Intensive Interaction Sustainability Conference

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Intensive Interaction Sustainability Conference

Starting Anew Lessons to be learned from an
Australian experience Mark Barber PhD Metropole
Hotel, Leeds, 2005
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Bayside Special Developmental School www.baysides
ds.vic.edu.au

• S.E. Suburbs of Melbourne Moorabbin roll of
  80 students
• 2-18yrs
• class sizes lt8 pupils per 2 staff
• 33 classroom staff i.e. Teacher / unqualified
  support worker
• SLT, Physio pt O.T.

2003
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Bayside Special Developmental School

• Staff attend initial seminar on Interactive
  Approaches to
• teaching e.g. Collis Lacey 1996
• Parents invited to Intensive Interaction
  information evening
• Description of approach
• Opportunities for questions
• Request for informal consent

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Bayside Special Developmental School

• BAYSIDE PROJECT
• Baseline period 12 weeks
• Video record of identified pupils in
• i) unfocused i.e. non-directed time
  10x5min
• ii) During 11 teaching sessions 10x5min

• Staff training
• all staff attended teachers support workers
• 10x1 hr. after school presentations about I.I.
• 2003

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Bayside Special Developmental School
Baseline period staff training 10 weeks

• Identifying relevant population
• Overview of Intensive Interaction
• Interactive Approaches vs. Behavioural /
  Typical Development
• Examine paradigms of understanding of
• Early Cognition and
• Early Communication .as applied to PMLD/ PIMD.
• Overview of how to do it
• Observation
• Responding
• 2003

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Bayside Special Developmental School
Staff identified 11 pupils who they considered
were pre-intentional or for whom the approach
was appropriate

• i.e. identify pupils in school who have
• a high dependency on the interpretation of
  others to make themselves
• understood
• a level of awareness of their own intentions
  which is low, or difficult to
• determine
• a level of comprehension which is low or
  difficult to determine
• very limited or inconsistent ways of
  communicating
• typically very withdrawn or who spend large
  amounts of time in ritualised, self
• oriented behaviours
• Grove, N., Bunning, K., Porter, J. Olsson, C.,
  1999, See what I mean interpreting the meaning
  of communication by people with severe and
  profound intellectual disabilities, Journal of
  Applied Research in Intellectual Disability, 12,
  190-203, 2003

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Bayside Special Developmental School

• Baseline Video period 12 weeks
• MB in school 2 days per week
• Time divided between 3 classrooms
• videoing
• assisting observation/ discussing possible
  approaches ways in approaching/getting to
  know identified pupils

• Intervention period 22 weeks/approx 2 terms
• Interacting with pupils approx 30 minute I.I.
  sessions in classrooms
• Assisting teachers to write goals using e.g.
  PIVATS Lancashire N.
• Curriculum Document
• Supporting/mentoring/working alongside
  teachers/support workers

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Bayside Special Developmental School

• Evaluation period 1 school term
• Video records
• in unfocused undirected time
• 11 Intensive Interaction sessions
• Comparisons made between baseline unfocused
  undirected
• time 11 teaching sessions evaluation
  unfocussed
• undirected time 11 Intensive
  Interaction sessions
• 2004

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Bayside Special Developmental School

• UNFOCUSED videos currently being rated to
  record e.g.
• visual scanning
• showing no interest in what
• is going on around
• contingent vocalization
• non-contingent vocalization
• involvement toy/object
• monitors staff
• monitors peers
• organized self involvement

• Teaching I.I. Session videos currently being
  rated to record e.g.
• no interactive behaviours
• looking at or towards practitioners face
• socially directive contact
• joint focus
• contingent vocalization vocalizes in
• response to a direct stimulus from
• staff/adult
• engaged a state of complete absorption
• in a shared social interaction with an
• adult

NB Adapted from Kellett Nind 2003
Implementing Intensive Interaction in Schools
David Fulton London
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Bayside Special Developmental School

• INITIATIVES 2004
• Principal makes funding available for an extra
  teacher to be
• employed 1 day per week to support I.I.
  project.
• I.I. teacher enters classrooms to deliver a
  lesson so that teacher or
• support worker is able to give learner
  without distraction 11
• anywhere on campus
• this has contributed to enabling fully
  pupil-led interactions, pupils lead
• staff to favourite venue, prolonging periods
  of motivating joint
• attention/focus
• I.I. POLICIES in place adapted from Kellett
  Nind 2003

