I get emails pretty frequently from people who are new to the field of ABA. If you are making the switch to being an ABA Therapist then its pretty normal to have lots of questions about what to expect and how to approach the job. Especially if you work directly for a family, you probably wont get much information about the first day and what you should/shouldn't do. Many families believe that the ABA professional will show up on day 1 knowing exactly what to do. However, the truth may be that you're nervous or a bit confused about what you should be doing.
There are SO many settings an ABA therapist can work in, from the classroom, to an agency, to directly for a family. I will try to be all-inclusive, but some of this information may not apply to certain settings. For example, if you start a new job with an ABA agency then typically your first day will be some type of training or orientation, and it can be anywhere from a few days to a couple of weeks before you actually start working directly with clients.
I will mainly talk about new ABA therapists who are going to work with a client in the home setting.
Below is a general list of tips. This is information that I wish someone would have shared with me when I first entered the field of ABA. I hope its helpful!
- Do Your Research- If at all possible, observe the client during 2-5 therapy sessions (across multiple staff) before you start working with the client by yourself. This is sometimes called Shadowing, and its when you are paired up with another therapist and follow them around as they go into the field to work. Despite what some agencies/companies may think, Shadowing is not the same as Training. Simply shadowing someone for a few days does not mean you will necessarily be ready to work with the client by yourself. During your first few days, ask TONS of questions, review the program binder and Treatment Plan, and pay attention to how the client interacts with current therapists. As the new kid on the block you can pretty much expect to have all sorts of testing behaviors thrown at you, so its always helpful to know what the client looks like on a good day. You also want to observe transitions and down times during the therapy session. If the current therapist starts every session by playing a DVD and giving the client grapes, there's a good chance the client will expect you to do that too. The current therapist is a valuable source of information to you, as they already know the client very well. Its one thing to sit and observe a session, but when you are responsible for running an entire ABA therapy session all of a sudden ABA doesn't look quite so easy. Be patient with yourself, and understand that there is a learning curve.
- Establish rapport- Pairing is taking the time to establish rapport with the client, and to approach them with the items/objects they find highly enjoyable. This process should occur prior to formal instruction. I typically tell new therapists to spend their initial sessions pairing, and running mastered programs. You want to build a positive relationship with the client and take time to learn their personality and strengths. Pairing is essential because it makes the child want to be around you, and it makes escaping from you less desirable. Ask caregivers or current therapists what the client LOVES to do, and then do those things with the client. One of my very first clients used to love to go to a neighborhood park. He rarely got to go because all the other therapists came at night. Well, as the only mid-morning therapist I took that child to the park every single day. Over time this child associated me arriving to his house with his favorite activity, and we had a great paired relationship. You can use activities, tangibles, or edibles to pair with the client. You could also use people, such as playing with the child while he sits on Mom's lap. Be careful when using people though, because it can be hard to separate the client away from Mom when its time to start working.
- Meet The Parents/Caregivers- When you initially start working with a new family, use that time to familiarize yourself with the household routine, rules, and get clear answers about the family's expectations of you. Ask the simple questions (Where does the family want you to park? Where are reinforcers stored? Does the family have pets?) as well as the bigger questions (What other therapies does the client get? Is the client aggressive at all?). On day 1, its a good idea to ask for a tour of the home. It is helpful to know where the closest bathroom is located, where the child's bedroom is, where favorite goodies are stored, etc. Familiarize yourself with the therapy materials, and ask the parents how they want things organized. I have had families ask me not to park in their driveway, to remove my shoes in certain rooms, or inform me about a loose back door the client may try to bolt out of. All good information to have!