The word “Functional:”We sorted the goals from certified SLPs based on FOURC model components.
As you can see below, the vast majority of goals were written as Skills & Abilities or certain types of Intentional Strategy. Environmental Supports and Motivation & Confidence were rarely addressed. Only 5% of goals included an explicit communication outcome (Communication Goal). Of the 12% that were combined, most included Skills and Abilities and Intentional Strategies.
The word “Functional:”It was used in 26% of the Skills and Abilities goals in reference to: objects, words, phrases, communication, reading, tasks, sentence completion, settings, item, skill, material, contexts, yes/no questions, need, activities, mathematical calculations, one-step commands, speech, language tasks, questions, picture scene, prompt, writing skills, living environment, activities, social setting, scripts, rote language tasks, social situations, story, actions.
“In some settings, I have used the language from the FIM to guide goal writing”
“I find it helps to situate a goal into a long term goal of something like managing own health care or safety at home”
“At our aphasia programs, we always develop roles to go with the goals. For example, if the goal is to practice single word greetings, the role would Aphasia Program Greeter and we would have that person hand out name tags, while getting support and cueing from other group participants to say “Hello, how are you_______(Name)?”
“I typically write my goals with the level of assistance required to complete the functional skill working from Max(100% assistance) -mod (50% assistance)-min (25% assistance) -modified independence (using compensatory strategies independent) and finally no assistance”
“I want to learn how to incorporate the safety needs with aphasia patients along with the skill building required in order to increase overall language skills”
“EMRs often have restrictive character limits–this is very frustrating and my overall goal writing ability has suffered as a result”
“The challenges I encounter most are related to teaching graduate students about the different methods and techniques in a systematic manner so that they have tangible and understandable information to apply to clients with aphasia.”
“It is challenging to write goals that demonstrate caregiver involvement to improve functional communication”
“Love the idea of a goal pool. It’s interesting to see what others are working on in aphasia. It’s also great to have some more structured resources to share with students. I find it hard to teach and describe goal setting as it’s such an informal procedure”
“I would love to collaborate with other SLPs on functional activities for people returning to their lives and living with aphasia”
“Developing a database of rating scales would be extremely useful”
“I struggle with making goals functional, yet achieve able to their abilities, given the time I see them for therapy”
“SMART and SMARTER goals listed on the Australian aphasia pathway along with ASHA leader article are very helpful”
“It’s tough to find the balance between realistic and truly measurable goals (that you can really know when you’ve met them) and functional goals that are less structured. I always think about this when I am writing my goals and I think this is a great project and undertaking!”
“Goal writing is a challenge especially at the start of treatment before you really know a patient and capabilities”
“Goals need to be specific and be functionally relevant for that particular patient and his/her primary communicative environments”
“My greatest challenge is to get clients to respond to question ‘What goal is most important’ with something more specific than ‘I want to talk'”
“As you move into conversation and you are teaching strategies, like SFA, performance goals can feel very artificial because you can’t genuinely control the number of times a client may need to use a strategy”
“While I try to find alternatives to measuring outcomes by standardized tests only, I find alternatives, like GAS, a complex approach to teach new clinicians and haven’t seen a good teaching tool to assist acquisition of this approach”
“I find setting goals for communication is often speech pathologist led as clients tends to want to improve communication overall but not specifically”
“When trying to attach numbers to goals, I feel like I get trapped into writing impairment-based goals that I can measure in the clinic setting”
“Challenge is writing participation or activity goals that are reimbursable”
“I want to know that my goals are meeting Medicare and third party payor guidelines, as well as meeting patient needs”
“I want to make sure the goals are specific enough and indicate the needed compensatory methods, not just a FIM/FOM label of assist”
“The most challenging aspect regarding goal intervention in aphasia is writing SMART goals to include community reintegration and facilitate motivation and language recovery”
“Being called upon to write initial goals after first evaluation sessions, goals can be added later, but setting initial goals based on 1 hour visit, is often challenging”
“It is challenging to find an appropriate balance between treatment goals that target restoration of speech and those that target the use of compensatory supports like augmentative and alternative communication”
“Initial goal writing tends to be broad and overly general until I get to know the patient better and then can refine the goals and tailor them to patient needs.”
