According to a recent research paper about the use of Intensive Interaction across day services for adults with profound and multiple learning disabilities in Sheffield by Prof. Judy Clegg et al 'Examining the impact of a city-wide intensive interaction staff training program for adults with profound and multiple learning disability ...*':
‘Structures supporting the use of Intensive
Interaction centred on training and the role of the advanced practitioner …
[this] role was viewed as vital … The advanced practitioner role was an
important factor in maintaining a focus on Intensive Interaction’
This made me think about some previous attempts (mine and others) at defining the essential nature of any such advanced Intensive Interaction practices or practitioners. I then remembered Melanie Nind & Mary Kellet's three defined levels of ‘Interactive style and practice of Intensive Interaction’ as set out in their book Implementing Intensive Interaction in Schools**. From their work I have had a go at using and or adapting/simplifying these levels, and came up with the three levels below:
Emerging Intensive Interaction Practice: when the Intensive Interaction practice is increasingly well-rehearsed, but might often be described as constrained or formulaic.
Emerging Intensive Interaction Practice: when the Intensive Interaction practice is increasingly well-rehearsed, but might often be described as constrained or formulaic.
Established Intensive Interaction Practice: when the Intensive Interaction practice
is enacted with increasing confidence, is clearly based on Intensive
Interaction principles, and as such is clearly responsive and sensitive in
nature.
and then there was ....
and then there was ....
Advanced Intensive Interaction Practice: when the Intensive Interaction practice is fluid
and highly sensitive, and is informed by reflective thinking within and around a
broad range of Intensive Interaction engagements.
So in Leeds we are thinking about how, in more detail, we could say with some certainty that a practitioner had attained the correct level to be such an ‘Advanced Intensive Interaction Practitioner’, and it is my view that the following aspects of ‘Advanced Intensive Interaction practice' should be observable in their practices:
1. Their use of observation is skilful, sensitive and reflective in nature.
2. Their interactive practice is fluid and sensitive, and is informed by the active use of observation and associated reflective thinking within and between interactions.
3. Their physical positioning during practice is adapted as and when necessary based on current or previous reflective observations.
4. The tempo of their interactive practice is well-paced, and is skilfully employed to maximise the participation of the student or service user.
5. The practitioner uses selective imitation and provides appropriate presentations for the student or service user to join in with or reflect back.
6. The practitioner uses a broad range of vocal intonation and/or articulation (when appropriate) to facilitate the engagement of the student or service user.
7. The practitioner’s interactive routines are varied in content and intensity.
8. The practitioner is able to engage and sustain interactions with the most challenging and socially isolated students or service users.
9. A student or service user’s communications of complex and/or negative, as well as positive, emotions are handled and responded to confidently by the practitioner.
10. The practitioner is reflectively aware of their own interactive practices, their insights being gained through regular non-judgemental self-appraisal and shared feedback, and they can articulate their reflective thinking to others.
2. Their interactive practice is fluid and sensitive, and is informed by the active use of observation and associated reflective thinking within and between interactions.
3. Their physical positioning during practice is adapted as and when necessary based on current or previous reflective observations.
4. The tempo of their interactive practice is well-paced, and is skilfully employed to maximise the participation of the student or service user.
5. The practitioner uses selective imitation and provides appropriate presentations for the student or service user to join in with or reflect back.
6. The practitioner uses a broad range of vocal intonation and/or articulation (when appropriate) to facilitate the engagement of the student or service user.
7. The practitioner’s interactive routines are varied in content and intensity.
8. The practitioner is able to engage and sustain interactions with the most challenging and socially isolated students or service users.
9. A student or service user’s communications of complex and/or negative, as well as positive, emotions are handled and responded to confidently by the practitioner.
10. The practitioner is reflectively aware of their own interactive practices, their insights being gained through regular non-judgemental self-appraisal and shared feedback, and they can articulate their reflective thinking to others.
