Background Intensive Interaction is an approach to developing the pre-verbal communication and sociability of people with severe or profound and multiple learning disabilities and autism. Previous research has indicated many potential benefits; however, the approach is not consistently used in social care. Aim To report on the significant and influential issues for care staff when adopting Intensive Interaction as a novel approach in the social care setting for clients with profound and multiple learning disabilities. Materials and Methods Twenty-nine care staff from four residential settings were trained and supported in the use of Intensive Interaction over a 6-month period.Interviews with staff members and researcher field-notes were analysed using a Grounded Theory methodology. Results and ConclusionsIncreased and novel client responses were reported which were consistent with previous research. However, some practical and philosophical difficulties were highlighted by staff regarding their adoption of the approach. Consideration of care staff's experiences and perspective could enable future Intensive Interaction interventions to be more successfully planned and supported.

Accessible summary Intensive Interaction is a way of communicating sociably with people who have severe or profound learning disabilities and/or autism. The writer of this paper thinks that some people may have different ideas why they do Intensive Interaction with people who have severe or profound learning disabilities and/or autism. Some people use Intensive Interaction to communicate with and respond to people who have severe or profound learning disabilities and/or autism, in whichever way works best. Other people use Intensive Interaction to help people who have severe or profound learning disabilities and/or autism to learn more ways to communicate and get on with other people around them. The writer of this paper thinks that there should be more research into what people think about Intensive Interaction. Summary Intensive Interaction is an empirically researched approach to developing fundamental communication and sociability for people with severe and profound learning disabilities and/or autism. However, it is the author’s contention that certain aspects of Intensive Interaction are not universally conceptualised in a uniform manner, and that there are two general process models that are used to describe the approach by an increasing number of multi‐disciplinary practitioners and advocates. Firstly, there is a ‘Social Inclusion Process Model’ of Intensive Interaction, with practitioners using the approach with the primary aim of inclusively responding to the communication of a person with learning disability, however it is expressed. Secondly, there is a ‘Developmental Process Model’, with practitioners having identifiably educative or developmental goals, rather than the approach being viewed simply as a means of contemporaneous social inclusion. In an attempt to clarify this position, this paper makes the case for a ‘Dual Aspect Process Model’ of Intensive Interaction.

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