Imagine a trip to the dentist or doctor’s office when you already suffer from heightened sensory experiences or are unable to communicate. Would that environment feel comforting or would you fear the worst?
What if you were suspected of criminal behavior when you are simply engaging in self stimulatory behaviors with odd patterns? Imagine being told to comply with complex demands you do not understand and people quickly approaching you.
That would be quite frightening!
For individuals with autism, some experiences can result in scary or dangerous outcomes. Therefore, it is important people learn more about how to build relationships with individuals with autism. Relationship building starts with rapport, or a close bond in which individuals understand each other’s perspective and communicate well.
According to the DSM-V, one of the many diagnostic criteria for individuals with autism is impairment in social relationships. The impairments are described as “Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.”
These deficits present unique problems for individuals with autism. Not only are peer relationships troublesome, but many individuals may also experience problems with adults, medical professionals and figures of authority.
How to build rapport with clients
For treatment professionals such as therapists and doctors, building rapport is crucial in treatment success. Without rapport, the client is likely to become disinterested or refuse to engage in treatment altogether. The ability to meet clients where they are, engage them in their preferred interest, and work to communicate in a way that is effective is the goal.
When thinking about individuals with autism, what does that look like? Perhaps you have items or toys available that the individual loves or tends to gravitate to when attending a session or appointment. You may sit and allow them to play before making requests of them to perform an action or allow a medical procedure. For nonverbal individuals, you might offer visual supports or pictures to help the client communicate. We teach our therapy staff and parents how to build rapport through a process called pairing.
What is pairing?
Pairing refers to pairing yourself with reinforcement. You want the client to see you as a source of reinforcement. This is done through interacting with the client for a time that is oriented around fun activities and play that the client chooses. Follow their lead and watch what they like to do, play with, manipulate and join in the fun! Play alongside the individual and refrain from making demands of them or giving instructions. Start each therapy or appointment in this manner and gradually fade in mild requests, working up to more difficult or unpreferred requests as sessions or appointments progress.
Relationships are a two-way street. Building relationships with anyone takes time and thoughtful effort. For individuals with autism is may take longer or require more attention to the details, but is an invaluable skill once they have acquired it. Be patient. Remember that the end goal can improve their quality of life, increase their safety and provide them with potentially missed opportunities.
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