Using 'Perseverative Interests' ... as joint focus activities in Intensive Interaction

Perseveration is defined as an uncontrolled, repetitive behavioural response to a set stimulation, despite the termination of the initial stimulation, the continuation of which appears contextually irrelevant to the current situation. The definition of 'perseverative interests' (PI) in the DSM (4th Ed), is: 'encompassing preoccupations with one or more stereotyped and restricted patterns of interest that are abnormal either in intensity or focus'.

Now the reason I am blogging about perseverative interests (or behaviours) is that during Intensive Interaction I will often join-in with such highly repetitive and 'contextually irrelevant' behaviours to try and create a person-centred and joint-focus, social engagement context ... and I recently came across a paper (Vismara & Lyons, 2007) that suggested that if an individual’s perseverative interests are integrated into the topic of a joint focus activity (in this case as part of an approached called Pivotal Response Treatment), then this was found to enhance that individual’s levels of social engagement (no s**t Sherlock!). So here are some interesting (well to me anyway) extracts from the paper:

'Perseverative Interests to Elicit Joint Attention Behaviours in Young Children with Autism' 

Vismara, L. & Lyons, G. (2007) Journal of Positive Behaviour Interventions, 9(4), 214-228. 

This study looked 'to examine whether joint attention initiations for social sharing would occur as a collateral effect of utilizing the motivational techniques of Pivotal Response Treatment (PRT) in conjunction with perseverative interest stimuli for three young nonverbal children with autism' ... using 'a large variety of highly preferred age-appropriate board games, activities, and toys'...  (and people sometimes say that I'm a bit 'too wordy'!) ... anyway: 

'[The] results indicated an immediate increase in joint attention initiations when perseverative, or highly preferred, interests were incorporated within the motivational techniques of PRT. Additional findings included collateral increases in joint attention initiations towards less preferred interests, as well as improvements in the quality of interaction between the children and caregivers' (my underlining not theirs).

'In summary, the findings suggest that using PI stimuli in conjunction with PRT appears to increase a child’s motivation to share his or her perseverative interest socially with another person and consequently to improve the quality of initiations and interactions. In addition, this study indicates that children in this type of intervention use their perseverative interest in a socially appropriate and controlled manner without the presence of negative side effects. The results are also promising in terms of providing an approach that utilises learning mechanisms that may be similar to those used in typical development'. 

Now 'Pivotal Response Treatment' (PRT) is not Intensive Interaction (it is a more behaviourally abstracted, controlled, and less naturalistic approach), but it clearly utilises one of the practices of Intensive Interaction ... and it resulted in increased sociability which also generalised out from the PI activity to improve 'the quality of initiations and interactions' via 'learning mechanisms that may be similar to those used in typical development'. 

So, does this add to the evidence base for Intensive Interaction [which is directly based on the learning mechanisms seen in typical development] ... well, actually I would say "yes": but only indirectly*, and only for this one particular 'joint attention' strategy ... but I think it is still a yes*.

(*my underlining again - and this time with a bit of added bold!).