Yes, it’s just like that…except not
quite.
The goal of rapport building and
pairing during ABA therapy is to develop a caring, fun, positive relationship with
the client so they find you reinforcing. Not the toy
you have or the bubble machine you just turned on, but you.
This goal isn’t always easy to accomplish and there will be times when even after you accomplish this goal you have to start over again. Like after the client has been on vacation and hasn’t seen you in a month, or if the client is feeling ill or on medication (if the client has a stomach virus when they see you, inadvertently you could become paired with them being sick/feeling terrible).
This goal isn’t always easy to accomplish and there will be times when even after you accomplish this goal you have to start over again. Like after the client has been on vacation and hasn’t seen you in a month, or if the client is feeling ill or on medication (if the client has a stomach virus when they see you, inadvertently you could become paired with them being sick/feeling terrible).
A great technique for having a cooperative learner during a therapy session is called “Demand and a Promise”. This
technique can be used across settings, and it’s very easy to learn.
I’ll also include another bonus tip at the end of this post.
Quick
Note: This technique is more helpful for a client who may be having a bad day, going through a regression of behavior, or your pairing
relationship may have weakened recently. If you are working with a client who
is defiant and resistant on a regular basis, I wouldn’t recommend using
this technique. Instead I’d recommend you use 3 Step Prompting.
The idea behind this technique is simple: When you present a demand to the client you are “promising” them a specific reward in advance, for their cooperation and completion of the demand.
The demand and a promise technique makes your demand
more interesting because of the promise attached to it. I typically
use this technique to help with the transition at the start of the session into the work area, which for many clients can be the toughest part of the session.
(You don't need to use an index card, that's just for illustrative purposes)
Here’s what the technique looks like:
Procedure:
1. Approach the client as he or she is
engaged in a preferred activity, such as on a break with their iPad. Present a simple demand
to do something else, like “Come with me”. Make sure that you are close to the client when you place the demand as you will be providing
prompts/guidance if necessary.
2. As you deliver the demand show the
client an open palm holding a highly preferred reinforcer.
3. If the client begins to cooperate with
the demand and does not engage in problem behaviors give them the reward immediately. If
the client does not begin to comply or begins engaging in problem behaviors,
close your hand around the reward and use prompting to finish out the
demand.
Notice the wording “begins to cooperate”.
With this technique you provide reinforcement before the full demand is
actually completed. If you told the client to clean up, then once they start picking up toys, you give them the reward.
If the client says “no”, walks away from you, or ignores the demand, you guide
or physically prompt them to go sit down and they lose the reward. What is actually being targeted here is initial (and prompt) compliance with a transition into demand.
A very common question I get from
therapists about this technique is “What do I do if the client takes the
reward, and then runs off and goes back to play?”
Yes, this may happen: Before implementing demand and a promise get in super close proximity so if the client bolts after taking the reward you are able to immediately block escape and prompt completion of the task.
Yes, this may happen: Before implementing demand and a promise get in super close proximity so if the client bolts after taking the reward you are able to immediately block escape and prompt completion of the task.
**Bonus Tip: Another strategy I use is I remove the task from my
demand.
Instead of saying a task statement like “Go clean up the toys”, I say something like
“Come with me/Follow me”. Once the
client follows you to where the toys are instead of saying “Pick those up”, say
“Sit down”. Or you can just sit down yourself and say “Do this”, so the child
will imitate you and sit down. Depending
on how strong the client's imitation skills are you can start picking up toys
and see if they copy you, or you can present the demand like a question. Such
as “Where does this go?” as you hold out a toy. If needed, prompt the client to
put the toy away. Continue until all the toys have been put away. This
technique is a way to subtly embed demands while building upon previous compliance, similar to Behavior Momentum.
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