Articles by Day: November 15, 2021
Those trained to provide ABA Therapy will understand well the concept of “pairing.” Play and pairing is the foundation of instructional control in any behavioral therapy session. Simply put, pairing is a way for ABA therapists and technicians to help build a rapport with a child by finding out what interests them and then linking whoever is working with the child to that interest/activity/object so that we can facilitate positive reinforcements in each session. It’s a means of letting the child guide us to what motivates them. When we know what that is, we use it as a positive reinforcer for expected behaviors.
So for example, a child who is new to ABA therapy will begin with a few “pairing” sessions with their ABA therapist/RBT (registered behavior technician). This is a time when we simply play together, we’ll let the child lead, allowing free access to toys, games, songs, and other stimuli. It may look like we’re just “playing,” but remember two things:
- Play is how kids learn.
- By discovering what they love to play with, we can help motivate them to learn important skills and promote helpful behaviors.
Let’s say the child falls in love with a toy train set. We then restrict play with that train set to only our sessions. The child earns play with the trains as a positive reinforcer for expected behaviors.
Speech therapy uses a similar technique in motivating kids to talk. Such toys are so-called “communication temptations,” something we’ve written about extensively in prior speech therapy blog posts.
Pairing is also important because it lets the child and therapist establish a positive, trusting relationship where they come to understand that even when learning can be challenging at times, it’s also fun and ultimately benefits them (by giving them what they want). Parent input during pairing is very important too! We will spend time interviewing caregivers about what their child is really into, and we can then build on those ideas.
From there, we’ll work on trying to teach mands/requests. (Think of a mand as short for “demand.” It’s how a person requests something. For example, we may hold a piece of that toy trainset or car until he/she asks for it or a turn with it.
A child may avoid eye contact for a number of reasons, but it’s something to really pay attention to because it’s one of the earliest indicators of autism spectrum disorder (ASD). Infants who avoid eye contact with their parents – something that can be observed in a baby as young as 3 months – need to carefully monitored and assessed if the problem persists. Most babies start making eye contact no later than 6 months of age. If this is something you’ve noticed, it’s imperative to talk to your pediatrician about a potential referral for ADOS testing. If you already know your child is on the spectrum and is struggling socially, our Fort Myers OT (occupational therapy) team has some strategies that may help improve eye contact.
When Should My Baby Be Making Eye Contact?
Babies start using eye gaze to regulate behavior at around 5-6 months of age. By around 7-9 months, they use eye gaze to initiate joint attention. Joint attention is when a person purposefully coordinates his/her focus of attention with that of another person. In other words, two people are intentionally paying attention to the same thing for social reasons. If you say to your child, “Look at that big ball,” and the child looks to where you have pointed to see the ball. You’ve just engaged in joint attention. Kids on the autism spectrum struggle with joint attention, as it’s considered a social skill. Difficulty with joint attention can lead to or at least be closely correlated with developmental language delays.
As our Fort Myers OT professionals can explain, most toddlers will pair eye contact with their gestures at least half the time when they’re communicating. When kids struggle to pair their gestures or words with an eye gaze, it could be a red flag. For a child with social-communication deficits, consider that it can be really difficult to listen to someone talk, understand what they are saying and look at them at the same time.
Even as they get older, kids with autism may be apprehensive about establishing eye contact because they don’t have the ability to communicate. Some kids on the spectrum require a great deal of concentration to make and sustain eye contact. It’s important for parents not to force their kids to have eye contact, as this could result in frustration and anxiety. Instead, there are tactics we as occupational therapists can use in sessions and teach you for carryover.
Fort Myers OT Tips for Encouraging Eye Contact
With patience, positivity, and encouragement, you can help your child make and maintain eye contact. It can be difficult at first, but know that working on this skill is something that is not only going to help them in the short term, but long term when it comes to making friends and succeeding throughout life.