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Learning ThroughSocial Connection

Sara Moroza-James

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Human Communication

Human CommunicationHow many every day communications have some sort of product, concrete goal or outcome?

about 30 - 35%

Most conversations are the sort of

‘hot air’ of human companionship….

PHATIC COMMUNICATIONS

“I hear John’s getting married.”

“Did you see the match?”

“Have you heard the one about…?”

“Do you remember when we used to…?”

‘’They probably came from outer space’’

Phatic Communication

Bronislaw Malinowski (1923)

Phatic communications are …

“utterances that are said to have exclusively social, bonding functions like establishing and maintaining a friendly and harmonious atmosphere in interpersonal relations…”

Senft (2009)4

Adler & Rodman (2006) list four functions of human communication. It fulfils:

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Physical needs

Identity needs

Social needs

Practical needs

“The point here is that personal communication is essential for our well being and it may be that communication is the ‘primary goal’ of human existence” (Adler and Rodman, 2006)

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BUBBLE

‘Dual Aspect Process Model’ (Graham Firth)

1. ‘Social Inclusion Process Model’ 2. ‘Developmental Process Model’

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1. Learner does

something

2. Teacher

responds to learner

3. Learner responds

to teacher4. Teacher

responds to learner

An Intensive Interaction “conversation”, game or activity looks something like this …..

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2. Teacher responds

4. Teacher responds to 3

SCENARIO 1

SCENARIO 2

→ →

1. Teacher does something

1. Learner does something

3. Learner responds to 2

2. Learner responds

3. Teacher responds to 2

Learner responds to 3

→

→ → →

Teacher watches and waits

Or like this …..

Body language/ self awareness

“I had a beautiful moment with my

son tonight. He pressed his face to

my face and looked into my eyes. It

was lovely. I think there is a deep

shift happening between us. I feel it

and I hope he does too. I’m really

happy I came across Intensive

Interaction. I feel it is making a

huge difference.”

Shared Attention

Joint Attention

How does it feel when Intensive Interaction is going

well?

• “I feel comfortable and at home in a world which is

valuable and meaningful to the learner.”

• “I feel that I am learning and understanding more and

more about that world.”• “I feel fully present in that world.”

• “I begin to realise that I am welcome here when I

respectfully join in, listen and try to understand.”• “I begin to share the joy my learner feels, I have to pretend

sometimes, especially at first but, eventually, the feeling is

100% genuine”

• “I let go of my agenda and I allow myself to be surprised

and delighted by everything and anything that occurs.”

(Ditte Andersen, Intensive Interaction, Denmark)

Distance Mentored Training Course

for parents

1. Study Intensive Interaction materials in your home2. Send footage

3. Follow-up discussions via Skype (or equivalent)4. x 4 study units

Intensive Interaction

“This evening I was able to leave Henry in the

garden, playing with his brother & another

child – D, while I did the washing up. Such a

small, everyday thing for most families but

huge for us. I could hear him asking for

chasing games & when I sneaked to the door

to watch, I could see him pointing to D &

absolutely demanding his attention,

referencing both faces & responding to their

suggestions & requests. It felt so normal! This

has all come through I.I. giving my son the

confidence to initiate play, not just with trusted

adults, but also with other kids.”

10 questions on using Intensive Interaction

with someone who has speech

1. Is Intensive Interaction different with a verbal learner?

2. Why is non-verbal communication so important?

3. How do I teach non-verbal communication to my verbal

learner?

4. What if sessions with my child are highly repetitive?

5. Can I also help my child with speech and language?

6. Help! My child keeps asking for things

7. How should I respond to my learner’s unclear speech?

8. Must I reply to my learner’s speech with speech?

9. Should I use language teaching techniques?

10.Do I always respond to the literal meaning of the words?

11.How do I respond to a conversational learner?

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6

4 5321

A visual representation of ‘structured’ teaching

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?

?

?

?

?

The complexity of communication learning

Progress from REPETITION!

• Adult-infant interactions - repeated 1000s of times• I.I. interactions should be even more repetitive?• Duration, content, sophistication, complexity

gradually grow• Repetition – THE main force for progress• People at early stages of development

LIKE repetition• Repetition provides…

Familiarity, Predictability, Security, a Sense of Control and Structure

• As confidence grows, learner experiments more,teacher contributes more and repertoire grows

Progress:

REPETITION!!!!

Frequent, repetitive,

numerous

sessions/experiences

– day by day by week

by month22

first access - small

beginnings

- repetition of early

engagements

frequent, daily

sessions

- many learning

outcomes gradually

emerging

repetition

repetition

repetition

Other areas of learning

gradually becoming

available and opening up

outcomes

emerging

outcomes

emerging

outcomes

emerging

outcomes

emerging

- more repetition

repetition

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Time lineEarly Days

Brief eye contacts, smiles etc

Brief engagements

30 sec. sequence

s

longer eye contacts, smiles etc

More facial expressions

More meaningful noises

‘ah’ ‘b’ and ‘guh’

Interactions get going more quickly

He’s initiating activities

Initiating outside I.I.

sessions

5 min sequences

Less nervous around other

children

Fewer outbursts

Visibly taking more interest in

world around him

More relaxed and happier generally

Less difficulty with transitions

Is putting his own socks on

Sleeping better

interacting with siblings

II developments

Other developments

Interested in different toys

In Intensive Interaction

we create the right

environment and the

learning happens.

