My husband and I have two children: M. (girl), aged 5 and R. (boy), aged 3. Both were diagnosed with autism before their second birthdays. Despite sharing genetic material and the same diagnosis, they are total opposites in everything: personality, preferences and learning style! M. tends more towards classic autism and attends a special school; and this blog is mainly about her as she responds amazingly well to Intensive Interaction. R. is more verbally able and is going to attend a mainstream primary school with an autism unit. Intensive Interaction sessions tend to take a different format with each of them, with M.'s sessions being often very physical, tactile and active whilst R.'s sessions often centre around word play and vocal repetition.
Our journey to II was not immediate. Shortly after M. was diagnosed, a Speech Therapist told us about II. However, I had concerns: was it not mainly for children with Profound and Multiple Learning Difficulties? Would imitating autistic behaviours such as spinning and shaking arms not reinforce them? Was it actually teaching anything or resulting in tangible progress? In the end we opted for ABA (Applied Behaviour Analysis) combined with PECS (Picture Exchange Communication System). These teaching systems are quite directive in nature, with a very specific curriculum (student should acquire skills X,Y and Z) and a definite teaching methodology (you teach them X,Y and Z by offering rewards and then fading the rewards as they acquire the skill).
We ended up drifting away from ABA, although I'm not against its use and it did teach M. a few useful skills. For instance, she was progressively trained to respond to the instruction 'come here' through rewards and this has lasted to this day - she (nearly) always comes when requested! However, a lot of the learning intuitively felt meaningless to me and (I suspect) to M. - for instance, a child being trained to undertake a 'pretend tea party' with teddy bears when they don't know what's going on and don't see any point in pretend play anyway doesn't feel like a very productive or satisfying way to spend time. I think ABA is probably a good way of acquiring functional skills that the child actually needs, but shouldn't be used just to make a child seem neurotypical.
As for PECS, it's an excellent, systematic communication system but the problem was that M. didn't really have the desire to engage with me, so acquiring the ability to hand over a PECS symbol card (which she quickly did) didn't make her want to actually do it! In the end she did start handing over drink and food cards spontaneously (because they motivate her highly) but didn't have the motivation to hand over any others. Thus, we needed to supplement PECS with a different approach that would actually increase M.'s motivation to spontaneously approach other people and initiate interactions.
This approach was Intensive Interaction. We got into II when we employed a private Speech Therapist because we wanted regular family visits and structured 'homework' that would help us as parents to help her. Our Speech Therapist is very pro-II and was very helpful in video-recording our interactions with M. and suggesting how we could improve it. After a few weeks I was convinced that II was contributing to her development, as we were getting more frequent eye-contact, more spontaneous approaching to initiate an interaction, and more moments of 'shared jokes' where we would burst out laughing about the same silly antics together at the same time. I think that although the outcomes with Intensive Interaction are perhaps less tangible than with ABA (where you fill in data sheets to chart specific skill acquisition) they are nevertheless more 'real' and meaningful in that something is happening that is felt by both M. and us. There is a subtle shift in the relationship, as though M. has realised for the first time that interacting with other people can be interesting, fun and can even effect change (like getting what you want!). That feels very satisfying for both her and us, and definitely promotes a sense of 'connnectedness'.
Another advantage of II is that (I think) it promotes M.'s self-esteem. That's important because I know she is aware that R. is overtaking her in many areas despite being 18 months younger, and that is difficult for her. II sends quite a different message from ABA in that respect. For instance, take building blocks, which M. likes to gather up in big handfuls and pour over her head. ABA would say 'the correct way to play with blocks is to build them into a tower and we will teach you how to do this through physical/ verbal prompts and rewards for building' whereas II says 'that pouring looks like fun, can I join in too?'. That's quite a powerful validating message, like saying 'you're OK where you are right now and I like you that way'. (Having said that, II does allow for the possibility of expanding play by subtly introducing new ways to play with the blocks, but only after you have validated her way, joined in with it and really got her attention and acceptance of you as a playmate).
In the future, I think we'll continue with PECS alongside II. We may even use ABA principles when there are particular skills we want her to acquire. Purists might argue against a pick-and-mix approach as there are areas of incompatibility (for instance, some ABA practitioners argue that imitating autistic behaviours provides social reinforcement of them and should be discouraged) but I take more of a pragmatic approach in the sense of 'do whatever works'. However, I think that Intensive Interaction has some unique advantages as an approach in terms of promoting connectedness with our children and deepening the relationship and the desire to communicate.