INTERACT Intensive Interaction Intensive Interaction Priorities & Principles for teaching communication to pupils with PMLD CCEA Conference 22nd October 2009 Dr. Dave Hewett c/o 31 Buntingford Road Puckeridge Herts UK SG11 1RT +44 (0)1920 468621 daveinteract@hotmail.com sarahinteract@hotmail.com (Sarah Forde, PA) Dr. Dave Hewett www.www.davehewett.com www.intensiveinteraction.co.uk

My intentions in this talk Try and make some big general points about human communication Commend the Quest Guidance to you Relate communication, Intensive Interaction issues and my other points to the Quest Guidance Offer some curriculum theory on Intensive Interaction   (not necessarily in that or any, order, but hopefully with inter-connectedness)

A big, general issue about human communication

Why do human beings communicate?

Why do human beings communicate? Surely, mainly for the pleasure and fulfilment of sensations of companionship, relationship, psychological and emotional ‘connectedness’ How many of our daily communications with each other actually have any kind of ‘product’ or instrumental outcome Most of them are ‘hot air’

Mission How about if we think about how to teach the most complicated things that a human being ever learns…. To the people who have the most severe learning difficulties…?

Quest for learning

“ "for those individuals who consistently fail to show measurable progress on conventional assessments, a different model of progress is required. It is not that these individuals cannot make progress, but we would argue that the instruments by which progress is measured do not suit the people whose abilities are being measured." Barber & Goldbart (1998) Quest for Learning (page iiii)

“It is important that individuals working with children who are severely disabled are given tools that enable them to address the relevant features of the child's behaviour without trying to fit the behaviour into a pre-existing assessment tool that was not developed for, or related to, the behaviour of someone with very special problems i.e. unique abilities and patterns of growth.” Wolfe Schein (1998) Quest for Learning (page iiii)

This guidance: offers an overview of the main theories and background information underpinning effective teaching and assessment; considers the complex interaction between the sensory impairments, motor disabilities, medical problems and cognitive processing difficulties experienced; takes a more holistic view of learners by focusing on how they learn and by acknowledging their different abilities and achievements; takes account of preferred sensory and learning channels and ways of processing information; focuses on those early communication, cognitive and sensory skills that are the foundation to all future learning and crucial to an improved quality of life; (Dave’s emphasis) supports the development of learner-centred approaches and the focus on emotional well-being through all the Key Stages from the Foundation Stage through to Key Stage 4; (page 2)

The Fundamentals of Communication enjoying being with another person developing the ability to attend to that person concentration and attention span learning to do sequences of activity with a person taking turns in exchanges of behaviour sharing personal space using and understanding eye contacts using and understanding facial expressions using and understanding physical contacts using and understanding other non-verbal communications vocalising and using vocalisations meaningfully (incl speech) learning to regulate and control arousal levels lots and lots of emotional er, stuff the development of neural links? face & mind ‘reading’

We started work on Intensive Interaction because:

Our communication curriculum was inadequate Our curriculum was inadequate Communication was the absolute priority for all students We could find little help, little knowledge in existing literature Most of us were uneasy about all the trappings of behaviourism (‘Skinnerism’) we were using We were moving intuitively toward a more play-based curriculum

To what extent do the issues in those bullet-points still apply today?

Intensive Interaction Central Principles Basically, the teacher makes space for the learner to lead the activity. The teacher develops the content and the flow of the activity by: RESPONDING!!!! Responding to things the learner does. Some ways of responding: imitation/joining-in/mirroring delighted face/voice/body language bursts of speech – running commentary Therefore it is necessary for the teacher to ‘tune-in’ to the learner, constantly read and assess the learner for things that the teacher can respond to in order to create ‘communication moments’ The effect for the learner is then that: The tempo of the activity is okay – the learner dictates the tempo The content of the activity is understandable since the starting point is things the learner does and understands The behaviour of the teacher is understandable – more like the behaviour of the learner.

The activities contain many pauses Where the teacher watches and waits Therefore The activities contain many pauses Where the teacher watches and waits Does not – 'drive on'

Repetition & Repertoire Therefore, from sometimes quite small beginnings, frequent repetitions of the game-activities that work, gradually enlarges the activities. They grow in duration and complexity. Therefore: Repetition is good Repetition is the main engine-room of forward progress. People who are at early stages of development like repetition Repetition provides: familiarity predictability security a sense of control and structure Gradually, a widening repertoire of familiar activities is generated. This provides a sense of confidence for the learner to experiment, do new things which also get responded to and added to the repertoire.

