Talking Sense: One-on-one intervention

Intervenors have been with us for twenty years now, and their numbers are growing fast – but what exactly does their role involve? SJ Butler finds out.

I choose supported housingIn any group of congenitally deafblind people, each has his or her own ways of communicating and of understanding the world – one may use British Sign Language (BSL), another hand-on-hand, another may have a personal system of signs, and another may, for example, blink or clench his body to show like or dislike. Some will be fully mobile, others may use a wheelchair. A very few will have no vision or hearing at all, others will have a whole range and degree of sensory impairments. Some will have profound learning difficulties, others may learn quickly. There’s no one template for the way that someone with multi-sensory impairments interacts with the world.

As a result, even in a setting designed for deafblind people, each individual deafblind person needs help that is specific to them in order fully to participate.

An intervenor works one-to-one with a deafblind person. They get to know them well, learning about the subtle nuances of their communication style, and they use their knowledge to bridge the gap between the deafblind person and the rest of the world. They work in a range of different settings, and each person they work with demands different skills.

Here’s Anna, who is an intervenor for two-year-old Amelie at nursery:

“They use their knowledge to bridge the gap between the deafblind person and the rest of the world”

‘Because Amelie’s profoundly deaf, and has cochlear implants, I introduce her to sound, so if a child is crying in one end of the room, I’ll say ‘Oh, someone’s crying’ and do the actions with the signs as well, and facial expressions. I’ll also sometimes walk her over to the child that’s making the sound so she can have a look and see what’s going on. This has worked so we’re at the point where when she hears something she’s instantly aware and she shows concern and that builds up her emotional and personal development. She has the ability to take on those skills if the access is given to her, rather than staying in her own sort of world.’

Kalil works with five-year-old Sam at home:

‘Sam needs someone to be there to encourage him to try different activities that he wouldn’t necessarily have tried on his own. For example he’s quite tactile defensive (he is resistant to being touched) and I do a lot of hand and feet painting with him - so through painting I encourage him to be more confident and explore different materials. As his intervenor I help him to explore his environment, because he doesn’t have that many opportunities to do that.’

George is a young man, supported by his intervenor Clark:

‘What I do is build the relationship first and foremost, getting his trust ... We build his confidence and self-motivation, get a good level of self-esteem. I support him to do whatever he wants to do, basically. So if there are any barriers in the way of him participating in something, we look to overcome them together'

Sixteen-year old Dominic has recently arrived from Hungary. His intervenors support him at school; one of his teachers, Kevin, says: 

‘I may produce some special work for him to do, or discuss that with the intervenors, but what is really good about the intervenors is that if I present Dominic with some work or I’m doing some work with the whole class and Dominic is not necessarily quite there with us, they will very readily adapt what I’m saying or doing to enable Dominic to access it. And if I ask them to, they’ll also provide some specialist resources or do some translation work for me, so it supports my teaching hugely and means that Dominic can be engaged with most of what is going on.’

Just these four examples show clearly that no two interventions are alike. Intervenors work with people of all ages, and all abilities. They work in educational settings, and as social intervenors. Wherever they work they do things with the person, and not for them. They supply the information the deafblind person needs to be as independent as possible. Indeed, the more intervention the person receives, the more independent they can be.

Communication is key

At the heart of any intervenor’s work is communication, as it is with so many types of work with deafblind people,. They are communication partners – deafblind person and intervenor work together to communicate, taking on the challenges as a partnership.

Jenny Fletcher, who runs Sense’s intervenor training, says, ‘Communication is the essence with anybody. If you think you’re being listened to, if you think you’re being acknowledged, if you think you can contribute, then everything else falls into place really, no matter how disabled you are’. 

But there’s more to being an intervenor than communication. Intervenors need to be able to operate with independence and autonomy, taking a significant amount of personal responsibility for planning and reviewing the support provided to deafblind person they are supporting. An effective intervenor needs good observation and assessment skills, and the ability to collaborate with a wide range of people, from family to other professionals.
Most deafblind children attend mainstream or special schools that do not specialise in deafblindness - so the knowledge and understanding of deafblindness the intervenor brings is important.

Sarah Stott, Deputy Head, Thomas Wolsey School sees the benefit clearly: ‘Having the intervenors in school all of the time means they are very much part of the bigger team. … One of the reasons it’s very successful is that they learn from us, we learn from them, they share information. We share knowledge so every child is getting the best deal, because all the people around them are working together.’

This integrated team approach is relatively rare, however, and in many schools, the intervenor works more or less alone. Here their ability to co-ordinate many professionals and to explain the child’s needs to non-specialists really comes to the fore because it’s not unusual for a child to have ten or twelve professionals working with them, in addition to their teachers. In school, therefore, a vital part of the intervenor’s role – alongside daily one-to-one support in the class – is to incorporate programmes from all these professionals into the child’s routine. They could therefore be delivering visual training, hearing aid tolerance, movement, long cane work … as well as adapting the class teacher’s lessons for the child.

