When a demand is not a demand (I'll choose the place, you choose the time)

My ideas for blog posts come directly from my conversations during mentoring and training. To explain things to a new trainee I often have to find a different explanation and sometimes I think that it might be useful for other people to hear this too.  This happened this week when I was mentoring the new group of staff on my course.
The situation was that a child was playing with a wooden train set on a table.  His pattern of behaviour was as you might expect, adding bits of track, pushing the train down the track and also, because there was sand on the table too, blocking and burying the trains in sand.  The teaching assistant reported that when she had tried to play with him in the past he would often push her away and that she was finding it difficult to engage with him.
I began by advising that perhaps she could try to share his space by being less direct and just playing with the trains herself in the same space rather than trying to engage him directly.  The result of this was that the child was happy with her being alongside him as a fellow train-player and the teaching assistant found that she could share his space for longer than before.
When we looked back at the video of the interaction the teaching assistant noticed one of her direct attempts to engage the child that hadn’t worked well.  She had added a few pieces of track herself and had then asked the child if they wanted to push a train down the new piece of track.  The child just ignored her.  When I asked the teaching assistant what had worked well she noticed that just sitting beside the child playing with trains had resulted in the child choosing to reach out and engage with her.  My way of explaining what was happening went something like this.
The key here is to understand the difference between an instruction and an offer.  I am giving an instruction if I am choosing the time I want my partner to respond ie. by saying “it’s you turn” or “do you want to push the train now?”. Given such an instruction (which can also be non-verbal), my partner is left with only two choices: to do what I have instructed or to refuse.  In my experience of people with communication disabilities I find that a common response is to refuse, ignore or react negatively, responses which do not seem to be helpful when we are hoping for our partner to choose to be with us. Often such a partner may be called demand sensitive but is it the demand they are sensitive to or us and our habitual ways of interacting?
An offer however is different from an instruction in that we leave the timing up to our partner. We do something that allows our partner to choose what to do.    In the context of the example above we might, in response to something our partner did, just move one of the trains a little closer to him. Our partner is then free to choose what to do with it.  If our offer is too close it might be seen as a demand, if it is too far away they might not notice it.  If it is just right then our partner might choose to reciprocate our offer.  Other things that the TA could have done include changing her position, amplifying what was happening by joining in with her partners actions using her voice (e.g. saying ‘wheeeeeeee’ when he moved the train), making a pile of sand, building a tower of trains etc.  All of these are not direct attempts to ‘engage’ but responsive offers that leave the child with choice.
This explains why picking up our partners hand and hitting a drum with it during a music session often doesn’t seem to have the desired effect.  Or saying ‘it’s your turn to dance, Mavis’ on a dementia unit.  The reason that we haven’t been successful is that our attempt to engage the person, even with the best will in the world, has been seen as an instruction because our partner feels they have no choice.  In these examples just offering the drum and playing yourself, or playing some music that Mavis might like and dancing a little bit yourself may work as offers that may just be taken up by your partner as they make a self motivated choice to be with you.
To find just the right offer for a person to choose to interact with us and play can take a little time and investigation.  What worked for one person as a good offer may be seen as an instruction by a more sensitive person so our reflective practice is importance in order to discover how to be the person that our partner needs us to be.
So this is why I say that we as practitioners we might be choosing the “place” (how and when we choose to approach for example) but, by understanding how to offer, we let our partner choose the time…
 
 

How to record Intensive Interaction: Classroom Wallchart

My previous post explained how we ascertain a baseline interaction level at Woolley Wood using the engagement profile that was introduced to the Intensive Interaction community of practice by Mark Barber and Graham Firth.  Once we have completed the baseline we can then use the engagement profile to record the interactions that are taking place and, if we are interested in progress, we can then compare this with the baseline level.
To make this work in the classroom I eventually settled on a wall chart format.  More detailed methods of recording were failing because staff, assailed with many other things to record, were not managing to find the time to complete the records and the blank sheets were therefore remaining in the folders.  So I developed this wall chart with the aim of capturing as much information as possible in the most efficient and accessible way.
There are two PDF’s to download. On the first I have have completed an example line on the record so you can see how it works.  The second download is completely blank with no example filled in.
Interaction Record
Interaction Record No example
The wall chart allows for the recording of an ‘average level of interaction’ and a ‘best moment’.  These are self explanatory… the average level is the level that the child seemed to be at for most of the time while the best moment is the highest level episode of interaction that happened.  I felt that the distinction was necessary because when I began exploring the engagement profile many years ago I found it difficult to assign one level to an interaction – a child may have spent 5 minutes showing no social awareness and then suddenly shown consistent attention to the social encounter for 30 seconds.  Does this mean that they are around the level of Attention and Response? I found that with an average level and best moment we could say that such a child would be at the average level of encounter with a best moment of Attention and Response.  This to me seems more accurate.
 
Using the Interaction Record
The most accurate way to record an interaction is to film it.  Watch the film and use the engagement profile questions to ascertain the level and best moment.  Then enter the date on the Interaction record and use the top row (more coloured) to mark the best moment and the lower row (faded) to mark the average level.  If you have not filmed the interaction then you need to make an educated guess as to the levels.  Add your initials in the space provided and then use the last space to note anything that worked well or didn’t work so well.
Recording Intensive Interaction in this way has a number of benefits:

  • All members of the staff team can keep up to date on break throughs or things that are working or not working.
  • The record can be used to support video footage to compare with the baseline and discuss how effective the approach is.
  • As the staff team engage with the method they will share a more accurate understanding of the engagement profile, supporting the development of a community of practice.
  • The method will help the staff team will share an understanding of what level a child is at and how the team can work together to support the child’s communication development.

All of the above things are very important but perhaps even more crucial to me is that this it works and is being used successfully in each classroom.
Any questions please just get in touch.