Some thoughts on a curriculum theory for Intensive Interaction

Interactive approaches Facilitating the development of fundamental early communication skills requires practitioners to use process-based, interactive approaches rather than product-based behaviourist ones. Interactive approaches have moved away from the teaching of small sequential steps, controlled by the teacher, and instead focus on broader attainment which is not necessarily easy to measure or record. The principles of the interactive approaches are that: Page 13

learning is contingent upon good interpersonal relationships; there is sensitivity to feedback from the learner; the focus is on understanding, developed through relationships which foster respect, negotiation, participation and motivation; the quality of the teaching and learning process is as important as the performance of the objectives; teaching is not always dependent on dividing that which is to be taught into its constituent parts. page 13

Other areas of learning gradually becoming available and opening up many learning outcomes gradually emerging these activities lift off and spiral upwards with success breeding on success day-by-day Stern, Beebe, Jaffe et al 1977 repetition repetition frequent, daily sessions - activities spiraling repetition repetition of early engagements first access - small beginnings Parent-infant interaction and Intensive Interaction work like this – ‘spiralling’ Fom: Hewett, D. (2006) ‘The most important and complicated learning: that’s what play is for!’ ICAN, Talking Point, March. www.talkingpoint.org.uk

? ? ? ? input/output input/output input/output Communication My visualisation of the complexity of communication learning and performance Communication Fom: Hewett, D. (2006) ‘The most important and complicated learning: that’s what play is for!’ ICAN, Talking Point, March. www.talkingpoint.org.uk

A visual representation of conventional, ‘structured’ teaching 7 and so on then this first teach this 6 1 2 3 4 5 A visual representation of conventional, ‘structured’ teaching How we like to teach Fom: Hewett, D. (2006) ‘The most important and complicated learning: that’s what play is for!’ ICAN, Talking Point, March. www.talkingpoint.org.uk

This sort of teaching approach 6 This sort of teaching approach 1 2 3 4 5 How we like to teach Probably won’t work for teaching something as complicated as this ? ? ? ? ? The complexity of communication learning and performance Communication

This is a true ‘process curriculum’ The learning outcomes are gradually emergent over time As a result of the rolling, cumulative, generative process The learning outcomes are not set as targets or objectives, they simply gradually emerge within the process as a result of the process The ‘process’ is the regular, frequent activation of the activities The activities are the interaction sessions – the regular frequent practical rehearsal of the skills, abilities concepts and schemata concerned with being a communicator These activities are carried out in partnership with someone who is already good at it And each activity gradually builds on all the activities that have gone before, gradually growing in duration, content and sophistication

What is interactive about Intensive Interaction? The learner is a fully active participant likely to be influencing the processes of the activity as much the teacher does The teacher ‘tunes-in’ for and reads the processes of the learner moment-by-moment and allows that feedback to influence teacher behaviour We might say there are three basic principles: The learner is active The learning activity is intrinsically rewarding and motivating The learner shares control of the activity with the teacher (Nind & Hewett 1988) 17

If you think about it, most of the most important things that a human being learns – and also all the most complicated things – are learnt pretty much before the age of four. In nearly all countries, this is before the child goes to school.

Tharp and Gallimore (1988) refer to this learning as the ‘social curriculum’ or the ‘natural curriculum’

“In every culture, natural teaching transmits skills of immense variety and power – a ‘curriculum’ of far greater complexity than anything attempted in schools. Such interactions awaken mind, communication and expression…” Tharp & Gallimore (1988 p. 20)

Learning through play…. In fact, much of this learning is so complicated, multi- faceted and multi-layered, the only way in which this learning can be carried out is during play or play-like activities. That is what the play is for. Play is itself a complex, multi-layered, multi- faceted situation that is just right for learning things that are like that. Fom: Hewett, D. (2006) ‘The most important and complicated learning: that’s what play is for!’ ICAN, Talking Point, March. www.talkingpoint.org.uk

References Hewett, D. (2006) ‘The most important and complicated learning: that’s what play is for!’ ICAN, Talking Point, March. www.talkingpoint.org.uk Tharp, R.G. & Gallimore, R. (1988) Rousing Minds to Life: teaching, learning and schooling in social context. Cambridge: Cambridge Universtiy Press. Stern, D.N., Beebe, B., Jaffe, J. & Bennett, S.L. (1977) 'The infants stimulus world during social interaction: a study of caregiver behaviours with particular reference to repetition and timing', in Schaffer, H.R. (ed) Studies in Mother-Infant Interaction (London: Academic Press).

