The History of Intensive Interaction in Nottingham Learning Disability Services

Who are we?

We are a group of people that are interested in using Intensive interaction with adults with learning disability. The group is led by the speech and language therapy team. Parents and carers attend the group, alongside staff from setting such as day services and residential homes.

How did the group started?

The Speech and Language Therapy in Nottingham has for many years attempted to interest staff in using Intensive Interaction with the people they support, with varying levels of interest. The Intensive Interaction Special Interest group has been established for over four years. Just prior to this, the local planning group for people with learning disabilities asked the Speech and Language Therapy team for their views on a report. The report identified sixteen people in the Nottingham area who were thought to be isolated as a result of their communication needs. The Speech and Language Therapy team felt this to totally underestimate the extent of communication difficulties experienced by people and so carried out their own survey of a hundred people who attended local day services in either special units or provisions. This found that 69 of the 100 people scored as being the most isolated by their communication, 81 of service users were rated as quite to very difficult to communicate with by staff and 94 were thought to be quite to very difficult to communicate with by their peers. Almost all of these people would have benefited from Intensive Interaction. At a similar time a small staff team from a long stay hospital attended a day on Intensive Interaction run by Dave Hewitt. Following this, the team needed a way of sustaining their enthusiasm. Speech and Language Therapy and those staff who attended that original training day form a special interest group, and initially met on a monthly basis to develop some guidelines on using the approach in Nottingham. Since that time the group has grown (and sometimes fluctuated) in size.

What do we do?

  • Guidelines. Early on in the life of the group we produced our own guidelines for the use of Intensive Interaction in Nottinghamshire. We looked at existing guidance such as that from Somerset and other published work and adapted them to meet our local need. We looked at a variety of ways of recording our use of Intensive Interaction and continue to develop this even now.
  • Share ideas. The group is a great place to share ideas and problem solve. We can share things that have worked well and things that puzzle us. It can be very encouraging to hear that somebody else faces the same challenges or us - or maybe they have come up with a solution we can try.
  • Case studies. Hearing about real people is also encouraging. Within carefully agreed rules of confidentiality, we have watched video and heard people's accounts of their use of Intensive Interaction, successful or otherwise in a number of different settings.
  • Speakers. To get us thinking even more we have organized a couple of outside speakers to come and lead a day for us. So far this has included Cath Irvine and Phoebe Caldwell, but we hope to extend this to others in the future.
  • Providing training. We now run a rolling programme of introductory training events for staff and are hoping to run one especially for families in the near future. We are aware that we could do more, but try not to beat ourselves up about it! We also did a presentation on our work at a regional Valuing People conference on communication which was well received.
  • Influencing local services. We are aware of the need to raise awareness of Intensive Interaction as an important aspect of local services. So we have also invited local 'important people' who we want to hear more about the approach. For example we had a recent meeting when we focused on day service modernisation and invited the planning officers to hear our concerns about the impact of this on the people we support. Our next focus will be on meeting with the person centred planning coordinator. We see ourselves as a campaign and lobbying group so that Intensive Interaction will be seen as an important component of the communication entitlement for people and have recently submitted a bid to the Partnership board to allow further development of this work.

Things we have found difficult

  • Managerial support. We know it is important to have managerial support -a top down as well as bottom up approach. This is not always easy but we are trying to take opportunities to influence and educate.
  • Staff release and commitment. Staff not able to attend our meetings has been a recurring issue for us. This is partly due to lack of managerial commitment and understanding but also a reflection of the unavoidable fact of staffing problems in services. The progress we have made has recently been described as 'guerilla development' - taking ground where we can and biding our time when the realities of our circumstances dictate. This seems to us to make sense of the small steps we are able to make and cheers us up when we feel we should have achieved a lot more!
  • Changing patterns of service provision for this group of service users. There are lots of changes in services. Some are good. Some don't always take account of the needs of people who use Intensive Interaction and the staff who use it with them. We find a lot of our time is spent discussing this.

Things we have found encouraging

  • Hearing good news stories. It is great to hear the triumphs that people have had and to be able to tell others who understand the successes we have had.
  • Learning more from listening to each other. Often somebody else has faced the problem we have had and from listening to how they tackled it we can go away and try out new ideas.
  • Having parents and carers involved in our group. Our parent members offer a unique perspective and we are so glad to have them join us in our group. We hope to recruit more!
  • Sharing our frustrations with like minded people. It is just so supportive to know that the others in the group are 'on the same wave length.'
  • Reminding ourselves of the very small steps of progress we have made. It is easy to forget the progress we have made. There is usually somebody in the group who will remind us if we forget!

When and where do we meet?

We meet about four times a year, at various locations in Nottingham.

How can you join?

The Special Interest Group is open to anyone in the Nottingham area, who spends time with an adult with learning disability for whom Intensive Interaction is a valuable way of communicating.

For more information contact:

Vicky Romilly

Sue Thurman

Speech and Language Therapy Team
Denewood Centre
Denwood Crescent
Bilborough
Nottingham
NG8 3DH

Telephone 0115 9159619