Intensive Interaction

Also called II, Intensive interaction approach

Conversation before words: joining in with a person's sounds and movements until there's a to-and-fro, and building everything else on that.

What it is

Intensive Interaction is a way of being with a person who is at the very earliest stage of communication, where the partner joins in with what the person is already doing, their sounds, rhythms, movements and looks, and builds a playful back-and-forth out of it. No target, no task, no symbols. Just two people taking turns and enjoying each other.

Dave Hewett and Melanie Nind developed it in the 1980s at Harperbury Hospital school, from watching how parents and babies learn to converse before either has a word. The Fundamentals of Communication they identified, such as sharing attention, taking turns, using eye contact and enjoying being with someone, are what everything else is built on.

Who it can help

People with profound and multiple learning disabilities, people at the early stages of autism and communication who find social contact hard, and adults in care who have been described as "in their own world". Age doesn't matter; it's used with toddlers and with people in their seventies.

It isn't the right tool for a person who already has intentional communication and wants vocabulary; for them, it can feel patronising. And it is not a way of teaching words. It's a way of teaching that being with another person is worth doing.

How it works

The partner watches, then responds to what the person does in a way the person can notice. They tap the table; you tap the table. They hum; you hum back, in their rhythm. They glance at you; you light up. You let them lead, and you let there be pauses. Over minutes, and then over weeks, the exchanges lengthen and the person starts to initiate them: tapping, waiting, looking for your tap.

Sessions are short, often five to fifteen minutes, and frequent, ideally daily. They happen wherever the person is comfortable, on the floor, in the chair, in the bath. Nothing is recorded during a session; afterwards, the partner notes what happened, so progress can be seen across months.

Progress looks like more eye contact, more initiation, more tolerance of being near people, more vocalisation, and often, less distress. Those are the foundations that objects of reference, signing or symbols later stand on.

Getting started

Sit near the person, at their level, and do nothing for a minute except watch what they do.

Copy one thing, gently, and pause. Wait for anything that looks like a response: a stillness, a glance, a repeat. Respond to that. Stop after a few minutes, before they're tired of you.

Do it every day for a month before you decide whether it's working. Keep a two-line diary. The change is slow and real.

Where to get help

The Intensive Interaction Institute trains staff and families and publishes the approach's own guidance. PMLD Link shares practice from families and services. Mencap can point adult services towards training. Many NHS learning disability teams and special schools have a trained coordinator; ask.