While this is clearly a benefit to the young deafblind person, life in school can be challenging for intervenors, whose role is often not understood even by close colleagues. Vikki Pearson, who used to work as an intervenor in schools, comments, ‘Being an intervenor can be quite isolating, especially being in a school on your own, you don’t get much support from other teachers and you’re left to your own devices.’ Mark Flynn, who works in a mainstream school in Manchester, agrees that teachers rarely appreciate just how much time it can take to prepare lessons: ‘a simple half-hour maths lesson might take me an hour or two to prepare, and it might take a good hour to do that maths lesson, at the right time and in the right place for the child’.

Social intervenors, on the other hand, don’t have the structures of school to deal with – or to support them - and can find themselves feeling isolated. However, just like educational intervenors it is important they work closely with the other professionals supporting the deafblind person.

In some areas, there are strong systems in place that ensure that the intervenor is well supported, which in turn means an excellent level of support for the deafblind person and their family. In Suffolk, for instance advisory teacher Kim Hodge takes the lead, pulling together a team including speech and language therapists, occupational therapists, intervenors and class teachers to produce a cohesive and seamless service.
This service accompanies the deafblind child from earliest diagnosis into pre-school and then school. The child works with the same intervenor or group of intervenors throughout, and benefits hugely from their consistency of approach and understanding of his or her needs.

The relationship between intervenor and deafblind person can last a long time, and this is reassuring to parents of young children. Debbie, Amelie’s mother says, ‘It’s meant reassurance that when my child goes into her nursery or comes here that she’s getting the appropriate support and that somebody’s with her on a one-to-one basis and is able to communicate really, really effectively with her. As a parent, that’s just a huge comfort. Nobody knows your child as well as you do, but to know that somebody has the skills to be able to work with your child is just really comforting and reassuring. And it’s a relationship that will grow as she gets older.’

Families benefit from intervenors in other ways too. Sam’s mother, Nikki, really treasures the time she can spend with her daughter Emily, while Sam is with Kalil. And James’s mother says that while initially they asked for an intervenor purely for James’s sake, she has come to relish her two evenings a week where she can relax and eat a meal with her husband: ‘He’s out enjoying himself, he’s doing activities that he wants to do with highly qualified staff that he’s totally safe with, so now I don’t feel guilty, I make the best of the time I have when James is out for the evening.’

Today, there are intervenors across the UK. In some places intervenors are well established as an integral part of support for deafblind people (though they may not be called intervenors), in others their role is still little understood. Generally speaking, the well-established system of Statements of Special Educational Need means that there’s a clear route to receiving support from an intervenor in schools. When it comes to social intervention, though, provision is less consistent, although an assessment under the Deafblind Guidance should make it clear when someone will benefit from an intervenor.

Despite this inconsistent cover, there’s no doubt that intervenors – through their detailed knowledge of the person they support, their application of their understanding of how deafblindness affects the person, and their one-to-one focus on that person – make a huge difference to the quality of congenitally deafblind people’s lives and their ability to participate in the world around them.

This article draws upon a new DVD about intervenors which has been produced by Children’s Specialist Services at Sense.  

Life story 1: Amelie

Debbie Ward, Amelie’s mother: ‘It is quite incredible when the intervenor goes in and works with Amelie at nursery, and here at Thomas Wolsey, purely from the fact that Amelie will come home and you can tell she’s just absorbed so much information. She’ll come home signing a lot more, speaking a lot more. I’ve watched how they work with her, and they really emphasise the signing with her constantly and the body language and the non-verbal communication. Amelie picks up on all that and it’s really clear when she comes home just what a good day she’s had with them. She comes home very talkative, and very tired because obviously she’s had to work very hard to communicate.’

Life story 2: Dominic

Tanya, Dominic’s intervenor: ‘As a 15-year-old, it must be very hard to have someone with you all the time. So a lot of my role is to communicate between the two [Dominic and his class mates] if there’s a communication problem, but in a lot of ways you need to take that back seat and let those social experiences with his peers happen naturally.’

Life story 3: Sam

Kalil, Sam’s intervenor: ‘Sam has a lot more confidence in himself. He’s communicating a lot more. He’s using four-, five-word sentences, which he didn’t use before. He’s sharing with people a lot more. I think he’s a lot more aware of his surroundings, and because the sessions I do with him are very structured, he’s getting used to knowing what’s happening next. So it takes the anxiety and frustration out of the equation because he knows exactly what’s going to happen afterwards and doesn’t have to worry about what I’m doing next, and when the session will finish and so on.

Nikki, Sam’s mother: ‘Sam seems to calm right down with Kalil here. I learnt a very valuable lesson from Kalil, which is to talk things through with Sam. The best thing about having Kalil is that I can see the improvement that Sam’s made.’

Life story 4: James

James is supported by his intervenor Kalil to take part in social activities in the evening so that he can enjoy some independence.

