by Cath Irvine
Cath is, by profession a Speech and Language Therapist who has 15 years of experience in working with Intensive Interaction and supporting staff to use the approach.
In 1995 Cath introduced Intensive Interaction to Somerset Adult Learning Disability Services and developed the training of coordinators to teach, role model, support and evaluate the approach with service users.
Since 2005 Cath has been alternating freelance Intensive Interaction work in the UK with work in Eastern Europe with children in institutional care.
Cath is a founder member of the Intensive Interaction Institute and has a passion for empowering and supporting hands-on staff to use Intensive Interaction on a day-to-day basis rather than people viewing the approach as something only the ‘experts’ can do. She delivers training – mostly in-house/within organisation for Intensive Interaction Coordinators Courses and Endorsed Practitioners Courses.
Cath also teaches 2 of the modules of Dave Hewett’s Intensive Interaction Coordinator courses – her modules are focused on systemic and sustainable use of the approach in the coordinators workplace.
Embarrassingly it has been a few years since I updated this section to keep people up to date with what I have been doing – so a brief summary of the last couple of years.
Since being freelance I have undertaken Intensive Interaction Coordinators training in Oldham, Brighton, Sheffield and Oxford. Intensive Interaction Coordinators training is a fairly lengthy process involving supporting people to use and evaluate the approach confidently, teach others about Intensive Interaction and support the use across their organisation. In addition to working with the coordinators part of the process is negotiating support from the organisation. Often this involves meetings with managers to agree and write supporting practice guidelines.
However, the Intensive Interaction Coordinators process, while empowering the individuals involved in the training did not always work in empowering all staff to use Intensive Interaction. Training coordinators to teach the one day course helped the issue of general dissemination and awareness but did not always result in staff going away and using the approach.
Over the last few years I have become increasingly convinced that potential practitioners need more than a one day course to encourage them to use Intensive Interaction. There are a variety of potential reasons for this: - having the confidence that an approach so seemingly simple can be effective, feeling foolish in front of colleagues, having managers support and understanding, finding time and appropriate space, having the motivation to use the approach long-term and being able to identify and document the progress made through the use of Intensive Interaction.
In addition to practitioners needs for support it appears that organisations require more structure in order to support the use of Intensive Interaction. The approach has been around, well evidenced and disseminated for over 20 years but compared with the use of communication approaches like Makaton, Signalong, Pecs and Teacch is not so systemically used. One of my recent considerations has been that in target driven services where managers need to be able to pre-plan their expenditure and resources; perhaps some simple structure and consistent outcomes could be useful in the implementation of Intensive Interaction.
For this reason over the last 3 years I have been developing a mentored Intensive Interaction course aimed towards empowering staff to use and evaluate Intensive Interaction over a period of 4-6 months with one individual.
The coordinators in Sheffield, Brighton and Oxford have been involved in piloting, evaluating and improving the course content. Coordinators attending Dave Hewett’s courses have also been instrumental in delivery and improvement. The course involves an informal assessment on completion – a big contribution to continuing motivation of the practitioners!
I have delivered this course in a number of schools and organisations and it is received with great enthusiasm since it gives practitioners the time and support to use Intensive Interaction and the organisation is assured of some outcome measures at the end of the process – usually resulting in the organisation wanting to continue the use of the approach.
In order for this course (now named The Endorsed Practitioner Course since it is endorsed and recognised by the Intensive Interaction Institute) to be increasingly disseminated opportunities for assessment need to be taken out of my hands. The hopes of the Intensive Interaction Institute are that the newly formed Regional Support Groups can take responsibility for evaluating and signing off Endorsed Practitioners.
In my travels around services across the UK I regularly find people who are confused about what Intensive Interaction is. I have, on occasions found people very antagonistic about the approach (worryingly this is often families) Since I am increasingly passionate about Intensive Interaction and the changes it promotes in people’s lives I find this antagonism really difficult and I invest a great deal of time in reintroducing the approach and gently helping families understand what it involves.
My hopes are that the Endorsed Practitioner course mentors people through every aspect of Intensive Interaction and encourages good reflective practice in a positive, interactive way rather than a directive, judgemental manner that can contribute to the aforementioned antagonism.
The long-term hope for this course is that it will be more widely available once more evaluation has been done and the assessment procedure has been ratified.
I continue to respond to families who wish to know more about Intensive Interaction and who may need some encouragement in their use of the approach. As a point of principle I offer this work free but am restricted by a number of considerations. Firstly, I’m not always available, secondly and most importantly I really feel that families should be getting this support locally and from people who can offer free on-going support.
The use of Intensive Interaction within pre-school services is still sparse but it is the professionals within these services who are in the best position to support families. For this reason I have concentrated more on supporting the ‘community of practice’ through the Intensive Interaction Institute via the formation of Regional Support Groups (see below) than on individual work with families. My hopes for the future are that families will be able to contact someone from their regional group and that group will be in a good position to offer support from within their membership.
