Summary of the impact

Research by Melanie Nind of the University of Southampton and her collaborator (Hewett) has had a national and international impact on the practice of professionals who teach people with severe learning disabilities. The Intensive Interaction approach is included in UK National Curriculum guidance, the Government's Strategy for people with learning disabilities, and it is used across education, psychology, social care and speech and occupational therapies. Nind's research has shaped the implementation of Intensive Interaction, and provided practitioners in Eastern Europe, New Zealand, and Australia with new data and concepts that help to inform practice to enrich the lives of a vulnerable population.

Underpinning research

Communication with people who have severe and complex learning disabilities or autism can be extremely challenging and many remain difficult to reach and socially isolated. In response, Melanie Nind (Professor of Education since 2004) with D. Hewett developed a new approach of Intensive Interaction which facilitates the learning of fundamental communication and social abilities by applying principles elicited from research on caregiver-infant interaction. Nind has been researching Intensive Interaction for over two decades. The approach and its underpinning research were introduced to a wide practitioner audience in the 1994 book, Access to Communication (combining the doctoral research of both authors) with a second, updated edition in 2005 [3.1]. Nind's local authority-funded research began by showing the efficacy of Intensive Interaction (Nind, 1996), its effect on behaviour (Nind & Kellett, 2002) and its role in the curriculum (Nind & Cochrane, 2002) and in reinstating teachers' confidence in their own knowledge and skills thus widening its relevance and appeal beyond those looking for a specialist technique to inclusive educators (Nind & Thomas, 2005) [3.2].

During Nind's time at Southampton, she has conducted research on the practice and uptake of the approach within psychology, speech and language therapy services, education, and the National Health Service Disability Trusts. The research has extended to include the examination of cultural differences in interactions and the effectiveness of Intensive Interaction when adopted by novice practitioners. Specifically, the research tested the hypothesis that staff could learn the principles of Intensive Interaction sufficiently to have a positive effect on their relationships with their clients [3.1, 3.3]. More research has explored the ways that Intensive Interaction promotes social and emotional well-being, building on Nind's EU-funded work with Weare (also Professor of Education at Southampton-2008, then emeritus) on interventions promoting mental health [3.1,3.4]. Further research has extended into how access is understood and negotiated for people with learning disabilities. This includes an ESRC-funded seminar series (with Seale, Senior Lecturer at Southampton until 2011) which involved people with learning disabilities and their support workers, researchers and professionals. An important element of that was the development of a multi-dimensional model of access that Nind has disseminated to Intensive Interaction practitioners and others [3.5].

Most recently, Nind's work has developed a conceptual framework on inclusive research processes and on positive risk-taking for people with learning disabilities, arguing that risk can be positive as illustrated by Intensive Interaction as a working example [3.6]. This body of work connects with, and builds from, Nind's earlier work on Intensive Interaction, which has helped to create an extensive collection of supporters and users of Intensive Interaction who are highly receptive to applying key messages from research related to it. The award of an ESRC grant to research `Quality and capacity in inclusive research with people with learning disabilities' is further indication of the quality and direction of Nind's underpinning research.

References to the research

Key publications:

Linked grants:

• Nind (PI): Concepts of access for people with learning disabilities: towards a shared understanding — ESRC Seminar Series RES-451-25-4145, 2005-2007, £15,000

• Developing the Evidence base for Mental Health Promotion and Prevention in Europe — EU Framework 6, 2008-2010, €60,000

• Nind (PI): Quality & Capacity in Inclusive Research with People with Learning Disabilities — ESRC Small Grant RES-000-22-4423, 2011-12, £78,478

Details of the impact

Research from Southampton has had an impact on practitioners and professionals in the UK and internationally and thereby contributed to the health and wellbeing of many thousands of children with learning difficulties.

Within the UK, Nind's research has had an impact on the practice of professionals who are responsible for the educational and social development of more than 38,000 school-aged children in England with severe/profound and multiple learning difficulties. The 2009 General Guidelines of the Qualifications and Curriculum Authority `Planning, which oversees the curriculum for pupils with learning difficulties has endorsed the Intensive Interaction approach [5.1]. The Department for Education's online materials developed in response to the Salt Review (2010) include 2 modules on Intensive Interaction and refer readers to the 2009 guidelines [5.1]. Adult services have similarly been influenced by Nind's Intensive Interaction research. For example, the Leeds &York NHS Foundation has a psychology service-wide commitment to Intensive Interaction and their Intensive Interaction newsletter is circulated to 1250 people across four continents. Nind's Southampton research is singled out for its relevance and influence in this material and also in the Foundation's published research summaries for practitioners. Oxfordshire NHS Learning Disability Psychology Services, for whom Nind has been a long-term training consultant, have also embedded Intensive Interaction in their Good Practice Guidelines and online resources [5.3]. Nind's work has also stimulated debate among practitioners through newsletter discussions of the impact of Intensive Interaction on the quality of people's lives [5.2, 5.3]. The UK Government's three-year national strategy document `Valuing People Now' (Department of Health, 2009), in its outline of its vision for people with learning disabilities, includes an exposition of Intensive Interaction, its history and benefits, and cites Nind.

