What is Pairing?
In the field of ABA therapy, the term “pairing” often refers to the process of building a positive therapeutic relationship between the therapist and the child. It’s about creating a genuine, positive connection where the therapist and child build trust and connection. Pairing is an essential first step in any therapeutic activity, including an ABA therapy program. Developing a strong, positive relationship helps set the stage for successful learning and skill development.
Why is Pairing Important?
Before any meaningful teaching and learning can occur, a child needs to feel comfortable, safe, and engaged with their therapist. The process of pairing and relationship building helps clinicians achieve this by:
- Building Trust: through play, positive interactions, following the child’s lead, minimizing instructions/demands, and responding to the needs of the child warmly, the therapist can begin to establish a trusting relationship with the child
- Creating Motivation: by associating the therapist with preferred activities and a sense of fun and safety, a child can be motivated to engage in therapy sessions with the clinician, because those therapy sessions are fun, positive, and affirming
- Reducing Anxiety/Stress: a strong, positive relationship with a therapist can help reduce anxiety or stress that a child may feel during therapy sessions as they are presented with new challenges and goals to work toward
How Does Pairing Work?
Pairing involves spending time with a child during which there is not a focus on presenting demands, instructions, or adult-directed tasks. Instead, effective pairing can be achieved by focusing on activities the child enjoys. This might include:
- Playing games: a therapist follows a child’s lead in their favorite games, showing genuine interest and enthusiasm
- Engaging in preferred activities: a therapist participates in activities the child enjoys, such as reading books, building with blocks, or drawing. Sometimes, the therapist and child engage in these activities together and sometimes they engage in them separately, but alongside each other!
- Offering preferred items: a therapist provides access to toys, activities, and other interactions that the child prefers
- Using positive reinforcement and encouragement: a therapist provides frequent and meaningful praise, encouragement, and other forms of positive interaction to the child
Pairing Beyond the Initial Stages
While pairing is especially important at the beginning of an ABA therapy program, it is an ongoing process! Therapists continue to build and maintain relationships with their clients throughout the course of their therapy program. Ways that therapists can continually build positive relationships with their clients include:
- Regularly considering the child’s preferences: a child’s interests and motivations change over time, so it’s important for clinicians to continually assess and adjust activities as preferences shift
- Incorporating choice: a therapist can provide the child with choices throughout the therapy sessions and this can increase the child’s sense of control, autonomy, and engagement
- Being responsive to the child’s needs: a therapist who continues to honor and build a positive relationship with their client pays careful attention to the child’s cues and adjusts the pace, activities, and goals of the therapy session as needed
A GentleCare Clinician’s Perspective:
What tips would you provide to a new behavior therapist or RBT who may have limited experience with the pairing process?
When starting as a technician, building a relationship with your client is a crucial part of long term program success. However, with limited experience, it can feel daunting to begin forming a connection with your client.
In order to build a relationship with a client, be sure to be as communicative as possible with them. Verbally engaging with your client no matter their level of functional communication is a great starting point to begin building rapport and increasing engagement with your child. Aim to make your language clear, concise, and kind in tone to ensure your client feels comfortable when you speak to them.
To increase engagement, you may choose to verbally describe qualities about the items the child is playing with, model or describe the items function, or describe the actions and feelings your client is displaying. Secondly, be sure to play with your client in ways that are approachable to them for their skill level, and remain engaged with them for the duration of your session. This could mean sharing in joint attention to a visual fidget toy, playing peek-a-boo, or putting together a puzzle.
Engagement will look different for every case! Every glance, smile, or shared item is a sign of successful pairing. While playing and throughout session, practice having a smile on your face and relaxed body language, or bring yourself to their level when you speak to them. Finally, be sure to have fun and stay creative! Encouraging your learner to explore their interests and providing those interests to them is a key part in building client/clinician relationships! – Dezirey S., Lead RBT
