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The Luxury of Pairing

Janine Shapiro, Co-Clinical Director of Access Behavior Analysis

Working in the ABA world as a speech-language pathologist, I realize I’m lucky.  I’ll go further:  I’m spoiled.  I used to rejoice when a third party payor authorized sixty half-hour sessions of speech-language therapy across a one year period.  Today, I’m accustomed to designing programs for clients that target speech and language for between twenty-five and forty hours per week!  The benefits of intensive services are numerous and are well-documented in the scientific literature.  Perhaps the greatest advantage of the gift of time is the opportunity to pair with clients.

What is Pairing?

I tell parents new to ABA that the first week or two of ABA therapy, that is, the first fifty to eighty hours, will be devoted to pairing.  Pairing is the association of a child’s preferred items and activities with the therapy clinic and the therapist.  During pairing, very few instructions are given to the child.  Instead, the therapist follows the child’s lead to find out what he enjoys.  At every opportunity, the therapist tries to enhance an activity’s fun quotient with her presence.  The goal of pairing is that the child will want to work for the therapist and will, therefore, be an active, happy, and engaged learner.

A therapist may be smart and the treatment plan may be exquisitely tailored to the child’s needs, but if the child refuses to engage with the therapist, then efficient learning won’t occur.  A child should get excited as the parent pulls into the parking lot of the therapy clinic.  We want the child to run towards his therapist with a smile on his face.  Of course, based on a child’s history and age, pairing will take longer with some children than with others.  And it’s always a work in progress.  Pairing should occur throughout a child’s day at therapy every day.

An Investment of Time

Back when I only received thirty hours total of therapy per year with a child, I felt compelled to immediately dive into therapy.  On day one, I brought out the flashcards and the tongue depressor, and I hit the ground running.  While it seems counterintuitive at first, had I simply delayed targeting speech and language goals and focused my first few sessions on pairing, I’d likely have made even more progress with my clients.  Pairing time isn’t wasted time.  It’s an investment that lays the foundation for more productive therapy.

Watch the video below to learn more about the science and importance of pairing!

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