Publications and research on Intensive Interaction   Nind, M. & Hewett, D. (1989) 'Teaching pupils with very severe learning difficulties by means of Intensive Interaction. Some typical questions and answers.' Portage Into the Nineties Papers from the 1989 National Portage Association Conference. The National Portage Association. Hewett, D. & Nind, M. (1992) 'Returning to the Basics: A Curriculum at Harperbury Hospital School' In: Booth, T. et al, Curricula for Diversity in Education. London: Open University Press/Routledge Hewett, D. & Nind, M. (1993) 'Access to Communication. Intensive Interaction: an approach to helping learners who are still in the pre-speech stages of communication learning.' Information Exchange May 1993. Hewett, D. (1996) 'How to do Intensive Interaction', in Collis, M. & Lacey, P. 1996 (eds) Interactive Approaches to Teaching: A Framework for INSET, London: David Fulton. Hewett, D. & Nind, M. (2003) Severe Learning Difficulties: Intensive Interaction’. Five to Eleven, Vol 2, No. 10 30-32. Hewett, D. (2007) ‘Do touch: physical contact and people who have severe, profound and multiple learning difficulties’, Support for Learning, 22, (3) 116. Hewett, D. (2006) ‘The most important and complicated learning: that’s what play is for!’ ICAN, Talking Point, March. www.talkingpoint.org.uk Irvine, C. (2001) ‘On the floor and playing…’ Royal College of Speech and Language Therapy Bulletin, November 2001, 9-11.  Kellett, M. (2000) ‘Sam’s story: evaluating Intensive interaction in terms of its effect on the social and communicative ability of a young child with severe learning difficulties’, Support for Learning, 15 (4), 165-71. Kellett, M. (2003) ‘Jacob’s Journey: developing sociability and communication in a young boy with severe and complex learning difficulties using the Intensive interaction teaching approach’, Journal of Research in Special Educational Needs, March. Kennedy, A. (2001) ‘Intensive Interaction’, Learning Disability Practice, Vol 4, No. 3, 14-15. Books Nind, M. & Hewett, D. (1994) Access to Communication: Developing the basics of communication with people with severe learning difficulties through Intensive Interaction. London: David Fulton.   Hewett, D. & Nind, M. (Eds) (1998) Interaction in Action: Reflections on the Use of Intensive Interaction. London: David Fulton. Nind, M. & Hewett, D. (2001) A Practical Guide to Intensive Interaction Kidderminster: British Institute of Learning Disabilities. Kellett, M. & Nind, M. (2003) Implementing Intensive Interaction in Schools: Guidance for Practitioners, Managers and Coordinators. London: David Fulton. Articles & Chapters Cameron, L. & Bell, D. (2001) ‘Enhanced Interaction Training: A method of multi-disciplinary staff training in Intensive Interaction to reduce challenging behaviour in adults who have learning disabilities and who also have a severe communication disorder’, Working with People who have a Learning Disability, Vol 18, (3) 8-15. Culham, A. (2004) Getting in Touch with our Feminine Sides? Men's Difficulties and Concerns with Doing Intensive Interaction, British Journal of Special Education, 31 (2), 81-. Elgie, S. & Maguire, N. (2001) ‘Intensive Interaction with a woman with multiple and profound disabilities: a case study, Tizard Learning Disability Review, Vol 6, No. 3, pp ? Gardner, A. and Rikberg Smyly, S. (1997) ‘How do we stop doing and start listening: responding to the emotional needs of people with learning disabilities’, British Journal of Learning Disabilities, vol. 25, 26-30. Hewett, D. & Nind, M. (1988) 'Developing an Interactive Curriculum for Pupils with Severe and Complex Learning Difficulties'. In Smith, B. (Ed) Interactive Approaches to the Education of Children with Severe Learning Difficulties. Birmingham: Westhill College. Hewett, D. (1989) ‘The Most Severe Learning Difficulties: Does Your Curriculum Go Back Far Enough?’ In Ainscow, M. (Ed) Special Education in Change. London: David Fulton. Hewett, D. & Nind, M. (1989) 'Interaction as Curriculum at Harperbury School'. PMLD Link 5.

