Introduction
Many parents of pre-verbal autistic children long for more moments of connection with their child. You may find yourself wondering what your child is thinking, how they experience the world, or how you can help them develop communication skills when spoken language has not yet emerged.
It can be tempting to focus entirely on helping a child learn words. However, communication begins long before speech develops. Before children learn to talk, they develop a range of foundation skills that make communication possible. These include enjoying being with another person, paying attention to others, taking turns, anticipating interactions, copying actions and sharing experiences.
One approach that has been widely used to support the development of these early communication skills is Intensive Interaction.
Intensive Interaction is a neurodiversity-affirming approach that aims to build social connection, communication and shared enjoyment. It does not attempt to force eye contact, stop autistic behaviours or teach children to behave in a neurotypical way. Instead, it focuses on meeting children where they are, joining their world and creating opportunities for meaningful interaction.
Research suggests that Intensive Interaction can support the development of social engagement, attention to others, communication behaviours and joint attention skills in autistic children and individuals with learning disabilities (Firth and Barber, 2011; Hutchinson and Bodicoat, 2015).
What is Intensive Interaction?
Intensive Interaction is an approach to communication development originally developed by Dave Hewett and Melanie Nind during the 1980s.
The approach was based on observations of how typically developing babies learn to communicate during their first year of life through interactions with parents and caregivers.
When adults interact with babies naturally, they typically:
- Follow the baby’s lead
- Respond to the baby’s sounds and movements
- Copy facial expressions and vocalisations
- Take turns
- Pause and wait for responses
- Repeat enjoyable interactions
- Focus on shared enjoyment rather than teaching
These interactions help babies develop the building blocks of communication long before they begin speaking.
The theory behind Intensive Interaction suggests that some children with developmental differences may benefit from continued opportunities to experience these early social interactions, even when they are older.
Importantly, this does not mean autism is caused by a lack of interaction, nor does it suggest parents have done anything wrong. Rather, it recognises that autistic children may develop social communication skills differently and may benefit from additional opportunities to experience enjoyable, responsive interactions.
Why does Intensive Interaction matter?
Communication is about much more than words.
Before children learn language, they typically develop skills such as:
- Social awareness
- Shared attention
- Eye gaze shifts
- Turn-taking
- Anticipation
- Imitation
- Emotional connection
- Joint attention
These pre-verbal skills form the foundation upon which spoken language develops.
Research suggests that children who develop stronger early social communication skills often show better outcomes in language development later on (Mundy and Newell, 2007; Charman, 2003).
Intensive Interaction focuses on these foundational skills rather than directly teaching speech.
What is joint attention?
One of the most important skills supported through Intensive Interaction is joint attention.
Joint attention occurs when two people share attention towards the same object, event or activity and both recognise that they are sharing the experience.
For example:
- Your child points to an aeroplane in the sky and looks at you.
- You show your child a bubble floating past and they look at both the bubble and you.
- You both enjoy looking at a picture book together.
Joint attention is different from requesting.
If a child points to a biscuit because they want it, they are communicating a need.
If a child points to a butterfly simply because they want to share the experience with you, they are demonstrating joint attention.
Joint attention is one of the most important precursors to language development because it provides opportunities for children to:
- Learn new words
- Share experiences
- Develop social relationships
- Understand communication as a shared activity
Research consistently identifies difficulties with joint attention as one of the earliest characteristics associated with autism and one of the strongest early predictors of later communication outcomes.
The link between Intensive Interaction and joint attention
Intensive Interaction naturally creates opportunities for joint attention to develop.
Rather than directly teaching a child to point or follow another person’s gaze, Intensive Interaction focuses on creating enjoyable social experiences that encourage shared attention.
During successful Intensive Interaction sessions, you may observe your child:
- Looking towards you more frequently
- Noticing your reactions
- Anticipating favourite interactions
- Looking between you and an object
- Sharing enjoyment
- Bringing items to show you
- Responding to things you point out
These are all important developments in joint attention.
Research has found that Intensive Interaction can improve social engagement, responsiveness and attention to others, which are all closely linked to the development of joint attention skills (Firth and Barber, 2011; Hutchinson and Bodicoat, 2015).
What does adult-baby interaction teach us?
When we think about how adults naturally interact with babies, several important features emerge.
There Is No Goal
Most interactions are not designed to teach anything specific.
Adults interact with babies simply because it is enjoyable.
The Baby Leads
Adults respond to what the baby is doing rather than directing the interaction.
Interactions Are Short and Frequent
Babies learn through many brief interactions throughout the day rather than long teaching sessions.
Adults Copy and Respond
A baby smiles.
The adult smiles back.
The baby vocalises.
The adult vocalises back.
These simple exchanges teach turn-taking and social connection.
Repetition Is Important
Babies love repetition because it makes interaction predictable and enjoyable.
The same principles underpin Intensive Interaction.
What is the goal of an Intensive Interaction session?
The main goal is simple: Shared Enjoyment
Intensive Interaction is not a teaching session.
It is not therapy in the traditional sense.
It is not a test.
Instead, it is an opportunity to enjoy being together.
Many parents report that removing pressure to obtain a specific outcome allows both parent and child to relax and enjoy interacting with one another.
Ironically, communication skills often develop most effectively when interaction feels fun rather than demanding.
