Intensive Interaction

Intensive interaction is an approach for people with severe or profound and multiple learning disabilities — especially those who are pre-verbal or non-verbal. It rebuilds the earliest forms of human communication: eye contact, facial expression, physical contact, and non-verbal turn-taking.

It was developed in the early 1980s by David Hewett, a special-needs school principal near London, working with colleague Melanie Nind. Hewett found that no teaching could happen until the basic barrier of connection with his students was broken. Originally called "augmented mothering," the approach applies the natural back-and-forth patterns between babies and their parents to older children and adults with profound communication difficulties.

How it works

The communication partner — usually you, the parent or carer, trained by a speech-language pathologist or intensive-interaction practitioner — changes their own behaviour to meet the child at the child's level:

• Follow your child's lead. The child chooses the activity; you comment and respond rather than direct.
• Get down to their level. Physically (sitting on the floor) and in tone, body language, and pace, so you feel less dominating.
• Mirror and take turns with your child's own behaviours. Sounds, gestures, movements. Rhythm and repetition keep your child's attention and make what happens next predictable.
• Read subtle signals. A look away can mean "I need a rest." A repetitive movement may be an invitation to join in. One example from the source book: a child who rubbed his palm with his thumb began interacting when the therapist simply joined in the movement.

The fundamentals it builds include eye contact, facial expressions, physical contact, non-verbal communication, attention and concentration, turn-taking, copying sequences, sharing personal space, and managing excitement levels.

Evidence and who it helps

• Research summarized in the source book reports gains in social engagement and initiation, more smiling, eye contact, face-looking, tolerance of physical contact, and improved vocalisation — with children generally happier after sessions. Intensive interaction also has a genuine published evidence base beyond the book, including material from the UK charity Mencap.
• It is most effective for children and adults who are pre-verbal or non-verbal — including people with severe autism and Down syndrome.
• It needs specialist training. This is not a download-and-go activity — the communication partner must be taught the approach. That said, the basic take-home principles are safe for any parent: daily dedicated time on the floor, letting your child choose the activity, and observing and following rather than leading.

For children with the highest support needs

This is one of the few communication approaches aimed squarely at children with the highest support needs — non-speaking children with severe autism or profound multiple disabilities. Many families combine it with signing systems and objects of reference (real objects used to stand for activities or places) for a fuller communication picture. Availability of trained practitioners varies, so check what your local speech-therapy or disability services offer.

Not medical advice. Intensive interaction should be delivered under specialist guidance. If you want to try its principles at home, ask your child's speech-language pathologist or specialist team for training and supervision.