Do these 10 criteria sound about right?
... and if so, I think that we should also ask ourselves how we could set about robustly evidencing (and even certificating) an Intensive Interaction practitioner's attainment of such an 'advanced practice' level; especially as having such 'Advanced Practitioners' across a service is evidenced in peer-reviewed research (by Clegg at al) as being vital in sustaining the provision of good quality Intensive Interaction for the people we care for and support.
*Clegg, J. , Black, R., Smith, A. & Brumfitt, S. (2018) 'Examining the impact of a city-wide intensive interaction staff training program for adults with profound and multiple learning disability: a mixed methods evaluation', Disability and Rehabilitation. pp. 1-10. ISSN 0963-8288.
**Nind, M. & Kellet, M. (2003) Implementing Intensive Interaction in Schools. David Fulton: London.
*Clegg, J. , Black, R., Smith, A. & Brumfitt, S. (2018) 'Examining the impact of a city-wide intensive interaction staff training program for adults with profound and multiple learning disability: a mixed methods evaluation', Disability and Rehabilitation. pp. 1-10. ISSN 0963-8288.
**Nind, M. & Kellet, M. (2003) Implementing Intensive Interaction in Schools. David Fulton: London.
Dave Hewett: I’ll just offer some notes below on the points in Graham's posting, taking them in order. I cannot agree with Graham's proposal and I'll itemise my thoughts in order.
ReplyDeleteGraham: “and it is my view that the following aspects of ‘Advanced Intensive Interaction practice' should be observable in their practices”:
1. - 4.
Dave: These items form part of the basis of good Intensive Interaction practice. Even on our one-day courses we are doing our utmost to help practitioners, from the outset, to have these facilities as the basis of their technique. The limitations of a course of only one day are well-known, but we nonetheless have good feedback of various sorts, that we can succeed in availing beginning practitioners of thee aspects of technique. I do not see anything ‘advanced’ about these facilities.
Furthermore, I suggest you have missed out on two absolutely essential aspects of basic technique which we have been even further emphasising in our courses for the recent three years or so.
• Tuning-in
‘Tuning-in’. Is the practitioner ‘tuning-in’ to the other person, reading her/him minutely, listening-in with all their senses so that they can be informed, second by second, about how to respond and maintain the flow? Again, this is basic, if the practitioner is not tuning-in they are not doing Intensive Interaction.
• Don’t do too much, a sense of minimalism
Also basic, this sense of minimalism. The practitioner does not do too much, does not produce ‘spare’ behaviour, does not do things ‘off the cuff’ which are not based on what the other person just did.
5. - 7.
Graham, I actually don’t understand number 5. What does ‘provides appropriate presentations’ mean? This sounds like you are suggesting that a so-called advanced practitioner knows how to take the lead in the interaction. This is nowhere recommended as an aspect of technique.
Number 6. Yes the practitioner will be prepared to be creatively responsive in articulating vocal responses – in response to the other person. Yes, there will be an element of gently offering some further articulation within the response, but I would suggest greater care than simply defining advanced technique as offering a ‘broad range’. The practitioner will have a broad range potentially available, not automatically used. However, this feature I would again suggest as basic technique.
7. The practitioner’s interactive routines are varied in content and intensity.
Number 7 provokes some of the same concerns as above. It can happen that a person who is carrying out the learning will gradually, through the processes of the interactions, develop a wide, creative repertoire of different activities within the interactions, at the same time as making progress with the Fundamentals of Communication because of the activities. It can also be the case that a learner person makes progress with the Fundamentals of Communication within a much more narrow repertoire of activities where the continued, familiar repetitions seem to provide a basis of security which is right for their flourishing. It isn’t any kind of given that the practitioner has interactive routines that are ‘varied in content and intensity’. Indeed, the practitioner does not have interactive routines. The practitioner has interactive routines in partnership with the other person, routines which are customised and different with each individual person and generated by their mutual understandings.