Kalil, James’s intervenor: ‘My role with James is as a social intervenor – going out and about with him, helping him to explore surroundings, environments that he wouldn’t necessarily have the opportunity to do himself. I work with James in the evenings, generally after the Anne Wall Centre is  closed. James has a condition which means he can’t be out in bright lights – even exposure to light for a short time would bring him out in third-degree burns, so you have to be very aware of that when you’re working with him. James wears cochlear implants, so he’s a signer but he does speak as well.

James is a very sociable, happy person, very happy to talk to anyone and to go and do things. He’s very aware of his surroundings. If you give James choices he’ll tell you exactly what he wants to do, how he’s feeling and so on, so in that sense he’s a very independent person.

I’ve given James a choice of things we can do and he’s always chosen bowling. We get to the bowling alley quite early so we sit in the bar, relax, have a chat, maybe have a drink.’

James

When you go out with Kalil, what do you like doing? Pizza Hut. Bowling.
Why do you like bowling? I like getting the goal.
What happens to the ball? It goes in the hole.
What does it knock down? Pins.
Do you knock them all down? Yes.
Who won last week? Me.
After bowling, where did you go? Pizza Hut.
What did you eat? A big pizza.
When you go out with Sam, what do you do? Air hockey.
Do you like that? Yeah!
How do you get home? By bus.
Why do you like coming on the bus? It’s excellent.
What else would you like to do? Pub.
What do you like to drink in the pub? Red wine. Guinness.

Kathy, James’s mum: ‘We first asked about the intervening service because when James was at school he boarded four nights a week and therefore had a social life away from the family. For the past year, since he’s been in adult services, he’s lived at home full time, and I was really concerned about the fact that he was having to socialise at 21 with parents, which isn’t really ideal. Before the intervening started, although he had excellent activities during the day, there was a whole gap in his life because he had been used to going out and socialising and doing things in the evening. And by the time I get home – I drive James home as well – and I’ve cooked and everything, it’s very difficult to muster up enough energy to start doing the sort of activities he’d been doing before.

Since James has been going out with the intervenors he has two evenings a week where he’s collected from the centre at four o’clock. They decide together the sort of activities he wants to do. James has become very fond of bowling, and now there’s a weekly bowling session and little bit of competition going on about who wins between himself and his intervenor as he would have if he was out with a peer group. That’s really good fun for him because it’s something he can do regularly, something he enjoys.

Going out with the intervenor means that James is still supervised, in a very caring and structured way, but he sees it as outside of carers and much more as friends and going off to do things like everybody else does.
Having an intervenor has meant that James has the freedom to do things that he couldn’t do with just general people and friends. Because of his complex situation, particularly with his skin, he has to wear protective clothing, he has to be monitored with a light meter, and to be really honest that’s a little bit too much to be asking friends and neighbours to be doing. We really needed somebody with expertise and somebody who could be trained to keep him safe while he was out.’

Life story 5: George

Clark, George’s intervenor: ‘Swimming is a massive step for George, because up until six weeks ago he wasn’t keen on swimming. He’d not swum for about four or five years. His family used to take him swimming when he was younger, but as he’s getting older and it’s a bit more strain on them, he hadn’t been swimming for a while. So to build George’s confidence we took him in while other swimming sessions were happening and he’d just sit by the pool and watch sessions. This went on for a few months, then eventually he’d splash the water, and then he’d dangle his legs in and now he regularly gets into the pool and he’s quite happy swimming around. Praise is extremely important, and a vital part of working one-to-one with somebody as an intervenor.’

How to become an intervenor

Sense runs regular courses for intervenors around the country. The first stage is to attend a five-day course, at the end of which you will be a ‘trained intervenor’. You then have the option of seeking accreditation for your learning through Northampton University, which involves the completion of two work related projects. The credits gained through accreditation can count towards a degree.

Most people are funded by their employers. Plenty of people attend the course who will not practice as intervenors but who want to learn the skills or to find out more about the role – teachers in special schools, and sensory support team members, find it extremely useful, for example.

‘The impact of the training on the education of deaf-blind children has been remarkable. After the training we get so many emails, from teachers, parents, the intervenors themselves, just saying how much the child has developed. They may have been working with the child, and working quite closely with them, but doing the training and applying that knowledge to the child has made such advancements in the child’s development.’ Jenny Fletcher

Organisations and further information

‘The role of the intervenor’, an excellent factsheet by Joan Graham for RNIB.

The National Organisation of Intervenors (NOI) supports intervenors. It holds an annual conference, runs workshops, provides information and mutual support. Contact Anne Cheesbrough at jfnoi@btinternet.com

George Brown College, Ontario – YouTube video about intervenors (Note though that in Canada intervenors work with both congenitally and acquired deafblind people.)

British Columbia Provincial Outreach Program for Students with Deafblindness: Intervention strategies www.public.sd38.bc.ca/deafblindweb/Intervention/strategies

This article appeared in Talking Sense, Spring 2007

Read other Talking Sense articles

 

First published: Monday 20 August 2012
Updated: Tuesday 15 October 2013