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Bayside Special Developmental School

• DEVELOPMENTS 2004 POLICIES IN PLACE
• Every pupil at Bayside SDS has the fundamental
  right to be able to communicate
• Every pupil has the right to develop his or her
  ability to communicate, at what ever level, and
  to be given the opportunity to respond to and
  control his or her environment

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Bayside Special Developmental School

• DEVELOPMENTS 2004
• 1) Opportunities to be actively engaged in
  communication learning will be offered across the
  curriculum.
• Lessons will involve pupils in a range of
  processes including
• Responding to others/Communicating
  preferences/Expressing choices/Initiating
  interactions
• Expressing emotions/Anticipating social
  responses/Sustaining social responses
• Progress will be monitored through narrative and
  other means, noting significant developments such
  as
• New responses, initiations, repairs and
  directing behaviours/Increasing range of facial
  expressions
• Emerging vocalisations/Body responses
  approaching gestures/ More effective use of gaze
  to effect changes in the
• communication exchange
• 2) Opportunities for actively working with others
  will be offered in all Key Learning Areas.
• Lessons will involve pupils in a range of
  processes including
• Awareness of others/ Joint focus/Turn
  taking/Sharing.
• Progress will be monitored through. noting
  significant developments such as

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Bayside Special Developmental School

• INITIATIVES 2004 continued
• Monthly meetings/seminars with involved staff to
  discuss
• E.g. TARGET WRITING
• Planning, teaching and assessing the curriculum
  for pupils with learning difficulties QCA
  Framework for Recognising Attainment QCA /
  PIVATS as reference points
• and stop/start/hypotheticals with classroom
  video tapes of interactions
• Several generations of session recording sheets
  evolve

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Bayside Special Developmental School

• Issues that have arisen from the project
• Small minority of staff were initially resistant
  to approach because of
• Lack of perceived structure i.e.
• Conflict with perceived requirement to predict
  outcome of interventions
• Conflict with dominant skills based teaching
  culture i.e. Specific
• Measurable Achievable Relevant Targets
• Satisfaction with current teaching methods
• Suspicion if its so good why have I never heard
  of it?
• Organizational issues When to do it ? what to
  miss out?
• Handing over of control to learner vs. classroom
  control
• I.I. seen as yet another issue or drain on time

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Bayside Special Developmental School
Issues that have arisen from project

• Solutions
• Very high level of public support from
  School Principal including
• employment of Intensive Interaction Coordinator
• employment of extra teacher 1 day per week
• high profile given to project within school
• encouragement of involvement of parents through
  PSG meetings, school magazine, school
  brochure
• highlighting needs of PID pupils in curriculum
  development
• consistent presence and contribution at all
  I.I. problem solving meetings
• teachers supported/authorized to experiment
  e.g. freefall teaching
• i.e. no equipment/focus
• learners make the first move
• staff maintain availability rather than be
  directive
• supporting changes in school culture of target
  writing

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Bayside Special Developmental School
Issues that have arisen from project

• Solutions
• Define population involved i.e. not blanket
  approach
• Intensive Interaction Coordinator has flexible
  timetable
• wholly dedicated to I.I. development
• time presence in rooms with practitioners i.e.
  leading by example
• Peer discussion with involved practitioners.
• I.I. occurring in playground / outside of rooms
  / in range of venues i.e.
• presence, on show and part of school
  culture
• I.I. not delivered as a therapy but as a means
  by which a range of
• interventions can be accomplished
• Consistent opportunities for discussion,
  mentoring and reflection
• Demonstrated support from other therapists
• Speech Pathologist, Physiotherapist, Sensory
  Therapist

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Bayside Special Developmental School

• Issues that have arisen from training
• Establishment of a culture of recording
  interactions
• - recording seen as part of interaction time
• Evolution through a range of recording styles
• - proforma/reflective diaries/ticks

