Playtime vs rapport building: The deal-breaker in working with children with autism

Building rapport is one of the most important things that an Applied Behavior Analysis (ABA) therapist can do with a child with autism. In ABA we refer to this process as pairing. We consider a therapist to be “paired” when the child associates the therapist with the delivery of positive reinforcement (e.g., delivery of preferred items, activities, and praise.)

4 reasons why pairing is necessary

1. It builds a crucial rapport between your child and therapist. We want your child to be excited when the therapist arrives and disappointed to see her or him leave. Rapport equals a lasting relationship.
2. Pairing creates a positive learning environment!
3. The pairing process answers vital clinical questions such as: What motivates the child? What can be used to reward or positively reinforce desired behaviors while reducing challenging behaviors?
4. Pairing allows the therapist to bring the session to life! By learning your child’s motivations, the clinical team will be best suited to encourage desired behaviors and bring out the vibrancy of your child.

What to look for

There are many methods that a therapist can use to build crucial rapport with your child. At times, it may appear as if the therapist and your child are simply playing her or his favorite games. In part, this is true, but data is collected on each of these interactions and analyzed. These collected data are used to make informed decisions and improve the likelihood of success. During the pairing process, an ABA therapist may do a few of the following things:

• Ask you to get involved. No one knows your child like you do! You know her or his motivations, what they value and what they dislike.
• Clear, or “sanitize,” the environment. The clinician will clear the room where she or he is working with your child. They’ll remove any preferred toys or games so your child will be motivated to engage or approach them for access to these items. This helps the child to associate the availability of preferred items/activities with your ABA therapist.
• Refrain from placing demands or giving any instructions. Making demands on a child this early in the process may cause the child stress. As a result, this could increase problem behavior. Before instructions are given, the child and therapist must have created sufficient rapport.

How do you know when pairing is successful, and rapport has been built?

One great way to tell if your child and therapist are paired is if your child is excited to see her or him and sad when they go. When pairing is successful, the child will often take the therapist by the hand, leading her or him around. This process can take anywhere from the first week to the first month. However, there are instances when pairing needs to be re-established. Your clinical team should re-focus on pairing when:

• New problem behavior(s) arises
• The ABA therapist/client relationship becomes weakened
• A new therapist is introduced

Pairing and rapport building in ABA creates the vital relationship between therapist and child. This relationship allows for successful interventions. For the therapist, this learning stage allows them to understand what motivates your child. These understandings enable important clinical decisions that will create more impactful and vibrant behavioral results.

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