How and Why Intensive Interaction can Support Advocacy.

"I’m really excited to be sharing this blog from Janet Gurney, Director of Training at Us in a Bus. Intensive Interaction is an incredible way of connecting with people who we might be working with and supporting in our Non-Instructed Advocacy Work. Whilst on our QPM travels we’ve heard some great stories of where advocates are using Intensive Interaction in their advocacy practice.

We also often read IMCA reports, Care Act and IMHA case files where it is clear that the advocate is short on time, and also unsure of the ways they might be able to connect with the person and gain insight into what is important to them.

For me personally, my work at Us in a Bus (a very, very long time ago!) and using Intensive Interaction with people on a daily basis was one of the key stepping stones to me becoming an advocate. It was so clear to me that the people we worked with had a lot to say about life and how they preferred to live it and that through using Intensive Interaction, I was able to gain insight into each person and the things that were important to them.

As an advocate using Intensive Interaction, the information people were ‘telling’ me about themselves was then able to be used to influence decisions being made. Their voice could be a part of decision making in a powerful and meaningful way in the kinds of decisions we’re often still engaged with as advocates; where people live and who with, the ways people prefer to be supported, the kinds of activities someone might want in their life as well as the ways that people like to engage with others and spend their time. What kind of room might they want? Do they prefer a noisy, busy environment or a quieter, calmer one? What kind of music does someone like? How do they like to interact with the world around them? How can this person be supported to live the life they chose? Using Intensive Interaction can give you insight into how someone feels about all these things and more!

I hope this blog gives you food for thought and potentially some new tools in you communication tool boxes!

Thanks Janet!"

Gail Petty, Advocacy & Voice Lead NDTi

How and why does Intensive Interaction support non-instructed advocacy?

We have probably all found ourselves in the position of wanting/needing to get to know someone but struggling to find the first step to take – especially when we might have limited time together. One of the most useful things that Intensive Interaction encourages us to do is to realise we don’t need to take that first step ourselves; what we need to do instead is to notice what steps the other person is already taking themselves, even if those steps are not obviously conventional social steps. What I want to explore here is how to notice those steps, ponder their importance to the person who is making them, and discuss how to follow those steps in a way that can create a bridge between our worlds.

I often meet advocates who are trying to get to know the likes, the dislikes, the needs and the aspirations of someone who has no clear intentional communication skills. The advocate may have limited opportunities in which to make this vital connection – and there may be a lot resting on their ability to ‘get it right’. There may also be the constraints of wondering how to make sure that they are not being patronising, that they are treating the person with the respect due to someone of their chronological age. There may be a hopeful – or a judgemental - audience to this conversation. In this situation, it is hardly surprising that the systems of communication that are called into use are ones we recognise and use ourselves, like speech, signs, facial expression, objects of reference. These are intentional systems and, of course, they work well when both people in the conversation understand those systems. But what about when this is not the case; when the person you are trying to make that vital connection with has lost their ability to communicate using words and those other intentional systems.

This is a universal journey – not just one for people that don’t use words to communicate. None of us are born with the ability to express ourselves intentionally. We are all born with the ability, to a greater or lesser extent, to express our response to a stimulus (e.g. pain, hunger, fear); this commands the attention of the people around us, but we are only reacting to the stimulus, not deliberately asking for help. But gradually (if you are reading this, or discussing it with a colleague) you must have learnt how to express yourself deliberately. That process was not automatic; it depended on the people around you making sure you knew you were noticed. They did this by copying what you were doing – again and again and again. Think of how you act around babies (one you are related to or complete strangers!) you reflect their smiles and frowns, you exclaim at their noises, you copy their movements – you celebrate their every action in an unabashed and joyous way. You are not just entertaining them; you are unconsciously giving them the wonderfully motivating sense of being noticed and attended to. It is this continuous confirmation of their existence that enables them to make their journey up their own individual ladder of communicative development to the point at which they realise they can express themselves deliberately (not just reactively) because they are being listened to.

But what happens when a profound learning disability, a sensory impairment, maybe a complex need like autism gets in the way of a baby being able to absorb all that precious confirmation or if a person develops dementia and loses the ability to absorb this information. The steps of the ladder can be tricky and intentional communication stays out of reach. The all-important sense of being noticed doesn’t happen and the social and communicative world seems elusive. The most important lesson I have ever learnt (thank-you Phoebe Caldwell, Dave Hewett, Melanie Nind) is that there is no chronological door that slams shut on anyone’s ability to recognise their own sounds, movements, actions being reflected back to them. If we can get good at noticing the things someone is doing in their own inner world, speculate about the sensory experience they are creating for themselves and find a way of reflecting that sensory experience back to them in a way that is exciting and accessible, we are in the privileged position of enabling them to experience that wonderful sense of being noticed and confirmed. This is the essential core of Intensive Interaction – no more, and certainly no less, than the way you learnt to make the most of your communicative potential. Human beings don’t have another way of finding their way up that ladder to intentional communication – and Intensive Interaction gives us the framework and the encouragement to support people to build their own bridge into the social and communicative world.

So, next time you find yourself wondering ‘How should I communicate with this person I’m meeting for the first time?’ switch over instead to thinking ‘How are they communicating with themselves? What are they doing to tell themselves that they exist?’. Then use their ‘language’ not yours, to let them know you have noticed their internal actions of self-confirmation. You might notice a rhythm – their fingers are moving in a pattern against their cheek. You could acknowledge that pattern by tapping it back on the arm of their chair. Maybe there is a sound they are making; try it for yourself. What does the sound feel like as well as sound like? You could copy it back as a touch rather than a sound. The possibilities are as wide as your imagination. When you let yourself be led in this way, you will be giving yourself the chance to get to know the person on their terms, at their speed, in their language – and you will be making the best use of the time you have together.

I know it is possible to make it sound too simple! It requires commitment, clarity of purpose and support. As Director of Training for Us in a Bus www.usinabus.org.uk I facilitate workshops (in-house or open to all; please contact us for details) which offer that support by exploring the practicalities of implementing Intensive Interaction as well as considering the sensory processing issues we need to understand to make sure we are using Intensive Interaction in a way that is best for each person. If you visit www.thecaldwellautismfoundation.org.uk you will find a series of short films of Phoebe Caldwell and myself in conversation, discussing ‘Responsive Communication’. Contact me janet.gurney@usinabus.org.uk for a reading list – or to discuss any thoughts and questions that this blog raises for you. And most importantly, pause, observe, respond and enjoy your getting-to-know-each-other intensive interactions.

Janet Gurney, Director of training, Us in a Bus