Skills that may develop through Intensive Interaction
Over time, children may begin to develop:
Awareness of Others
You might observe:
- Brief glances towards you
- A smile when you enter the room
- Changes in behaviour when they notice you
Social Engagement
For example:
- Smiling in response to your actions
- Moving closer to you
- Vocalising during interactions
Anticipation
Your child may show excitement when expecting a favourite interaction to happen again.
Imitation
You might notice your child:
- Copying sounds
- Copying actions
- Copying facial expressions
Turn-Taking
Simple back-and-forth interactions begin to emerge.
Joint Attention
Your child may begin:
- Looking at things you show them
- Sharing objects with you
- Looking between you and preferred activities
All of these skills are considered important foundations for later communication.
Principles of Intensive Interaction
Follow Your Child’s Lead
Observe what interests your child and join in.
Go Slowly
Allow plenty of processing time.
Pause Frequently
Many autistic children need extra time to respond.
Copy and Mirror
Copying your child’s sounds, actions or movements can be a powerful way of showing that you are interested in their world.
Keep Communication Simple
Use simple facial expressions, gestures and brief language.
Repeat What Works
If your child enjoys something, do it again.
Focus on the Relationship
The interaction itself is more important than any specific skill.
Activities you could try
Copying Vocalisations
If your child makes a sound, copy it back.
Joining Repetitive Play
If your child is lining up objects, sit nearby and line up similar objects.
Bubble Play
Pause before blowing the bubbles and wait to see whether your child shows anticipation or interest.
Rolling a Ball
Take turns rolling a ball back and forth.
Simple Commenting
Describe what your child is doing without asking questions.
For example:
“The train is going fast.”
“You’re spinning the wheel.”
This keeps pressure low and allows interaction to remain enjoyable.
Important considerations for autistic children
A neurodiversity-affirming approach is essential.
Do Not Force Eye Contact
Many autistic people find eye contact uncomfortable.
Interest can be shown in many different ways.
Respect Personal Space
Some children enjoy close interaction; others do not.
Consider Sensory Needs
Adapt your approach if sounds, touch or proximity are uncomfortable.
Recognise Different Signs of Engagement
A child may demonstrate engagement through:
- A brief glance
- Increased excitement
- Smiling
- Moving closer
- Vocalising
- Stimming
Not all engagement looks the same.
How long does it take to work?
Every child is different.
Some children show increased engagement very quickly.
Others may need many weeks or months of repeated opportunities before changes become noticeable.
It is important to remember that the goal is not immediate speech development.
Instead, Intensive Interaction provides ongoing opportunities for social communication skills to emerge naturally over time.
Final thoughts
Intensive Interaction is a powerful, relationship-based approach that helps autistic children develop the foundations of communication through enjoyable, meaningful social experiences. By following your child’s lead, responding to their interests and prioritising connection over teaching, you create opportunities for important pre-verbal skills such as social awareness, turn-taking, imitation and joint attention to develop.
Joint attention is particularly important because it provides the bridge between social interaction and language learning. Through shared attention, children begin to understand that communication is not only about getting needs met but also about sharing experiences, enjoyment and connection with other people.
Perhaps most importantly, Intensive Interaction reminds us that communication begins with relationships. Before children learn words, they first learn that being with another person can be fun, predictable and rewarding—and that is where communication truly starts.
References
Charman, T. (2003) ‘Why is joint attention a pivotal skill in autism?’, Philosophical Transactions of the Royal Society B: Biological Sciences, 358(1430), pp. 315–324.
Firth, G. and Barber, M. (2011) Using Intensive Interaction with a Person with a Social or Communicative Impairment. London: Jessica Kingsley Publishers.
Hewett, D. (2018) The Intensive Interaction Handbook. 2nd edn. London: Sage.
Hutchinson, N. and Bodicoat, A. (2015) ‘The effectiveness of Intensive Interaction for people with profound and multiple learning disabilities: A systematic review’, Journal of Applied Research in Intellectual Disabilities, 28(5), pp. 437–454.
Mundy, P. and Newell, L. (2007) ‘Attention, joint attention and social cognition’, Current Directions in Psychological Science, 16(5), pp. 269–274.
Nind, M. and Hewett, D. (2001) A Practical Guide to Intensive Interaction. Kidderminster: British Institute of Learning Disabilities.
Zwaigenbaum, L., Bauman, M.L., Stone, W.L., Yirmiya, N., Estes, A., Hansen, R.L., McPartland, J.C., Natowicz, M.R., Choueiri, R. and Fein, D. (2015) ‘Early identification of autism spectrum disorder: Recommendations for practice and research’, Pediatrics, 136(Suppl. 1), pp. S10–S40.
Further information
The Intensive Interaction Institute
The Intensive Interaction Institute provides information, resources and training in relation to Intensive Interaction www.IntensiveInteraction.org.
Books
The Intensive Interaction Handbook (2nd Ed, 2018) edited by Hewett, D.: Sage Publications, London.
Using Intensive Interaction with a Person with a Social or Communicative Impairment (2010) Firth, G. & Barber, M: Jessica Kingsley, London
Examples
There are many examples of Intensive Interaction activities on YouTube.
How we can help
If you have concerns about your child’s development, communication or behaviour, a private autism assessment can help you understand their needs. Jo Condon Autism Assessments provides NICE-compliant autism assessments for children from the age of two, carried out by experienced clinicians. Children under 10 are seen in person at one of our clinics. If you are not yet sure whether an assessment is right for your child, our free online screening test is a good place to start.
