Pairing in ABA: What the First Weeks of Therapy Should Look Like

Pairing in ABA is the process of building trust before teaching. In the first sessions, the therapist links themselves, the therapy space, and the materials with things your child already loves, so your child comes to see the therapist as the person who makes good things happen. Only then do they start asking your child to work.

Parents sometimes see a therapist sitting on the floor building block towers and wonder what they are paying for. This post explains what pairing is, why it matters, what it should look like, and how to tell whether it is going well.

What is pairing in ABA therapy?

Behavior analysts define pairing as embedding the therapy setting, the therapist, and the materials with preferred items and activities. In the words of a 2017 study by Lugo and colleagues, the aim is for the therapy context to signal that things are about to get better, not worse.

That matters because therapy involves asking a child to do hard things. Researchers note that a teaching setting can become something a child wants to avoid, which shows up as running away, refusing, or challenging behavior. Pairing is how a team prevents that from the first day.

It is not a one-time warm-up. Most good sessions start with a few minutes of it, and the therapist keeps delivering good things all through the session.

Why pairing comes before teaching

Children learn more from people they want to be around. That sounds obvious, and the research backs it up.

• In a 2019 study, Shillingsburg, Hansen, and Wright moved four autistic children who were starting intensive therapy from child-led play to structured teaching in nine gradual steps. The children made the move with minimal problem behavior, stayed in their seats, and stayed close to the therapist.
• In a 2015 study by Kelly and colleagues, three children whose challenging behavior was about escaping demands had less of it when sessions started with two to four minutes of play with a favorite item.
• A 2019 study let a 4-year-old choose how sessions began: with pairing, with free play, or with teaching right away. She tended to choose pairing.

Pairing has limits. A 2020 study that trained therapists in a pairing routine found only a very small effect on how fast children learned new life skills. Pairing mostly helps with cooperation and behavior. It makes teaching possible, but it does not do the teaching. A program that is all pairing and no teaching is not working either.

What good pairing looks like

The 2017 Lugo study broke pairing into seven skills that therapists can be trained in. You can watch for them yourself:

• Staying close. Within arm’s reach, on your child’s level.
• Specific praise. “You stacked the red one on top!” rather than “good job.”
• Echoing your child’s sounds and words.
• Imitating your child’s play. If your child lines up cars, the therapist lines up cars.
• Describing the play. Narrating what your child is doing, like a friendly sportscaster.
• Offering things. Handing over a favorite toy or snack before your child has to ask.
• Making the activity better. A ramp for the cars, a bubble machine, a silly voice.

During this stage the therapist also gives freely. Your child gets access to favorite things without having to earn them, and there are few or no demands at first. Over the following sessions, the therapist adds small, easy requests into the play, like “Hand me the blue car,” and makes sure following them leads to something good. Then the requests grow.

The study also found something worth knowing: in baseline, every staff member used each pairing skill at least once, but none used them well enough to meet the standard until they had training and feedback. Pairing is a skill. It is fair to ask how your provider trains it.

How long does pairing take?

No study sets a standard length, and you should be wary of anyone who gives you a fixed number. In the 2019 study, each child moved through the nine steps at their own pace, based on how they responded.

In practice, some children warm up within a few sessions. Others need weeks, especially children who have had hard experiences with adults placing demands, including in a previous ABA program. What should be clear from early on is the plan: what the team is watching for and what comes next.

Signs that pairing is working

The studies measured things you can see from across the room: whether a child moves toward the therapist, stays near them and the activities, and shows less problem behavior. Behavior analyst Greg Hanley’s practitioner framework adds a useful shorthand, happy, relaxed, and engaged: content and not trying to leave, calm, and interested in the activity or person.

At home and at drop-off, look for:

• easier arrivals, or your child heading toward the door or the therapist
• your child bringing the therapist a toy, or asking for a game they play together
• more smiling, laughing, and relaxed body language during sessions
• small requests accepted without protest, and then bigger ones
• the therapist being able to tell you what your child loves, in detail

Red flags

• Demands from day one. A therapist who starts with flash cards at a table before your child knows them is skipping the step that makes teaching work.
• Your child is trying to get away. Hiding, running to you, crying at the sight of the therapist, or new challenging behavior when sessions start are signs your child is not comfortable.
• Favorite things are kept out of reach. Holding back preferred items so the child has to work for them, before any trust exists, often backfires.
• Play with no plan. If weeks pass with play but no teaching, and no one can tell you what the pairing goals are, ask.
• Distress is pushed through. Your child’s “no” matters.

That last point is in the professional ethics code. The BACB’s Ethics Code for Behavior Analysts requires behavior analysts to obtain assent from clients when applicable. It defines assent as vocal or nonvocal behavior showing willingness to take part, from people who cannot give formal consent. For a young child, turning away, pushing materials off the table, or crying is information. A good team notices it early and changes something. If you see the opposite and nothing changes after you raise it, our post on how to switch ABA providers may help.

Re-pairing after changes and breaks

Trust built with one person does not automatically transfer to another. Re-pairing is often needed when:

• A new therapist joins the team. Ask for overlap sessions where the current therapist works alongside the new one, and for a written list of what your child enjoys.
• Your child comes back from a break. Holidays, illness, or a gap in authorization can mean starting with more play and lighter demands for a few sessions.
• Something hard happened. A session that ended badly, a scary medical visit, or a big change at home can make a child more cautious.

No research gives a timeline for re-pairing. This is clinical judgment, and your BCBA should tell you how they plan for it. Changes in staff are common in ABA. Most technicians are Registered Behavior Technicians, and the BACB requires that a BCBA or BCaBA supervise at least 5% of an RBT’s service hours each month, with at least two face-to-face contacts, one of them observing the RBT with a client. A good supervisor watches pairing closely during the first weeks with any new therapist. Our BCBA guide covers what that supervision should look like.

Pairing is something parents can do too

The same skills work at home. Follow your child’s lead, imitate and describe their play, and hold back on questions and instructions for short stretches each day. Our post on how to play with your autistic child covers this in more detail, and our parent training program can coach you through it.

How pairing starts at Orchid

At Orchid, the first visit is the assessment, and we start the way pairing does: meeting you and your child and watching your child play, with plenty of their favorite things on hand. When challenging behavior is part of the picture, our team uses Practical Functional Assessment, which reacts to early signs of distress instead of waiting for behavior to escalate. Our post on the ABA assessment explains the first visit in more detail.

Orchid runs academies for children ages 2 to 15 in Issaquah and East Wenatchee, school-based ABA in Kirkland and Sammamish, and in-home ABA across the Eastside, South King County, and the East Wenatchee area. If you want to see what the first weeks would look like for your child, request a call back or read more about ABA therapy at Orchid.