Knight, C. (1991) ‘Developing Communication Through Interaction’ in Watson, J. (ed) Innovatory Practice and Severe Learning Difficulties. Edinburgh: Moray House.   Lovell, D.M., Jones, R.S.P. and Ephraim, G. (1998) ‘The effect of Intensive Interaction on the sociability of a man with severe intellectual disabilities’, International Journal of Practical Approaches to Disability. Vol. 22, Nos 2/3, 3-9. Nind, M. & Hewett, D. (1988) 'Interaction as Curriculum.' British Journal of Special Education 15 (2) 55-57. Nind, M. (1996) ‘Efficacy of Intensive Interaction: developing sociability and communication in people with severe and complex learning difficulties using an approach based on caregiver-infant interaction’ European Journal of Special Needs Education, Vol. 11, No. 1, 48-66. Nind, M. & Hewett, D. (1996) 'When age-appropriateness isn't appropriate' in Coupe-O'Kane, J & Goldbart, J. (eds) Whose Choice? London: David Fulton. Nind, M. (2000) ‘Teachers’ understanding of interactive approaches in special education’ International Journal of Disability, Development and Education, Vol. 47, No. 2, 184-199. Nind, M. (2000) ‘Intensive Interaction and children with autism,’ in Powell, S. (ed) Helping Children with Autism to Learn. London: David Fulton. Nind, M. & Powell, S. (2000) Intensive Interaction and autism: some theoretical concerns’, Children and Society, 14 (2), 98-109. Nind, M. & Kellett, M. (2002) ‘Responding to learners with severe learning difficulties and stereotyped behaviour: challenges for an inclusive era’, European Journal of Special Needs Education, 17 (3), 265-82. Nind, M., Kellett, M. & Hopkins, V. (2001) ‘Teachers’ talk styles: communication with learners with severe learning difficulties’, Child Language, Teaching and Therapy, 17(2), pp. 143-159. Nind, M. & Kellett, M. (2002) ‘Response' (to JamesHogg, Juliet Goldbart and John Harris re 'Responding to individuals with severe learning difficulties and stereotyped behaviour: challenges for an inclusive era’, European Journal of Special Needs Education, 17(3), pp. 299-300. Nind, M. and Cochrane, S. (2002) ‘Inclusive curricula? Pupils on the margins of special schools’, International Journal of Inclusive Education, 6(2) pp. 185-198. Nind, M. (2003) ‘Enhancing the communication learning environment of an early years unit through action research’, Educational Action Research, 11, 3, pp.347-63. Samuel, J. (2001) ‘Intensive Interaction’, Clinical Psychology Forum, 148, 22-5.   Samuel, J. (2001) Intensive Interaction in context, Tizard learning Disability review, 6(3), 25-30. Watson, J. & Knight, C. (1991) ‘An evaluation of intensive interaction teaching with pupils with severe learning difficulties’, Child language, Teaching and Therapy, 7 (3) 10-25. Watson, J. (1994) Using Intensive Interaction in the education of pupils with PMLDs (ii) Intensive Interaction: two case studies, In Ware, J. (Ed.) Educating Children with Profound and Multiple Learning Difficulties. London: David Fulton. Watson, J. and Fisher A. (1997) Evaluating the effectiveness of Intensive Interactive teaching with pupils with profound and complex learning difficulties’, British Journal of Special Education, Vol. 24, (2), 80-7. Ph.D Theses Nind, M. (1993) Access to Communication: Efficacy of Intensive Interaction Teaching for people with severe developmental disabilities who demonstrate ritualistic behaviours. Ph.D Thesis, Cambridge Institute of Education. Hewett, D. (1994) Understanding and writing a methodology of Intensive Interaction – teaching pre-speech communication abilities to learners with severe learning difficulties: a naturalistic inquiry using qualitative evaluation methods. Ph.D Thesis, Cambridge Institute of Education. Kellett, M. (2001) Implementing Intensive Interaction: an evaluation of the efficacy of Intensive Interaction in promoting sociability and communication in young children who have severe learning difficulties and of factors affecting its implementation in community schools. Ph.D Thesis, Oxford Brookes University. Samuel, J. (2003) An Evaluation of Intensive Interaction in Community Living Settings for Adults with Profound Learning Disability, DclinPsychol thesis, Open University/BPS.