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You finally arrange for your child to start ABA services, and the therapist arrives at the door for the first day of therapy. Naturally, you are excited to have your child in treatment, and you probably envisioned what therapy sessions would look like. You may have imagined something formal and clinical. Maybe you envisioned a therapist arriving and instantly grabbing your child’s attention with some professional “magic” and checking a behavior goal off of the list in the first week.
Instead, you are met with a cheerful and friendly therapist who plops down on the floor with your child and starts to join in on whatever activity your child is currently in the midst of. If the child is coloring, you may see the therapist join in while reinforcing the activity with verbal praise, “ooooooo, I love coloring and drawing!” If your child is playing a game on the tablet, the therapist might make some observations and get excited with your child at each accomplishment.
Your therapist continues to follow your child around, joining in and reinforcing all of your child’s activity choices. This goes on for several sessions. You may start to wonder- “What is going on here? Who is in charge? The therapist or my child?”
Rest assured. There is a reason that your therapist is letting your child lead the way. Your therapist is building rapport and trust with your child. In ABA, we refer to this as pairing and it is an important first step to starting ABA services. Without it, a therapist may experience resistance from your child to the demands of the treatment plan.
What Is Pairing And Why Is It Important?
Pairing refers to the time period when your child’s new therapist spends time building a working (playing) relationship with your child. This usually happens during the first week or two of ABA therapy.
During the pairing phase, your ABA therapist will get to know your child through play. They will discover your child’s likes and dislikes, and they will take note of the things that motivate your child to participate in the therapy sessions. Most importantly, your therapist will make sure that they have the instructional control that they need to guide your child in a fun yet effective way.
These pairing sessions will be unstructured and fun. The therapist will follow your child’s lead in order to discover what your child gravitates to during playtime. The therapist will interact and playfully test skills like imaginary play, building, sequencing, communicating, and more. All of this can be done in play form.
Demands are kept low during the pairing phase. Your ABA therapist knows that if too many demands are placed on the child before a good working relationship is established, the child may not want to comply with the demands that will inevitably be placed on them during ABA sessions.The last thing any therapist wants is to become involved in a power struggle with a young client with autism. A good therapist knows that once trust and rapport are established with a child it is much easier to place demands on the child during the session.
What Are The Steps For “Successful” Pairing?
There is a process for establishing a good relationship with a client who has autism. The goal of a successful pairing is to establish the therapist as someone wonderful and positive to look forward to at session time.
When your therapist arrives, your child should be happy and excited that the therapist is here! If your child cries or runs away and refuses to work with the therapist, it is safe to say that the pairing process needs some work. If your child continues to reject the therapist after a couple of weeks of pairing, it could be that the therapist is not a good match for your child. It is not uncommon to encounter times when a child with autism and the therapist cannot seem to pair up successfully.
Most ABA agencies have dealt with this scenario, and it is perfectly okay to call your supervising Behavior Analyst to request a different therapist.
If your therapist is a good match, the pairing is typically successful in a short period of time if some simple steps are followed.
First, the therapist should follow the child’s motivation. When the therapist is following the child’s lead, the therapist is discovering which activities the child finds reinforcing. This helps the therapist to develop a working trust between the child and the therapist. For example, if a child picks up a ball to play with, the therapist can say “Wow, a red ball. That looks fun. I love playing ball.” Anything that the child does should be met with enthusiasm and parallel play as much as possible.
Slowly over time, the therapist can place some small demands and gauge how the child responds. Simple demands like, “come with me” or “look at this” can be delivered while still following the child’s choice of activities. Let the child run the show and discover what it is that motivates and excites them.
Once the relationship and the trust have been established, placing demands will be easier. Most therapists will know that they have earned that right to start placing demands during therapy when they can easily grab the child’s attention, when the child follows them, or if the child complies with simple directives. Furthermore, the child usually will display minimal maladaptive behaviors.
Once the initial pairing phase has been established and the treatment plan is in full swing, the pairing continues. The pairing process will never truly stop. The relationship between the client and the therapist will grow, and there will be the normal ups and downs that any friendship or relationship may endure.
At these points in the relationship, the therapist will sometimes step back and rebuild that rapport with the child before pushing the demands any further.
The end goal is to reinforce appropriate behavior, diminish inappropriate behavior, and continually develop the necessary skills that the child needs. It has to be fun and reinforcing, or it becomes too difficult for the client and the therapist.
Circle Care in New Jersey can pair you up with a therapist that will establish a good working relationship with your child. If your child with autism requires ABA services, we have wonderful professionals on staff to help your child and your family. Your child will benefit from a playful, highly reinforcing environment whether treatment is conducted at home, at school, or in our Center.
We look forward to hearing from you.