Emergent

Outcomes

"Be careful what you teach, it might interfere

with what they are learning"

Magda Gerber (RIE website)

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Progress Track March Susan

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Eye contact repeated –Sustained for about 5 secs

Sat near Alana –

Never done that before

Reached towardme smiling

Eye contact

for the first

time – about

two brief

looks

Smiling and clapping hands as we got to session time –Anticipation?

did turn-taking by imitating her vocalisation, 3 turns each

Tom’s story

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The triad of impairments(old diagnostic criteria)

• Social impairment

• Verbal and non-verbal language

impairment

• Repetitive/ Stereotyped activities

(new) DSM-5 diagnostic criteria• Restricted and repetitive behaviours.

• Deficits in social communication/interaction

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The evaluation, diagnosis and treatment of

gastrointestinal disorders in individuals with

ASDs: a consensus report

(Buie, T. et al, July 2010)

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“...the care provider should consider the possibility that a

gastrointestinal symptom, particularly pain, is a ...factor that

increases the likelihood that serious problem behaviour (e.g.

self-injury, aggression) may be exhibited. Sudden and

unexplained behavioural change (e.g. sleep disturbance or

irritability) can be the hall mark of underlying pain and

discomfort.”

“...the presence of pain ..can result in simple daily tasks and

routines being perceived by the child as much more aversive

than would be the case if the child were healthy and free of

pain.”

Q: how does someone with a severe

communication disorder tell us that they're in pain?

JUST PART OF THE AUTISM???

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“Expert clinicians have observed that aggressive

and self-injurious behaviour may be the primary

clinical manifestations of GERD in individuals

with ASDs, but these symptoms are frequently

attributed to nonmedical causes.”

GERD: gastro-oesophageal reflux disease

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That’s just part of his autism

his

He doesn’t like Tuesdays, he’s behaving like that because it’s Tuesday

OW!! My tummy hurts!

He needs to be taught more appropriate behaviour

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He’s a teenager. It’s his hormones

Full-time Home Programmes

PROGRAMME Approx

age begun

ABA (Applied Behaviour Analysis) 2 yrs, 8 mnths

VB (Verbal Behaviour/ ABA) 3 yrs, 3 mnths

RDI (Relationship Devt. Intervention) 5 yrs

Intensive Interaction 7 ½ yrs

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Before Intensive Interaction …Tom had many skills but did not socialise. Polarised skills

Verbal (scripts) (asked for things)Read / writeTell the timeGood at ITBilingualSongsHe could speak, read and write but not communicate socially at all.Fixated on certain activities, no play at all.He was unhappy and socially isolated.

Tom/ Numbers in the salt

1. enjoying being with another person

2. developing concentration & attention

span with that person

3. learning to do sequences of activity

4. taking turns in exchanges of behaviour

5. learning to initiate

6. sharing personal space

7. learning to regulate & control arousal

levels

8. Development of neural links

The Fundamentals of Communication (FOCs)

MIND-READING

using & understanding …

1. … eye contacts

2. ….… facial expressions

3. …. physical contacts

4. … other non-verbal

communications

5. vocalising (or speaking)

meaningfully (including

intonation)

Emotional learning:

•Knowing that others care, learning to care

•enjoying being with another person – connecting, bonding etc

•Attachment, attunement

•Self-security, to feel safe, secure, calm

•Self esteem, sense of self

•To identify own feelings & see same in others

•Gradually to understand feelings

•Trust

•Empathy, knowing/caring about how somebody else feels

•Right-hemisphere brain development (social communication/

attention/ intuition/ creativity)

(based on various: Bowlby, 1953, Lamb et al, 2002 , Schore, 2003)

Changing AttitudeFears and difficulties:

A step backwards?

‘Reinforce’ current interests?

Facing his greatest difficulties

Not a ‘proper’ programme?

Realisations:

We were difficult to reach

Who should be flexible?

Joining, key to reaching

No longer socially isolated

Approval = self-esteem, & sense of self

Tom could learn (naturally) given right environment

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Autonomic Nervous System

Dysfunction

In

Autism(Rodgers et al 2016; Maddox et al

2015; Patriquin et al 2013; Mazurek et al 2013; Daluwatte et al 2013;

Cheshire 2012; Bodner et al 2012; Anderson et al 2012; Beversdorf et al

2011; Narayan et al 2010; Fan et al 2009; Charlot et al 2008; Ming et al 2005; Toichi et al 2003; Ratey et al

1987)

Sympathetic Nervous System

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I.I. helps with socialising

Increased oxytocin

Socialising becomes easier

Increased oxytocin &

reduced stress

The virtuous

circle

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PlaySimple role-plays(mainly based on DVDs and books)

Children with autism can’t play(and they can’t socialise either)

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Other Areas of Progress

Flexibility

Independence

Playfulness

Broadening interests & repertoire

Seeing potential in us

Language (inc. nuances & subtleties)

Humour

???

NATURAL LEARNING?

.

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Thank you & please contact me!Friend me on Facebook! Sara Moroza-JamesEmail address: smjiicoordinator@gmail.comWebsite address: http://smjiicoordinator.wixsite.com/sara-moroza-jamesMy book on-line: https://issuu.com/treatingautism/docs/ta_i.i._handbook_final_single_pagesOrder Treating Autism documents from:mail@treatingautism.co.uk

Autism Comorbiditieswww.treatingautism.co.uk

Resources

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