Ricky is 11 and is severely autistic.
He attends a special school in Bristol.
Like many of the pupils, he has no usable speech
and a limited understanding of the world around him.
His teachers describe him as personable
but he can become withdrawn for long periods,
lost in his own world,
and communication with him can be difficult.
They wonder if there's any way this can be overcome.
Phoebe Caldwell has worked for over 30 years
as a practitioner with people with severe learning difficulties
and behavioural distress.
She uses a method of communication known as intensive interaction
to emotionally engage with them.
She's come to work with Ricky
to see if this method can help overcome
the communication difficulties and isolation that his autism presents.
Intensive interaction really is finding a way
of using people's body language
in order to get into conversation with them.
We're looking at all the things they do,
all the behaviours, all the sounds they make,
all the utterances, all the movements,
and particularly the rhythms,
and we tune into these in order to get
what we call emotional engagement.
What we're trying to do
is we're trying to set up signals which the brain recognises
and to shift their attention from what they're doing by themselves,
from solitary self-stimulation,
to shared activities, something we can do together,
so that what has been something they're doing on their own becomes interactive.
And this is the great bridge that one has to try and build.
As well as working with Ricky,
Phoebe is keen to show class teacher Claire Gates
how to practise this method
so she can use it on a regular basis.
He really likes to engage with people.
The way that he's doing it at the moment
is taking people to what he wants and touching very gently
and letting everyone know what he wants by guiding them.
Of course that is actually him learning to manipulate the world
rather than to relate to it.
It's Phoebe's first session with Ricky.
You should have two of you.
She asks Claire to join in, getting her to consider the sounds that Ricky makes.
It starts at the lowest level by just listening to their breathing rhythm.
Because the person will listen to their own breathing, they'll actually hear it.
So it shifts the attention from the inner self-stimulation to shared.
Yeah.
And so you actually see, very often, the surprise.
"Where did that come from?"
We're always trying to shift attention from solitary self-stimulation
to a shared activity.
Did you see that? His head came up immediately.
He was expecting you to do it with him.
You're trying to tune in to any sort of emotional level,
so if they're sort of shouting, "Aah!" you might go, "Aah!"
So you're actually tuning in to how they feel.
Ricky eventually turns round,
beginning to show more of an interest in Phoebe and Claire.
As well as being withdrawn,
people with autism often display obsessional behaviours.
For Ricky, this means sprinkling,
running things like corn or gravel through his fingers.
Phoebe wants to see how much Ricky will interact when he's sprinkling.
It's his most obsessional behaviour
and he can do it for hours at a time if left undisturbed.
We need to pick up on all the positive bits
and it really may be flapping their hands
or flapping a bit of string or banging a bead
or playing with rice or whatever and watching it dribble away.
Although these are fixations,
we are going to use them for communication.
I think Ricky likes this so much
because one of the things he does a lot
is play with his fingers, with his hands,
and he's actually giving himself a better version of that stimulus
when he's playing with this.
And so it gives him a sensation he's really happy with.
So is there a danger
of intensive interaction perpetuating these fixations?
I don't think anybody who's used this
has ever found that it actually reinforces their repetitive behaviour
because what it does is it shifts their attention
from that inner world to the world outside.
"That's mine but, oh, it happened somewhere else."
After a few minutes,
Phoebe develops the interaction by sharing only one tray.
Ricky seems to take this well
and his usually solitary sprinkling becomes a joint activity.
As soon as you use their language,
you get the eye contact, you get an increase in proximity,
you get interest in what people are doing,
you get emotional closeness.
Can I have some more? Thank you.
That's great. Now...
Hooray!