The Intensive Interaction Institute, founded by Nind's collaborator Hewett, and applying the results of the original research, has 21 regional networks and an annual conference of approximately 150 practitioners. The Institute has testified that "thousands of people (and often, their families) are experiencing better and more fulfilled lives because of their increased abilities to communicate and relate". Nind has presented her work through keynote addresses for the annual conference of the Institute, the most recent one in 2011, where she disseminated her new work on the importance of Intensive Interaction for emotional development, new understanding of access, and positive risk-taking and its relevance for sustainability in Intensive Interaction [5.4, 5.5, 5.6]. Nind has also promoted her research findings in the voluntary sector, e.g. giving a keynote in 2010 to the Us in a Bus organisation which uses Intensive Interaction with people with profound impairment. Nind is enriching understanding and awareness of Intensive Interaction among non-specialists by updating the factsheet on Intensive Interaction for the British Institute of Learning Disabilities (BILD) in 2013, the original one having had high usage. She has also provided training and workshops for education providers, speech/occupational therapist groups, and care providers (e.g. Suffolk Psychology service, Gwent NHS Trust, Oxfordshire NHS Learning Disability Trust, Pentahact Housing, Ravenswood Community, numerous special schools). Stories of the ultimate impact of the research and training are plentiful with beneficiaries broadening to include individuals who are deaf-blind or have dementia (Platt testimonial).

Internationally, the research on the emotional well-being benefits of Intensive Interaction has had an impact on practitioners and professionals in Europe, Australia, and New Zealand. In Eastern European orphanages, e.g. in Montenegro, positive results have been reported by a UNICEF-funded project which has used the approach; in Romania, the use of Intensive Interaction by young volunteers working with neglected children has shown positive results; and in Greece, Nind and Hewett's core guidance texts have been translated in Greek and disseminated to practitioners.

Intensive Interaction is being widely implemented in Australia and New Zealand with the Intensive Interaction led by trainer Mark Barber who uses Nind's research.

The Southampton research on Intensive Interaction is also having an impact in Thailand where Nind has advised the lead implementer, Rungrat Sri-amnuay. Nind has also been approached to advise on international developments in implementation by parents in France, who after finding that Intensive Interaction improved the quality of life of their autistic child sought to `share with the Education authorities, the Autism resource unit ..., the Academic Inspectorate, and, from there, other parents, teachers, schools, regional/national education authorities etc' (email Jones). At grassroots level, practitioners and families have created Facebook groups/pages which between them have over 1,000 members in four continents.

In Toronto Nind has supported the use of the Intensive Interaction approach in psychiatric clinical and educational practice to enable a lead practitioner to `engage emotionally with individuals manifesting ... problem behaviours (and support others in doing the same) and this has been associated with a reduction in the behaviours of concern as well as being embraced as a positive experience by both individuals and their care providers' (Bradley testimonial) [5.3, 5.4].

Sources to corroborate the impact

5.1 Dept of Health (2009) Valuing People Now: a new three-year strategy for people with learning disabilities (p.39)
http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_093375.pdf (corroborating claim that research is recognised/promoted in national policy)

5.2 Qualifications and Curriculum Authority (2009) General Guidance (pp. 20, 45) https://orderline.education.gov.uk/gempdf/144590022X/P_scales_Guidelines.pdf (corroborating claim that research is recognised/promoted in national policy)

5.3 Department for Education curriculum materials
http://www.education.gov.uk/schools/pupilsupport/sen/b00209601/send-materials-advanced See `Modules 2.3 The curriculum challenge and 3.3 Promoting positive behaviour':
www.complexneeds.org.uk (corroborating claim that research is recognised/promoted in national policy)

5.4 Firth, G. & Barber, M. (2010) Using Intensive Interaction with a Person with a Person with a Social or Communicative Impairment (Jessica Kinglsey)

(practitioner-oriented book corroborating claim that research is known and applied by a wide body of practitioners and claim it has made a material and distinct contribution to the lives of people with learning disabilities)

5.5 Jones, K. & Howley, M. (2010) An investigation into an interaction programme for children on the autism spectrum: outcomes for children, perceptions of schools and a model for training, Journal of Research in Special Educational Needs, 10(2):115-123.

(practitioner-oriented paper corroborating claim that research is known and applied by a wide body of practitioners and claim it has made a material and distinct contribution to the lives of people with learning disabilities)

5.6 Email correspondence (29 Oct 2012) and testimonial (3 May 2013) by the Psychiatrist-in-Chief, Department of Psychiatry, University of Toronto, (application of [4] in Toronto)

(corroborating claim of international reach and significance and that research has made a material and distinct contribution to the lives of people with learning disabilities)

5.7 Testimonial dated 7 Jun 2013 by the Sensory needs teacher & Southeast Regional Network Convenor, Intensive Interaction Institute (impact within Institute regional network; application of [2][3]) (corroborating claim that research is known and applied by a wide body of practitioners and claim it has made a material and distinct contribution to the lives of people with learning disabilities)

5.8 Contact service provider: Head of Psychology Services, Oxfordshire Learning Disability Trust Ridgeway Partnership

(able to corroborate claims that research is known and applied by a wide body of practitioners, that it has made a material and distinct contribution to the lives of people with learning disabilities and that beneficiaries have broadened to include people who are deaf-blind or have dementia, new settings and novice practitioners)

5.9 Director, Intensive Interaction Institute www.intensiveinteraction.co.uk

(able to corroborate claim that research is known and applied by a wide body of practitioners and claim it has made a material and distinct contribution to the lives of people with learning disabilities)

5.10 Intensive Interaction Project Leader: Leeds & York Partnership NHS Trust www.leedspft.nhs.uk/our_services/ld/intensiveinteraction;
http://www.southernhealth.nhs.uk/knowledge/intensive-interaction/

(able to corroborate claims that research is known and applied by a wide body of practitioners, that it has made a material and distinct contribution to the lives of people with learning disabilities and that beneficiaries have broadened to include people who are deaf-blind or have dementia, new settings and novice practitioners)