Intense interaction with people with learning disabilities

Early last year Bill Demel had not heard of Intensive Interaction. Now 18 months later it is an instrumental part of the way he and his team works at Beaconsfield Villas Residential Unit in Brighton, a service for young adults with learning disabilities.

In June Demel’s staff with a team from St. John’s College, a local college for teenagers and young adults with special needs run by charity St. John’s School & College, won a national award for their work using the approach from the Intensive Interaction Institute.

Demel says he first heard of Intensive Interaction by “serendipity” as it was suggested to him by speech and language therapist, Cath Irvine, who has been involved with the approach for many years, and was covering a maternity leave.

Beaconsfield Villas is a large Victorian house split into two flats housing four young men with profound learning disabilities and autism run by Brighton & Hove Council. It’s a new service, having opened in February 2006, and was set up to provide a facility for those leaving children’s services. Three of the men receive education services from St. John’s College.

Studying behaviour

Intensive Interaction was developed to reach those who don’t always like being in the company of others or who have very limited communication. It involves looking at people’s behaviour and the reasons behind it and trying to teach them fundamental ways of communicating in order to build relationships.

The two teams started using the approach in July 2006 with one resident, 21-year-old Ben*. They have recently also started to use it with Matt* another member of the household. It was their work with Ben for which they particularly received the award.

Demel explains how they were looking for new ways of working with Ben who had high anxiety levels and didn’t like being with other people. This would sometimes cause him to grab and injure staff which caused some to leave or be off sick. As well as being costly because agency workers sometimes had to be brought in, it also had a negative effect on team morale.

“People with autism and severe learning disabilities can be very shut off within themselves. We [using Intensive Interaction] want to try and build an enjoyable experience between two people,” he says.

Ben does not communicate verbally so Intensive Interaction between Ben and the workers involves them carrying out similar movements and gestures to him, but Demel stresses that it’s important that this is not in the form of mimicking as this is highly annoying for the person involved. So, for example, one day Ben was sitting in a car and he was drawing on the window with his finger. A worker outside the car started doing similar movements on the other side of the glass. This made Ben respond positively by having eye contact and interacting with the worker, something he previously had avoided doing.

For those who can communicate Intensive Interaction can also involve responding to something they have said or a noise they have made.

“It works with service users on their own terms without making a demand of them which is really important,” Demel says. “It’s about picking the positives out and working with those.”

Shortly after staff adopted the approach there were noticeable improvements in Ben’s behaviour. He became less anxious, happier and interacted more with others. This in turn now means staff want to work with him as it’s now an enjoyable experience.

Intuitive interaction

Adam Wright, a home care support worker at the unit, worked with Ben at a children’s home, also in Brighton, for about six years and then moved with him to Beaconsfield Villas. Having worked with Ben for many years they had developed an intuitive way of interacting, which is in effect a form of Intensive Interaction, before the unit decided to adopt the approach.

Since being trained himself in the approach he has realised how important the observation and recording of the results of Intensive Interaction is to ensure consistency.

“People [service users] will carry out certain behaviours to generate certain reactions so it’s important that you always have that reaction,” he says.

For Ben, consistent working practices from staff, as a result of them being trained in Intensive Interaction, has led to a consistency in his behaviour and made him more accepting of new staff as he has more of an idea about how they will act, Wright says.

The start-up costs for Intensive Interaction are low and the cost savings are high. One day’s training is required followed by a period of observation of the service users’ behaviour to work out what will be most beneficial to them.

For Beaconsfield Villas the approach has been nothing but positive. “It improved the quality of the service and the quality of Ben’s life,” concludes Demel.

* Names have been changed

This article appeared in the 20 September issue under the headline “Windows open on the world”