The Keynote Address: Where have we come from? Where do we want to go? and how can research help us get there?

The aim of my address at the Intensive Interaction Conference was to create a space in which we could reflect on the range of domains in which Intensive Interaction has now been shown to be effective. This emerging research evidence pushes us to think in richer ways about the nature of Intensive Interaction. How is it that this intervention should be so widely effective?

Intensive Interaction began in the 1980s as a technique for working with people with PMLD*. Since then, its use has been extended to adults and children with autism and to children who have experienced severe neglect (such as abandoned children in Eastern Europe). It has also been used to some extent with people with multi-sensory impairments (e.g., deafblind), with brain injuries, and with dementia. This is a very wide ranging set of ‘impairments’!

This awareness of the breadth of its effectiveness should make us pause and think more deeply about what exactly Intensive Interaction ‘is’. Yes, it is a technique for improving communication and reducing ‘challenging behaviour’ (which might more appropriately be thought of as ‘distressed behaviour’). But the rapid effect it has on joy, delight, and social engagement suggests that it taps into core aspects of our humanity. Intensive Interaction helps us to understand how emotionally powerful simply ‘being with’ another person is. It is the breadth of Intensive Interaction’s effectiveness that really brings this point to life.

Many practitioners are already thinking along these lines. They have experienced that emotional connection in their work with ‘clients’ and ‘service users’. This generates an intense enthusiasm for Intensive Interaction, and so news of its effectiveness has travelled largely by word of mouth. Thus, one of the aims of my talk was to encourage more research studies. A range of research methods can (and have) been used to demonstrate Intensive Interaction’s effectiveness, including narrative accounts of the experiences of staff/volunteers, longitudinal studies of changes in behaviour over time (e.g., decreases in self-harm or increases in social engagement), and micro-analytic examinations of subtle shifts in behaviour during an Intensive Interaction session (e.g. proximity, orientation, eye gaze, emotion). As I stressed several times, research is ‘merely’ a story – but it is a systematic one. Anything that can be systematically observed can become a research study.

And we need more research studies, if we are to help those unfamiliar with Intensive Interaction to become interested in it and to convince managers, funders, and others to trust it. How are they to decide between Intensive Interaction and other approaches, many of which have a more established research base? We live in a world of evidence-based practice these days, and so the Intensive Interaction community needs to acquire a much more robust evidential base. I know this may sound daunting for many practitioners, but it need not be. Research is essentially a systematic story. If we have a larger number of people telling such stories, then that will more rapidly generate widespread awareness of Intensive Interaction – amongst practitioners, educators, family members, psychologists, and philosophers. That would also assist our own thinking: on what bases are we drawing conclusions about its outcomes, its limitations, it cost-effectiveness?

Such evidence will enable discussions about Intensive Interaction to contribute not only to debates about techniques for working with people with communicative impairments – but to debates about the very essence of humanity.

*(Hewett & Nind started working in the early 1980s with young adults with severe learning disabilities, many of whom also had a diagnosis of autism - Ed).