INT. J. LANGUAGE zyxwvutsrq & COMMUNICATION DISORDERS, 1998, VOL. 33, SUPPLEMENT zyx TO ENGAGE OR NOT TO ENGAGE? AFFECTING THE INTERACTIONS OF LEARNING DISABLED ADULTS Karen Bunning Dept of Clinical Communication Studies City University Northampton Square London EClV OHB. email: kt.bunning@city.ac.uk zyxw An intervention, termed ‘Individualised Sensory Environment’ (ISE), was developed for use with adults with profound and multiple learning disabilities (Bunning 1996). The aim was to affect positively the interactive behaviours displayed by clients in the natural environment: specifically, to reduce the level of non-purposeful engagement, characterised by stereotypic actions, self- injury and neutral behaviour and to increase the levels of purposeful interaction with people and objects. Momentary time sampling was the chosen method of assessment. The results showed that the clients emitted high levels of non-purposeful behaviour at baseline. Post ISE intervention assessment revealed a decline in the level of non-purposeful behaviour and an increase in purposeful interactions. Introduction Establishing and maintaining social contact with people who have profound and multiple learning disabilities is often very difficult. A lack of formal linguistic code and the presence of additional sensory and motor impairments may place stresses on the interactive partnership of client and significant other. The non-conventional communication behaviours of these individuals such as body language, facial expression, eye gaze and vocalisations, make them highly dependent on the interpretations of others to make themselves understood. The presence of certain characteristics may disrupt the communicative and social interaction process further. There is a greater incidence of sensory impairment amongst people with a more severe learning disability. The degree of sensory impairment is also likely to be more severe in type as the learning disability increases (Kieman and Kieman 1994). Abnormal behaviour patterns characterised by a lack of purpose, such as stereotypy or self-injury, may challenge the communicative process. Prevalence of aggression, property destruction, self-injurious behaviour and other forms of challenging behaviour are positively correlated with the degree of learning disability. Multiple forms of problem behaviour are more likely amongst those people with the more severe learning disabilities and those who are non-verbal or experience particular difficulty with reception and expression of language (Kieman and Kieman 1994). Self-injury is closely related to the degree of learning disability: 70% of people who self-injure have a severe-profound learning disability (Oliver zyxwvut et zyxwvu af. 1987). Examining the relationship between challenging 1368-2822/98 $12.00 zyxwvut 0 1998 Royal College of Speech & Language Therapists