Building rapport is especially important during your first several sessions with a patient. Here are some ways to build rapport with your patient:
OK, I understood that one.
Jacob's not in here. He can't help you. Uh-oh, where's Landon? I don't know. Landon's hiding. Is he in the foam pit? No, not in there. No!
Where we going?
Where are you going?
Oh, the big old shark is going to get you. I'm going to swim and get you. I'm going to get you. I'm going to get you.
More shark. OK, ready? Ah! More shark. Ah!
Check in with caregivers or staff on starting the ABA session, in the following ways:
EXAMPLEHow is their day going? What are some recent successes or challenges?
EXAMPLEHow did the patient eat or sleep?
Every time we asked him to do anything, he sat down, and sort of not-- violent is the wrong word, but roughly, to where he almost threw his head back on cement a couple of times, where I grabbed his arms and lowered him because he was going to throw his head back, I thought. I have some tools that I use from you guys. None of them worked to--
Was he just having a bad day from the get-go?
I think it was more energy. You know what I mean? He's cooped up, and then, there's no way I'm doing what you're asking me right now. I'm glad I got to see Elan. I think he just was like, I'm not doing what you do. I'm going to play right now. And so we even tried that, to differentiate, if you go on the lawn, you can play. But you're going to walk with me, and then you can play.
OK. That didn't work, did it?
No, it did not work. It was sort of a setback in my mind. I hadn't seen this behavior. I had no idea what to do.
Oh, OK. Well, what I'll say-- we're here.
So not to make it dire, but yesterday, to me, was sort of a rough day. It was surprising to me. I know I make a lot of mistakes when I'm with him when he does stuff like that. But I know somewhere in here, the tools are there. But yesterday I was--
--they just all went out the window, because he was just--
He didn't listen to you.
Nothing was working. He was the boss yesterday. I couldn't figure it out.
Prepare the physical environment for the fluid implementation of the ABA therapy session programs and to prevent pauses or interruptions by doing these tasks:
In order to help reinforcement be as effective as possible, sometimes we need to look at making changes to the environment where therapy is taking place. This may be something as simple as maybe better organizing the room where toys are located. If a child or a student has free access to lots of motivating or fun toys, then it may be hard to keep their attention. So one easy thing that you might want to do is looking at maybe better arranging the area where therapy is taking place.
You may also need to consult with your supervisor if, when you arrive for a therapy session, the individual is already engaged in highly preferred activities, such as watching a movie or swimming in the swimming pool or eating a very preferred snack. These might be things where we need to help the parents prepare the student a little bit more effectively for therapy. We may want to ask the parent to reserve certain reinforcers just for therapy or after therapy or maybe even restrict certain activities maybe 30 minutes to an hour prior to a therapy session starting.
Now, these would be things that you would want to do in collaboration with your supervisor. However, if you're regularly showing up to a client's house or getting ready for a therapy session and you're having a hard time motivating that student or that child because of activities that they already have access to, this might be a helpful tool that you can use as a therapist to make your sessions more effective.
Review notes from previous sessions, including the following: