalisation (Watson & Knight, 1991; Lovell et al, 1998; Kellett, 2000; Elgie & Maguire, 2001; Cameron & Bell, 2001; Argyropoulou & Papoudi, 2012; Harris & Wolverson, 2014; Calveley, 2017).

• increased levels of socially significant physical contact (Lovell et al, 1998; Elgie & Maguire, 2001; Kellett, 2000, 2003, 2004; Forster & Taylor, 2006; Firth et al, 2008; Barber, 2008;  Samuel et al, 2008; Argyropoulou & Papoudi, 2012; Harris & Wolverson, 2014; Calveley, 2017).

• improved levels of joint attention (Nind, 1996; Lovell et al, 1998; Kellett, 2000, 2003, 2004, 2005; Leaning & Watson, 2006; Samuel et al, 2008).

Within the overall body of Intensive Interaction research there also appears to be two different time related aspects to the social communication progress being made i.e.:

1. Evidence of relatively rapid change in social interactivity associated with Intensive Interaction 

Instances of rapid change in social interactivity are often anecdotally related by practitioners using Intensive Interaction techniques with people for the first time, particularly when employing the techniques of behavioural mirroring or vocal echoing. Also empirical support for such claims of rapid ‘social inclusion’ (Firth, 2008) comes from short-term research evidence e.g. Lovell et al, 1998; Zeedyk et al, 2009a; Zeedyk et al, 2009b; Argyropoulou, & Papoudi, 2012; Harris & Wolverson, 2014.

Indeed, in the study using ‘micro-analytic analysis’ of Intensive Interaction by Zeedyk, Caldwell & Davies (2009b), it was shown that for all the participants Intensive Interaction was: ‘… effective in promoting social engagement ... well before the end of the first full intervention session’, with some changes being seen to ‘occur within minutes’.

2. Evidence of gradual developmental progress in aspects of social communication associated with the extended use of Intensive Interaction 

In addition to the potential for rapid increases in sociable communication over short timescales, the use of Intensive Interaction over longer periods has been evidenced to support ‘developmental progression' (Firth, 2008) as an outcome of systematic and sustained approach adoption.

Such extended use of Intensive Interaction has been shown to facilitate gradual and sustained development in certain aspects of the social communication practices of people with severe or profound intellectual disabilities and/or autism e.g. Watson & Knight, 1991; Watson & Fisher, 1997; Nind, 1996; Kellett, 2000; Kellett, 2004; Jones & Howley, 2010; Fraser, 2011; Calveley, 2017. 

Have a look for yourself in our Intensive Interaction: published research summaries 2018 document available on the 'Intensive Interaction Users' Facebook page (https://www.facebook.com/groups/13657123715/)  - but you will need a bit of time as there is plenty of it!

Evidence based practice is where we all need to go ... and we have an extensive and increasing body of Intensive Interaction evidence!