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Bayside Special Developmental School
Firths 2004 adaptation of QCA Framework for
Recognizing Attainment
ENCOUNTER The student or client is present
during an interactive episode, but without any
obvious awareness of its progression e.g. a
willingness to tolerate a shared social
atmosphere is sufficient AWARENESS The student
or client appears to notice, or fleetingly focus
on an event or person involved in the interactive
episode e.g. by briefly interrupting a pattern
of self-absorbed behaviour, movement or
vocalisation ATTENTION AND RESPONSE The
student or client begins to respond (although not
consistently) to what is happening in an
interactive episode e.g. by showing signs of
surprise, enjoyment, frustration or
dissatisfaction ENGAGEMENT The student or
client shows consistent attention to an
interactive episode presented to them e.g. by
sustained looking or listening, or repeatedly
following events with movements of their eyes,
head or other body parts PARTICIPATION The
student or client engages in sharing or taking
turns in a sequence of events during an
interactive episode e.g. by sequencing their
actions with another person, or by passing
signals repeatedly back and forth INVOLVEMENT
The student or client makes active efforts to
reach out, consistently join in, or even comment
in some way on the interaction e.g. by
sequencing their actions and signing, vocalising
or gesturing in some consistent and meaningful
way
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Bayside Special Developmental School
x
(Adapted from Firth 2004)
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Bayside Special Developmental School

• Issues that have arisen from training
• Reviewing/discussing recording styles and use of
  video footage identifies different levels of
  understanding after 12 months of project
• SLT sees process in video sessions e.g.
  t/taking e.g. note staff pause vs. learner
• pauses
• Teachers grasp principle of process and can
  usually apply
• Support Staff gt intuitive but see unfocussed
  play/passing time pleasantly
• E.g. I enjoy it, John enjoys it, but I dont
  know where to take it
• Its going well but I'm not sure what
  I'm supposed to be doing except
• hanging out with her and responding
• its great but theres nothing at the
  end of it

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Bayside Special Developmental School

• 2005
• Practitioners offered regular opportunities for
  supervision and support on
• i) individual
• ii) team
• iii) staff group basis
• develops into Intensive Interaction Club
• Alternate, weekly meetings for involved staff
• 3 week rhythm
• MODERATION watching videos of I.I.
  practitioners decide where, on Framework for
  Recognizing Attainment
• STOP START VIDEO DISCUSSSION what is happening?
  what are you thinking? What is pupil expecting?
  What are you expecting of pupil? What might
  happen next? Is this communication or self
  focused behaviour? What will you do if.? How
  might you do it differently? Is pupil
  communicating or are you interpreting through
  context?
• VICTORIES and PROBLEMS

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Bayside Special Developmental School

• MODERATION
• Takes away subjectivity problem introduces
  inter-observer reliability
• Promotes I.I. culture and ownership of approach
  within staff body
• PROCESS of MODERATION/START-STOP VIDEO SEGMENTS
• Gives training in the interactive process
• Creates forum of opinion exchange of ideas
• Staff see others do it removes practitioner
  isolation
• Mutual support and promotes confidence
• Underlines that other people fail too
• RECORDING with FRAMEWORK
• Gives structure and frame of reference
• Supports the notion involvement is more
  important that outcome
• Gives method of recording/monitoring progress
  and changes in
• levels of involvement

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Bayside Special Developmental School

• Changes that have occurred after 18 months
• Targets for learners have changed so that
  communication has
• become the central, dominant issue within
  involved classrooms
• Anecdotally, staff and parental opinion
  indicates positive changes in
• the levels and rates of learners
  communicative behaviour, initiation
• attempts, persistence of attempts, tolerance
  of proximity and touch,
• as well as decreases in self injury, isolation
  and anxiety.
• Jack has become unruly and often chases me
  around the room to get me to interact with him
  RSW
• Its like they trust me now it just feels
  better Mary Joyce SSO

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Bayside Special Developmental School
Changes that have occurred after 18
months Practitioners interact more frequently
outside of classrooms, using outdoor play times
and idiosyncratic opportunities as contexts for
communication and then record them. Its
like a resource for the pupils they learn a
variety of ways to engage you they know youre
up for a game and that youre better to play with
than sand or toys Mark Holland Teacher
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Bayside Special Developmental School
Changes that have occurred after 18
months Practitioners have independently
mentioned feeling better about their work, less
stressed and worn out at the end of terms due to
fewer confrontations, more able to write
constructive targets, and feeling that they were
empowered to address the crucial issues in the
education and lives of their learners. I cant
actually remember how I used to teach, this makes
so much sense for my SLD ASD pupils
Karryn Bowen Teacher
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Bayside Special Developmental School

