Please find below some helpful hints for using Intensive Interaction in what are different and uncomfortable times. They are from Graham Firth via the Intensive Interaction Users Facebook Group where there are always other useful discussions available to participate in or observe. 

Wishing you all the best from Us in a Bus

“These are certainly the most challenging of times. 

During the current Covid-19 pandemic we are personally and professionally required to keep social contacts to a minimum, and strictly adhere to all social distancing and infection control practice guidance. Inevitably this crisis is therefore creating many complications in terms of how we continue to care for our most vulnerable people, including how best to continue to use Intensive Interaction.

Many of those we care for or support will not be able to understand the need for social distancing or increased infection control measures, but they will still expect and need some form of responsive and reassuring Intensive Interaction engagement. 

Indeed, many of those we care for may currently be feeling highly anxious due to changes in their familiar care and support routines. Such increased anxiety will make the need for social engagement even more important for the mental health and well-being of those we support; all at a time when it is potentially more difficult to enact.

As we follow all the necessary steps to minimise the risk of a potentially fatal Covid-19 transmission, the use of gloves, face masks, and in some instances full Personal Protective Equipment (PPE) will become necessary (and is already in some services). Such mandated infection control practices will unfortunately limit some of our available means for social exchange e.g. physical contacts, close proximity, or if face masks are being used, even verbal/vocal exchanges and/or exchanges of positive facial expressions.

However, fortunately the varied means and flexible structure of Intensive Interaction allows us to explore some other potential means of social interactivity with those we care for and support. It may well be necessary to adapt our strategies for social engagement, avoiding when and where we can, or at least minimising physical contacts or close physical proximity (although for many this will still be required to meet their functional care needs).

Instead it may be necessary to use Intensive Interaction strategies that can be enacted with more and therefore safer social distance e.g.:

• Using more demonstrative body language e.g. using bigger hand gesturing or using more dramatised body posture, or shoulder movements, to communicate our social responsiveness.
  
• Finding more ways to exchange eye contacts and mirror facial signalling (from a safe social distance) e.g. using more dynamic, or even very dramatised eye-brow expressions and head movements from further away.
  
• Using more, or more kinds of behavioural mirroring (at a safe social distance), including amplified hand, arm or body movements to make our socially interactive responses clearer for the person to see or sense.
  
• Developing increased turn-taking in various forms (from a safe social distance) e.g. via sequenced hand, arm or body movements; clapping hands or stamping feet in sequence or together; tapping or banging items of furniture in sequence or together; using a range of sequenced voice or mouth sounds.
  
• Using standard vocal echoing or exchanges of vocal/verbal sequences (at a safe social distance): remember, responding to a person’s vocalisations does not have to be via a direct echoing; some physical movement can also act as an appropriate response, so long as the shape of the movement somehow matches the pattern of the person’s vocalisation.
  
• Using verbal “commentaries” on a person’s actions, or the actions of others in a shared environment; possibly at increased volume from a safe distance.
  
• Using more forms of ‘joint-focus’ activity that can be enacted with greater social distancing e.g. jointly listening to music or watching mutually interesting TV or films together, and regularly signalling the mutual enjoyment of the joint activity with the person e.g. via frequent eye contact and shared smiles.

Also, while Intensive Interaction is a mainly responsive approach, due to social distancing then more proactive social initiation by a practitioner choosing the safest, socially distant means, seems entirely prudent and correct i.e. proactively using the safest interactive means available (taken from any previously developed interactive repertoire with a person) will often be the most advisable. Trialling different ‘safer’ interactive means will at times be necessary; some adaptations will work well, others may not – that is just the nature of Intensive Interaction anyway!

Remember, it will be up to every practitioner and manager to discuss, agree and then trial any ‘safer’ adaptations to their normal and individualised Intensive Interaction practices; this may not always be easy, but in many cases it will be absolutely necessary to support the well-being of those we support and care for.

Please stay well, and practice Intensive Interaction effectively but safely!”