Monday, 25 March 2019

Intensive Interaction Regional Support Groups - what are they, and who are they for?

The other week I was kindly invited to the first meeting of the Kirklees Intensive Interaction Regional Support Group (II RSG) .... thanks for that Aileen ... and I have recently noticed an increase in reports or posts asking about local II RSGs across the UK - which is great. It is now over 10 years since the idea of these Regional Support Groups took shape. Initially Cath Irvine (one of the founding directors of the Intensive Interaction Institute) wanted to help create locally accessible and supportive Intensive Interaction communities, and these came to be called Intensive Interaction Regional Support Groups.

So what are such Regional Support Groups for? Well, according to the section in the 'Intensive Interaction Handbook' (2nd Ed, Sage, 2018) their purpose is to:
  • Support current Intensive Interaction practitioners e.g. by sharing and discussing case studies and/or video and collectively reflecting on good Intensive Interaction practice.
  • Support and encourage novice practitioners e.g. parents, by providing a shared and supportive learning environment.
  • Disseminate Intensive Interaction knowledge and information e.g. about conferences, practice guidelines, new books & DVDs, training opportunities, etc.
  • Provide opportunities for peer support, problem solving and celebrations of success.
  • Emphasise and further the multidisciplinary nature of Intensive Interaction work and provide a place for productive networking.
  • Participate in relevant studies/questionnaires when requested by others researching the use of Intensive Interaction.
Central to the idea of creating accessible Intensive Interaction ‘Communities of Practice’, the UK Regional Support Groups were encouraged to provide a friendly and open forum for Intensive Interaction focused discussion and collaborative learning. Generally meeting every few months, each group is seen as semi-autonomous and democratic in nature; the groups run by the membership specifically for the benefit of the group’s members. 

Although there is often a basic agenda, the content and structure of each meeting should address the specific concerns of the people who attend. Sometimes RSG meetings are arranged around a particular theme or presentation, and in the past these have included:
  • looking at the latest Intensive Interaction information or training resources e.g. the newest  Intensive Interaction DVDs and/or books.
  • an ‘introductory’ presentation for parents e.g. setting out the basics of Intensive Interaction for parents who want to know more about the rationale or techniques used.
  • video analysis for Intensive Interaction e.g. how to structure collective video analysis most productively.
  • record-keeping and analysis to highlight progress in Intensive Interaction.
Responsibility for organising the RSG groups can be relatively fluid, although there is often a dedicated individual or small group of practitioners that act as a contact and organise the dates and venues (and refreshments!) for each meeting.

Thus our Intensive Interaction RSGs have now become part of the fabric of Intensive Interaction support and dissemination in those areas lucky enough to have them. More RSGs are currently being proposed and/or set up in other locations across the UK to help support, encourage and maintain Intensive Interaction for their members, and those they care for and support. Can you get involved?

Monday, 18 March 2019

'At home with Tom: maximising my son’s potential with Intensive Interaction' - interesting quotes from a chapter by Sara Moroza-James.

Sara Moroza-James' son Tom has diagnoses of autism and epilepsy. Following Tom's success with the approach, Sara trained as an Intensive Interaction coordinator. She also now runs the 'Intensive Interaction for parents’ Facebook group, and works part-time training people, mainly with other parents, in Intensive Interaction. 

Below are a series of quotes I have chosen from her chapter 'At home with Tom: maximising my son’s potential with Intensive Interaction' in the book Delivering Intensive Interaction Across Settings' (Barber & Firth, Eds, 2019) which is now available as a paperback book (£4.43 from Amazon).

'A full-time Intensive Interaction programme has allowed this once obsessive and lost little child to blossom into a happy, social, and connected thirteen-year-old who has an ever-expanding repertoire of activities and interests'.

'Not only do parents understand their children best but our children would surely choose us as the people they’d most like to do Intensive Interaction with'.

'On our darker days, parents may see no way out of circumstances as difficult as severe sleep deprivation, extremely high anxiety, severe mood swings, self-injury, aggression or incontinence, all of which affected Tom.  My solution was to train up others to do Intensive Interaction with Tom on the days when survival was my only goal'.

'It felt as though Tom and I existed alongside one another in two separate bubbles - closed off from the outside world, but also from one another'.

'Studies reveal a disconnection between what professionals think parents want from an intervention and what they actually look for: Professionals believe parents most value evidence-based approaches whereas, in reality, parents are most interested in the benefits that the approach will bring for their child'.

'Doing Intensive Interaction out and about – at the swimming pool or on the swing at the park – made connecting with Tom easier in the early days – and many autism-parents report similar successes'. 

'Informal home life does not lend itself easily to formal record-keeping but is essential when proof of progress is needed for funding or to encourage a school to take on Intensive Interaction'.

'Introduced the right way, Intensive Interaction can help parents have hope instead of despair'.

'Professionals should always be very careful when talking to parents not to use language in way that might be perceived as blaming the parents– reference to specific academic papers or theories should always be used with great care to avoid making parents feel part of the problem rather than part of the positive Intensive Interaction solution'.

'I am indebted to Intensive Interaction for the transformation in my son, for the wonderful changes in my own life and the happiness it has brought my family as a result. My dream now is that long-term high quality and a high quantity of Intensive Interaction, involving both professionals and parents becomes accessible to all individuals with autism'.   

Sara has also written her own book about using Intensive Interaction - 'Learning through Social Connection: How Intensive Interaction can help your child who has autism to learn more naturally'.

