Background: The aim of this descriptive single case study was to describe a unique interaction with a person with profound intellectual and multiple disabilities (PIMD) in a holistic way--focusing on the client, the staff member, and the interacting dyad--and to include the experiential knowledge of the interaction partner. Method: A videotaped interaction of the staff--client dyad was analysed by triangulating data from video analysis, documents, observational rating scales, and an interview with the staff member. Results: The interactional pattern revealed in this study is that of a staff member who offers an activity that is considered to be stimulating for the client, by using a variety of initiatives and structuring strategies, and a client who is alert and responsive, but has limited chances to take own initiatives. Rather low scores were obtained on observations from a dialogical perspective. Conclusions: This study highlights the value of video analysis for practitioners, demonstrates the usefulness of describing an interaction episode supported by an integrative theoretical framework, and confirms the importance of combining observations by an independent researcher with experiential staff knowledge.