Make It Work: Write Targeted Treatment Goals Use these tricks to set goals that your client can hit—and that you can measure. Make It Work
Make It Work  |   November 01, 2013
Make It Work: Write Targeted Treatment Goals
Author Notes
  • Irene Torres, MS, CCC-SLP chair of ASHA's Multicultural Issues Board, is a clinician in New York City. This article was adapted from one of her posts on ASHA's blog, ASHAsphere. She concentrates primarily on infant and preschool evaluations and supervision of graduate students. She is an affiliate of ASHA Special Interest Groups 11, Administration and Supervision; 14, Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations; 16, School-Based Issues; and 17, Global Issues in Communication Sciences and Related Disorders.
Article Information
Development / Speech, Voice & Prosodic Disorders / Telepractice & Computer-Based Approaches / Make It Work
Make It Work   |   November 01, 2013
Make It Work: Write Targeted Treatment Goals
The ASHA Leader, November 2013, Vol. 18, 26-27. doi:10.1044/leader.MIW.18112013.26
The ASHA Leader, November 2013, Vol. 18, 26-27. doi:10.1044/leader.MIW.18112013.26
One of the most challenging things for new speech-language pathologists seems to be writing treatment goals. These goals should drive treatment, so they are important—but there is more to them than that.
We want goals to organize our treatment and make it more linear, more hierarchical. We want our goals to be read as a path to development or recovery: First do this, then move to this, and then go on to that. This process is, after all, the essence of task analysis.
Speech and language development or recovery, however, is not linear or even, in many instances, hierarchical. It is so much more—but that is for another article. We also want our goals to address the clients' most important needs and, in some cases, we are hard-pressed to figure out just what is most important. We also need to have our goals fit in with guidelines that our employers set and that often change frequently.
When writing goals, keep in mind that goals are supposed to be SMART: specific, measureable, attainable, relevant and timely. One of my pet peeves is goals like this one: "The client will improve his receptive/expressive skills." This goal is not SMART: It is not specific and, more important, it has no measurable component. In a report, you might say, "To improve his receptive/expressive skills, the client will ... " But those sentences are not goals and certainly are not SMART goals.
Many websites offer sample goals, but I have never found any to be just quite right—they all need to be tweaked for the client. You can certainly refer to goals on those websites, but you have the skills to write your own.
You can use a template such as: "(Name) will improve (skill) by (number) to (number) percent above baseline or (number) percent of the time as measured by (type of assessment)"—or some such formula—but you need to fill in everything from your own mental data bank. You can do this easily—and end up with SMART goals—by answering some simple questions you ask yourself.
Goals are not a separate entity—they just put what you want to do in treatment in writing. Ask the following questions for a start for your specific goals.
  • What are the client's communicative strengths and weaknesses?

  • What skills contribute to the strengths?

  • What skills are deficient and therefore contributing to the weaknesses?

  • Which of client's skills can be used to compensate for deficiencies?

  • Which skills can I actually help the client attain?

  • What do I want to work on first? And now answer: Why do I want to work on that first? That answer will help you determine if you have made a viable choice.

  • What tasks will I have the client complete or engage in to work on the skill?

  • What supports will I provide for the client?

When you have the answers to those questions you have the "specific" for the goals.
Can you define the skill that will determine if the client is doing what you want him to do and can you measure progress in that skill? How will you measure progress? When will you consider the goal accomplished? If you can answer all these questions, move on; if not, go back and adjust the goal to something you know you can see or hear and, therefore, measure.
Do you think the client can actually accomplish the goal in a year? If the answer is yes, move on. If the answer is no, go back and choose something you think the client can accomplish within a reasonable timeframe.
Will attaining this goal serve a communicative function for the client or will it just be something you can do with the client? Will it serve a purpose in the client's life, taking into consideration the limits and ramifications of the diagnosis and the client's cultural and social needs? In the case of an individualized education program, does this goal serve to move the child along to fulfill the Common Core standards? If the answer is yes, move on. If not ... yes, you get the picture, go back and start again.
Does the goal contain a timeframe or a date for accomplishing the goal? And can the goal be attained in that time frame? Short-term objectives need to follow the same criteria. They should not just be separate pieces of the overall task, but rather steps to getting to the long-term goal.
What best facilitates treatment is knowing what you want the client to do and knowing that your treatment is actually addressing this objective. This knowledge also facilitates goal-writing. Use it to write your goals. You have the skills. You need to convince yourself that you can use them. When you keep that in mind, goal-writing can be simple.
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November 2013
Volume 18, Issue 11