The principles of pairing in autism: the ABA technician's hurdle
Corinne Isaacs-Frontiero
Though pairing often seems the simplest task within the Applied Behavior Analyst Technician's ("ABAT")'s professional repertoire it carries the most weight and significance for it sets the tone of the Therapist-client relationship. Therefore, it is extremely important to get off on the right foot. Following are some precious tidbits the ABAT should keep in mind for successful pairing:
Really get to know your client be they five or fifteen: What are their interests? What do they enjoy doing? Have they any hobbies? Find out what motivates them be it coloring, drawing, music, or building models and try to incorporate these interests in a commonality of Independent Play.
A firm believer in "gentle teaching," I believe one needs to remember: you are being "invited" into their life not they into your's. Be involved but don't "storm the castle". Bear in mind, individuals with autism often have excessive anxiety. Take a soft approach and send the clear message: "I am not here to invade your space or your life rather to be here and help as both Therapist and friend". Be invited into their world: don't push your way in.
Give choices; and I don't mean between two negatives: give them the autonomy to express their likes, dislikes and preferences without "judging" or trying to "redirect", constantly initially. This will build trust in your relationship and ensure your client it is about "mutual purpose" not your "agenda".
Watch your body language. Crossed arms, hands on hips and the like all scream "My way or the highway" even to the youngest of clients. Always maintain eye contact: It affirms "I am interested in what you do and have to say." Watch your communications, also, tone, cadence and above all, be sincere. Be human! Admit when you are wrong and bear in mind this is a population that understands and immediately detects compassion and genuineness versus control and disgenuineness.
If you are doing home-based therapy and your client comes from a large family include other family members, particularly siblings. Siblings, often competitive will motivate a client to forge on when you reach an impasse. Including siblings also makes for greater generalization across the continuum for mastered tasks. Include family members in your client's goals. Encourage them to continue programs particularly "Sharing" even after you are gone from the therapy session.
Remember, "Rome was not built in a day." Many of our clients have had people march in and out of their lives. How long does a good pairing take if done successfully? In about two weeks you should be successfully on your way. You can tell if your client is receptive to you as their anxiety will fade as will your's with every meeting.
Have fun with your programs! Individuals tend to learn quicker when the environment is relaxed and fun. Particularly the little ones. Take time out to have fun. It's not always about our "programs" it's also about letting your client know you think enough of them to take time out and spend idle time with them, as well.
Finally, bear in mind some facts about first impressions:
1. You never get a second chance, the saying goes, to make a first impression. It turns out you may not even get that. Within 50 milliseconds of seeing someone's face, you unconsciously make decisions that will influence your interactions;
2. Those 50 milliseconds are difficult to overcome, says University of Toronto Professor Nicholas Rule. "Every time you see someone, even if it's someone you really know, you're making that first impression again."
3. Older faces are more telling than young ones. After decades of frowning, for example, a senior's muscles adopt an angrier baseline expression. So smile more - it won't hurt in the short term either;
4. What happens after the first 50 milliseconds? . . . don't discount vulnerability and humility, which will encourage authentic interaction.
5. First impressions have an evolutionary basis: early humans needed to quickly detect whether a person might deceive them or make for a suitable mate.
Finally, if you are not certain how you portray first impressions:
6. "The best way to know what sort of first impression you're making is to ask someone you trust" Rule says, explaining that for all the time we spend assessing others, we're poor judges of ourselves." Reader's Digest, February 2015 edition. Canada.
Pairing sets the tone and future relationship with your client and ultimately your success as an ABAT but more, significantly, your client's success. While ABA can often be an exact science knowing when to be "humanistic" not "scientific" is the key to pairing.