• Next stage- Sustainability gt Momentum
• Bayside SDS Victoria
• Redhill Special School Queensland
• Wangee Park School NWS

• Redhill Special School Queensland
• Video baselines before.
• Initial training day
• 2 terms _at_ 0.8 presence (MB)
• Project evaluated _at_ 18 36 months
• Ed Queensland involvement re
• adopting approach in teacher
• training

• Repeat Bayside model
• Initial post staff questionnaire
• Baseline, probe and evaluation PVCS
• Control group from adjoining schools
• State Govt Agencies involvement

• Wangee Park School NWS
• Initial training day
• Project Supervised by Speech Pathologist _at_ 0.2
• Project to be evaluated after 18 36 months
• NSW Education monitoring pupil outcomes
• DADHC involvement re adult services

Three way video link /chat room between schools
for meetings exchanges Community of
Practitioners
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Bayside Special Developmental School
Next stage- Sustainability gt Momentum Conferences
04-05
Australian Group on Severe Communication
Impairment AGOSCI National Conference 2005 New
Zealand National Special Education Initiatives
and Excellence, Hamilton, 2005 Far Northern
Coalition of Intellectual Disability Services
State-wide Conference 2005 Education Queensland
Training and Development Seminars TADS,
Brisbane 2004 AFSEA National Conference, Beyond
Inclusion Brisbane 2004 Queensland Government
Dept of Education State-wide Conference
2004 Queensland Community Services Health
Industries Training Council Inc 2004 2005
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Bayside Special Developmental School
Next stage- Sustainability gt Momentum Conferences
04-05
Australian Group on Severe Communication
Impairment Tasmania 2004 South Australia
Intellectual Disability Services Council IDSC
Adelaide 2004 2005 Australian Group on Severe
Communication Impairment AGOSCI Queensland,
NSW, SA, Victoria, Tasmania, West Australia, 2003
2004 Speech Pathologists Occupational
Therapists on Developmental Disability National
Conference 2003 2004 Australian Group on Severe
Communication Impairment National Conference
AGOSCI 2004 Something to say, Dept of
Education and Training Victoria Southern Metro
Region Spec Schools Forum 2004 5 x Independent
State-wide Intensive Interaction Day Seminars
Melbourne, Brisbane, Adelaide
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Next stage- Sustainability gt Momentum Residential
/day services
Melba Support Services, Victoria Far Northern
Coalition of Services for Intellectual Disability
, Queensland SCOSA Residential Services, Adelaide
South Australia I.D.S.C. Strathmont Centre,
Adelaide, South Australia Department of
Disability Ageing Home Care DADHC New South
Wales Central Bayside Adult Services,
Victoria ONEMDA Residential Services Melbourne
Victoria Information and Disability Services
Tasmania Yooralla SLT services, Melbourne,
Victoria
Schools received training Bayside DSD Moorabbin
Victoria Frankston SDS Frankston Victoria Nepean
Specialist School, Victoria Noble Park Special
School, Victoria Monash SDS Clayton, Victoria Mt
Evelyn SDS Victoria Glenroy Specialist School
Victoria Redhill Special School Queensland Woody
Point Special School, Queensland Clifford Park
Special School Toowoomba Queensland Wangee Park
School, Mukembe NSW
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Next stage- Sustainability gt investigation

• Speech Language Therapists very active support
• Define important issues
• who changes? the learner or the practitioner
• what is I.I.? / what is it not? were already
  doing that!
• universities?
• research funding??
• I.I. is in competition with fast turnover
  projects that generate unambiguous
• high volume data.
• Universities are bidding for, rather than
  commissioning projects
• Independent money? Need university backing

HOWEVERMomentum will inevitably be
practitioner-led until much of higher education
notices that the majority of approaches
discussed, do not address the needs of many of
the learners who experience PMLD and PID/Autistic
Spectrum Disorders, but address the needs of
those working with them
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Thanks to Mrs R Gallagher (Principal), staff,
parents and pupils of Bayside Special
Developmental School Moorabin, Victoria,
Australia 3189 (bayside.sds_at_edumail.vic.gov.au)
Contact me Dr Mark Barber drmarkbarber_at_hotmail.
com PO Box 2477 Melbourne 3001