Monday, 11 March 2019

The strengths and limitations of the body of Intensive Interaction Research

I am currently updating our Intensive Interaction Research Summaries document for inclusion in an updated 'II Schools Curriculum Documents Pack' and this got me thinking about the strengths and the limitations of the current body of research that supports our claims for the outcomes of Intensive Interaction. Below I set out my general thoughts on these issues:

The strengths of the current body of Intensive Interaction research:
  • The Intensive Interaction research is multi-disciplinary in nature i.e. it comes from a variety of professionals, with different participants and from different settings.
  • Intensive Interaction studies have been based on the work of a range of experienced researchers supported by experienced professionals/practitioners.
  • The Intensive Interaction research has been published across a wide range of well-established and academically well regarded journals (the majority peer reviewed), both in the fields of special education and in the more generic learning disability journals (and now one or two in Dementia journals as well).
  • There has been a mixture of research methods used across the Intensive Interaction research i.e. both quantitative and qualitative methods (some within the same 'mixed methods' studies), which give a more contextualised representation of the approach and its outcomes.
  • The Intensive Interaction research body consists of a mixture of experimental or quasi-experimental methodologies (e.g. ‘time-series multiple-baseline’ studies), comparative studies and individual case studies, using a range of well-structured assessment scales to help standardised measures e.g. PVCS.
  • Different variables have been researched, including the beneficial outcomes of Intensive Interaction, reductions in negative/challenging or socially isolating behaviours, as well as some of the factors that influence the use of the approach across a number of different settings.
  • Numerous case studies give rich data with good reliability using a range of data gathering methods and analysis (e.g. via non-participant/independent video momentary time sampling techniques), and the use of inter-rater assessment measures to help control or limit the potential for researcher bias.
  • Generally positive findings of increased social or communicative progression emerge across the body of Intensive Interaction research.
  • Intensive Interaction is based on well-founded and well-evidenced developmental theory, this giving the approach a clear theoretical coherency that enhances the plausibility of any positive findings.
The limitations of the current body of Intensive Interaction research:
  • There are some issues associated with the standardisation or the ‘fidelity’ of the Intensive Interaction practices used within the research studies i.e. it is unclear if all the practitioners were doing the same kinds of Intensive Interaction.
  • There could be some difficulties in replicating some studies (due to some methodological and/or procedural reporting issues) e.g. some studies do not make it clear of how the participants were sampled, and some had inadequate descriptions of the baseline phase.
  • Some studies have potentially unidentified or unacknowledged variables which may impact on the validity of some of the findings.
  • It is difficult to generalise from the findings of small cohort or individual studies due to the idiosyncratic nature of the participant group.
  • Finally, there still isn't by any means enough research making its way into the published academic and research literature. If we want as many people as possible to benefit from Intensive Interaction, then we still need more published research into the processes and outcomes of the approach across all the groups of people with whom it might be used.
(For further reading on this issues see: Hutchinson, N. & Bodicoat, A. (2015) 'The Effectiveness of Intensive Interaction: A Systematic Literature Review', Journal of Applied Research in Intellectual Disabilities, 28 (6), 437-454.)

Monday, 4 March 2019

'Intensive Interaction in a Special School: The Leadership Challenge' - interesting quotes from a chapter by school Principal Ric Day.

Ric Day is the Principal of Woody Point Special School in Queensland, Australia. He has has been a leader in a variety of roles within special education for over a decade as a Principal, Deputy Principal and Head of Special Education Services. 

Below I set out a series of quotes from his chapter 'Intensive Interaction in a Special School: The Leadership Challenge' in the new book Delivering Intensive Interaction Across Settings: Practice, Community and Leadership (Barber & Firth, Eds, 2019).

'In all schools, and probably all organisations, we need strong relationships and high trust. Intensive Interaction ... asks us to be more vulnerable than many other teaching approaches. Therefore the strength of our relationships and levels of trust need to be higher'.

'We must carefully consider how we sell our ideas to our staff and communities. We must build a narrative to help our teachers connect their practice with making a difference for students.'

'While anecdotal evidence is often poor research it is usually a good motivator ... I’m not in any way trivialising the importance of quality research, data gathering and analysis and using evidence to make good decisions. That is very much the job of good educational leaders. My point is simply that research and data should act as the compass that guides us on our journey, but we should not rely upon it solely to be the wind that fills our sails.'

'Leadership is an exercise in moving a community forward by taking others with you'.

'I think it’s beneficial to have the involvement and commitment of staff at all levels of the organisation. Members of the leadership team, teachers, teachers’ aides and therapists should all be involved at some level. Everybody has something to contribute.'

'As leaders we must create the right culture, for cohesive teams to exist and to build purposeful peer interactions. We must make sure that we maintain high expectations, recognise contributions of team members, and create feedback rich environments'.

'Essentially, I believe that in order to mobilise a workforce you need to make people feel something. Thinking alone doesn’t cut it. Intensive Interaction comes with its own intrinsic reward, practitioners already feel something when they interact with students and generally my experience is that they want more'.

'In my experience a school that has a strong commitment to Intensive Interaction typically has a school culture that is student centred and deeply respectful toward all students'.

'The most wonderful thing about school culture and Intensive Interaction is their symbiotic relationship. While the school culture I have described above will contribute to the effective implementation of Intensive Interaction, the implementation of Intensive Interaction also most certainly contributes to a more positive school culture'.

'At the outset I stated that leadership is difficult, and it is. It requires us to be a great many things to a great many people. It requires us to be careful guardians of change, skilful users of data and esteemed researchers. However, I believe that above all else it is the empowerment of practitioners, the development of a positive school culture with high trust relationships and the creation of a collegial and collaborative community of practice that are the keys to successfully embedding Intensive Interaction across a whole school community'.


Delivering Intensive Interaction Across Settings: Practice, Community and Leadership by [and Graham Firth, Edited by Mark Barber, FIRTH, GRAHAM]


For my blog today I am abridging a recent British Medical Journal 'Opinion' piece (14/01/21) People with an intellectual disability...