The institute was set up to support practitioners to use the approach and perhaps one of the most helpful things we have done is start the regional support groups. These groups have been running since autumn 2008 and the members of the Intensive Interaction board of Directors recognise that it is time to give these groups more support and some responsibility for the further support and dissemination of Intensive Interaction.
In February the directors of the Intensive Interaction Institute will meet with representatives from each group to discuss the roles, responsibilities and support needs of these groups. Part of this day will be to discuss the further dissemination of the Endorsed Practitioner Pack as well as discussions about supporting families.
It is hoped that these days will happen annually to aid the communication channels between the institute and the regional groups.
A major and recurring subject of the meetings of the institute is how to do what we need to do (support the community of practice, maintain an informative website, further dissemination and research support) without any money. All Directors give their time with no remuneration for time or expenses – in fact, in order to do the job we do we spend our own money and the royalties from some of the book and DVD sales going directly to support what is increasingly being seen as the ‘community of practice’
It is hoped that this will change in the future and funding will be found for the institute to more thoroughly support practitioners. At present some people get a bit fed up when emails and requests go unanswered and we hope this will soon be a distant memory once the institute can employ someone to respond to phone calls, emails, seek further funding, produce leaflets, organise parents support networks and keep the website updated.
Following the inclusion of Intensive Interaction in the Governments White Paper, Valuing People Now, Dave, Graham and I wrote to Jonathan Shaw – minister for disabilities – to request some discussions about the aims of the institute and possible funding. Unfortunately, despite the letter being sent a second time we have still not received a response.
At present these 12 children live in a poor environment with over 100 adults. The children have been assessed as having severe learning disabilities, but as ever, I am left wondering how severe some of these disabilities really are or whether they are the result of severe deprivation. The children’s ages range from 6 – 17. Some clearly have autism spectrum disorders, but one child was abandoned in hospital merely due to a dislocated hip, another abandoned because of asthma. Parents often cannot afford health care and abandon children so they don’t have to pick up the bills.
When I first met the children they had had no opportunities to play or explore. Their social skills were practically non-existent. They were all constantly on high alert – an indication that their personal safety was often threatened within their environment. None of the children recognised themselves since they had had no opportunities to look in mirrors. Toys were an unknown entity. One girl flinched in fear when a ball was rolled towards her.
We began by setting aside a safe space for the children to have sessions of either Intensive Interaction or interactive play. We put some routines in place and took and displayed hundreds of photos.
My job there is not to do all the work but to train staff to use therapies long-term. My first visit was a month long and I worked alongside staff to teach them how to use Intensive Interaction – including recording, reflecting and evaluating. Subsequent visits have been to assess the children’s progress, encourage and update the staff and write new guidelines that reflect the children’s progress and their slowly changing circumstances.
In the year I have been working with this group of children and the staff much progress has been made and we are now working towards integrating some of the children into special schools.
Two members of staff in particular have really enjoyed the use of Intensive Interaction and have become skilled practitioners. They have completed the Endorsed Practitioner Course and will be presenting some of their work at the Intensive Interaction Conference in June 2010.
The long-term aims for these children are family living situations but this can be a long process so as an interim solution the children have recently moved into a separate block within the institution with a better staffing ration and a nicer environment.
Alongside supporting the children in the institution I have also been introducing Intensive Interaction to parents who kept their children at home - with minimal support. There are some emerging and assertive parent groups and it’s been a real joy to work with them and give them some hope of progress for the children who have previously been written off as ‘vegetables’.
Five people from the parents groups have completed the Endorsed Practitioner Course and more opportunities are planned for the future. The two special schools have also welcomed the introduction of Intensive Interaction with staff from one of them eagerly anticipating their assessments for Endorsed Practitioner in February 2010 and the other school beginning this process ready for assessment in autumn 2010.
I am aiming to build a supportive community of practice for Intensive Interaction in Montenegro thus reducing their need for my presence.
My visits to Montenegro are likely to continue in 2010 and I will also be getting involved with another charity in some work in the Czech Republic.
I regularly get asked by Intensive Interaction Practitioners if they can accompany me in my work in Eastern Europe. So far, this has been difficult to accommodate as I work at the request of Governments but there is some exciting progress for people wanting to get more involved.
Initial plans and discussions for the work in Czech Republic are to link regional groups with different institutions in the country in order to regularly send out well-supported Intensive Interaction practitioners to work with the children and staff. This is in the early days of planning but the charity and most practitioners I have discussed this opportunity with are very keen for this to happen. Watch this space and get involved with your regional support group if you may be interested in the future.
It is estimated that over 1,000,000 children live in institutional care in Eastern Europe. There is a lot of work to do. Getting charities interested in working with the institutionalised adults is practically impossible but estimated numbers must be much, much higher than those quoted for children. And this is just Eastern Europe…..anything that can be done feels sometimes like merely scratching the surface – but for the children involved it is far, far more than a scratch.
Hopefully it won’t take another 3 years for me to update this section!
Printed from www.intensiveinteraction.co.uk on Thursday, 11th March 2010
For further information on Dave Hewett visit www.davehewett.com
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