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Which settings can take part?

• Special Educational Needs and Disabilities (SEND) educational settings or mainstream educational settings with SEND units around Great Britain 

• Settings with capacity and willingness to agree to the requirements of participation outlined in this information sheet and Memorandum of Understanding. 

  • Relevant staff must have capacity and willingness to complete online Intensive Interaction training, receive supervision and deliver the intervention as intended with the participating children/young people (more details on training and delivery are below), and complete questionnaires and videos.

• Settings with at least 5 children/young people meeting the eligibility criteria:

  • ​Aged 3 to 25 and identified as having PMLD. 

  • Expected to remain at the setting for the duration of the study.

  • Parent/carer willing to consent for the child/young person aged 3-15 to take part. [For young people aged 16-25, parent/carer willing to act as a consultee (in England/Wales) or consent as a Welfare Guardian/Welfare Attorney/Nearest Relative (in Scotland) for them to take part].

  • Parent/carer willing to complete online Intensive Interaction training, use the intervention at home, and complete questionnaires for the study.

  • Children/young people are not eligible if they have a degenerative condition or dementia

• Settings are not eligible to take part if staff have been formally trained in Intensive Interaction within the last 12 months. 

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Will our setting receive the Intensive Interaction intervention?

If you decide to take part, your setting will be randomly assigned to either the Intensive Interaction group or to the important control group, care as usual. If your setting is assigned to the group using Intensive Interaction, we will organise for your setting to receive training. If your setting is assigned to the care as usual group, your setting will not receive this training  and will continue as usual, but your setting will be offered the training at the end of the data collection period for the study. 

Assignment to each group is decided at random by a computer and will take place during the Autumn term. The children/young people involved will receive all other treatment or support as usual regardless of your setting’s random assignment. Randomly assigning which settings receive the intervention is essential, as it is the best way to find out the impact of the intervention. This type of research is called a randomised controlled trial. 

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What will the Intensive Interaction training look like? 

The research team will provide training and ongoing support to a speech and language therapist (SLT) supporting your setting, should your setting be randomly assigned to deliver Intensive Interaction. SLTs might be employed by your setting, the NHS, the local authority or privately. If your setting employs a SLT as a staff member and they have capacity to take on the role of trainer for your setting, your setting will be able to claim payment for the SLT’s role in the study (£36 per hour for a total of 49 hours), which you can use as you wish to. If your setting does not have a SLT with capacity, the research team will recruit an external SLT to support your setting. The SLT will train and support interventionists in your setting (e.g.  teachers, TAs, or SENCOs), as well as parents/carers, who will implement the intervention with eligible children/young people. It is up to you to determine how many interventionists will be required per child/young person as this will depend on factors such as part-time members of staff.

Training stage 1:

The SLT will receive the equivalent of 1 day of online training and 1 day of supervision from the research team. The training will consist of a live online training event with the research team (approximately 2 hours in duration), followed by the SLT being asked to familiarise themselves with content of four units about Intensive Interaction hosted on an online Google training website. Prior training will be recognised. Through this, the SLTs will be trained in Intensive Interaction and will be provided with guidance and materials to use to train and support the interventionists in your setting and parents/carers. 

Training stage 2:

Interventionists (parents/carers and education practitioners) will be provided with access to a role-specific Google training website and asked to complete four units on the website. The units cover the basics of Intensive Interaction and will take interventionists approximately 4 hours to complete. If any of the interventionists struggle to access the training website, where possible their associated SLT will talk them through the units either via a video call or in person, depending on the geographical location and the capacity of the SLT. 

Following this, the SLT will provide up to 4 days of ongoing support for the interventionists as they deliver Intensive Interaction to the participating children/young people. This will be delivered via video call, phone or email, depending on the interventionists’ preference. The ongoing support is designed to build confidence, skill and fluency in using Intensive Interaction. This will be provided weekly for the first 4 weeks and then monthly thereafter.
It is important that settings make appropriate plans to ensure that nominated staff will have time and capacity to complete the training and supervision outlined above (e.g. by arranging appropriate cover).

 

What will delivering Intensive Interaction involve?

Intensive Interaction is one way of focusing on quality in everyday interactions between communication partners and children and young people with PMLD. Intensive Interaction is about a particular way of interacting during activities. The activity can be pretty much anything that the person is taking part in. We might use Intensive Interaction to make changes to how we communicate. We might use a higher tone of voice to make us more interesting to the person. We might use Intensive Interaction to respond to the things that people are doing and to follow their lead. For example, we might repeat sounds or body movements that the person uses. 
Communication partners will often read meaning into actions that the child/young person with PMLD makes. For example, if the child/young person looks in the general direction of a toy, we might interpret as them indicating that they are wanting to play with that toy. Using Intensive Interaction, we try to use timing and rhythm so that we can help the person predict what is going to happen and so that both people are having fun and getting involved in interactions in ways that make sense to them. 

More information about Intensive Interaction can be found in the following factsheet: Intensive Interaction 

Following training, settings should deliver Intensive Interaction for a minimum of 18 weeks, with the duration of each session directed by the interventionist in a way that is responsive to the child/young person’s needs - likely to be around 5-15 minutes. 
Intensive Interaction should be embedded into daily activities; sessions should occur at least once each day the child/young person attends your setting. We ask for interventionists and parents/carers to complete a diary/session record log daily to record the number and duration of sessions delivered for each child/young person, the techniques used and how the child/young person responded. 

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What will taking part in this research involve?

If you decide to take part, we would like your setting to complete the below activities. This is regardless of whether your setting is randomly assigned to deliver the Intensive Interaction intervention or assigned to the control group. 
The research team will support your setting throughout the study and will provide guidance for each activity. You will be required to nominate a staff member to act as a lead point of contact for study.

 

• Distribute parent/carer information sheets and either an online or paper (depending on your preference) parent/carer consent form [(for children aged 3-15 years), consultee form (for young people aged 16-25 years in England/Wales) or Welfare Guardian/Welfare Attorney/Nearest Relative consent form (for young people aged 16-25 years in Scotland)] to the parents/carers of all eligible children/young people. Collect in any completed paper consent[/consultee forms] to be returned to the research team. 

 

• Confirm that participating children/young people, whose parents/carers have provided consent, meet all eligibility criteria and provide the names/emails for relevant staff (i.e. each child/young person’s main teacher/the teacher who knows them best and the interventionist, if allocated to use Intensive Interaction). 

 

• Nominated teachers will be asked to provide a 10 minute video recording of each participating child/young person taking part in a communication activity. The interaction will be naturalistic showing the teacher and child/young person interacting as they typically would. You will need to provide this at three time points.

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