Clinic Objectives 

Working on writing objectives will be closely guided by your clinical supervisors in your first year. Writing objectives that are meaningful and make sense to both professional and client audiences is a complex process. There are many right ways and few things that are just not okay. The information below will get you started!

FRAMEWORK FOR WRITING OBJECTIVES 

CONSIDER THE EBP TRIANGLE 

What are the client’s goals/concerns? 

What does the research say?

What do I know based on academic knowledge and past clinical experience? 

from ASHA: https://www.asha.org/research/ebp/

Get started by asking the following questions:

1. Who? Objectives are always written about the client or occasionally about the caregiver if you are training the caregiver to do a specific task or provide support, but never about the clinician

• The client will.... 

• The caregiver will.... 

2. Will do what? At this point you’ve narrowed down your assessment, done some additional dynamic assessment and chosen some specific, functional tasks. Those go here. 

Use word finding strategies (e.g. circumlocution, association cues, pausing) Use his AAC to make a request

Use visual aides to follow multi-step directions

Use apraxia modification strategies (e.g. slow rate, single syllable words) 

3. How will you measure progress? How will you know when the goal is met? 

This should be based on your baseline probe data. What is your client able to do now without support? Based on your best clinical judgment, what will they be able to do by the end of the term? “with 80” accuracy” is very popular, but not always the most appropriate or easiest to track. Also, consider your target, for Y/N questions 80% accuracy isn’t good enough. Here are some other options: 

In 3 out of 4 opportunities 

For 5 minutes

For 2 conversational turns

At least 3 times during a 10 minute conversation 

4. Will they be able to do this independently by the end of the term? If not, you need to include an additional level of support in the objective. 

Given a visual prompt from the clinician Given a verbal cue from his caregiver

In a structured 1:1 activity 

Now it’s your turn: 

Who?

In what context?

Will do what?

How will you measure progress? 

How will you know when the goal is met? 

Will they be able to do this independently by the end of the term? 

Pediatric Clinic Objectives 

 There are several types of objectives you could be working on with your clients. Some examples are:

Language: questions, narrative, syntax, vocabulary, communication functions, literacy, etc....

Social communication and/or engagement: imitation, eye contact, joint attention, etc...

Speech: shaping sound production, functional phrases, generalization of sounds in running speech, etc....

 When determining what to work on, clinicians need to take the following into consideration:

• Typical development? Don’t expect more than is expected of their typical peers

• Emerging skills (e.g. if they are requesting objects occasionally)

• Family preferences

• Results of assessment

• Baseline observations

• School benchmarks

• Sense of the child’s learning rate?

Pediatric objective examples:

Your objectives will include the following components:

1. Condition

2. Participant

3. Behavior

4. Criterion

5. How measured?

While looking at a book (condition), Sammy (participant) will answer What and Who questions (behavior)in 80% of opportunities (criteria) as measured by probe data (how measured).

While engaged with the clinician (condition), Sammy (participant) will link 2 or more related actions in a pretend play sequence (behavior) in 4/5 opportunities over 2 sessions (criteria) as measured by intervention data (how measured).

Scaffolding and support:

 Include this in your lesson plan procedures. You need to collect intervention data even if your objectives are measured by probe data. Probe data tells us how the client is generalizing the skill. Intervention data gives us the information we need to adapt supports, teaching methods, and activities. 

 Learning Steps:

This is where you try to think through how the objective will be learned in discrete steps over the course of the term and how you will support your client’s learning. Usually you can break it down into 4-6 steps. Your first step will always be what your client is doing right now. For example, if your objective is:

 While looking at a book, Sammy will answer What and Who questions in 80% of opportunities as measured by probe data.

 Your learning steps may be:

1. Answers What and Who questions occasionally (20%) with no prompts and consistently when given two choices with visual cues (e.g. While looking at a book “Who has the ball?”  and then offered 2 choices “The dog or the girl?”)

2. Answers What and Who questions sometimes (50%) with no prompts and consistently when given pause time, cloze procedure, or choices to cue an answer (you are fading your supports)

3. Answers What and Who questions sometimes with no prompts and consistently when given pause time, and occasionally cloze procedure.

4. Answers What and Who questions in 60-70% of opportunities with no prompts and consistently when given pause time.

5. Answers What and Who questions in 80% of opportunities with no prompts and consistently when given pause time.

 If you are unsure what the steps will be – just begin to teach and it will become more clear as you work with your client. 

Setting the Criteria:

 Most common:

• Quantity – name 8 colors

• Accuracy – usually a percentage or number of opportunities

Less common, but still good:

• Latency of performance -  child will return a greeting within 1 second

• First response – how they respond to an antecedent over a number of days – good for greetings

• Level of independence – will initiate 70% of steps to complete toileting routine 

• Time duration – will maintain a topic for 10 minutes

Be careful of “80% of the time” – this is hard to measure and may not reflect developmental norms.

 Speech Objectives

 You could be writing objectives for 3 general phases of learning:

• Shaping or introducing a sound(s)

• Practicing a sound(s) that the client is stimulable for in more naturalistic, functional practice

• Generalizing speech targets to multiple contexts and uses

 Speech objective example:

When shown picture cards containing the target sounds, Sammy will use bilabials p,b,and m with 75% accuracy when given faded visual/tactile cues and models.

 Why 75% ? If Sammy is only 2-3 years old then it is developmentally appropriate for him to be 50-75% accurate with these sounds. 

 Setting the criteria:

• If you take a multi-level approach you may set different percentages of accuracy for words vs. phrases (e.g 80% accuracy in words, 60% in phrases)

• You may decide to take a modified cycling approach (eg. Work on a skill for 3-4 weeks and then take a break no matter what your criterion)

• You may measure the skill over one or more sessions (usually no more than 3 is a safe bet)

 Scaffolding and support

Include this in your lesson plan procedures and your objectives.  You need to collect intervention data even if your objectives are measured by probe data. Probe data tells us how the client is generalizing the skill. Intervention data gives us the information we need to adapt supports, teaching methods, and activities. 

 Learning Steps for speech:

This is where you try to think through how the objective will be learned in discrete steps over the course of the term. Usually you can break it down into 4-6 steps. Your first step will always be what your client is doing right now. For example, if your objective is:

 When shown picture cards containing the target sounds, Sammy will use bilabials p,b,and m in CV, VC, and CVCV words with 75% accuracy when given faded visual/tactile cues and models.

Your learning steps may be:

1. Baseline: Occasionally uses bilabials p, b, and m when given no prompts and/or a model. Produces /m/ in word “my”. Is stimulable for all three sounds with support.

2. Consistently uses bilabials p, b, and m when given an model and visual and verbal shaping instruction (e.g “put your lips together” while looking a mirror and showing how to produce the sound) 

3. Consistently uses bilabials p, b, and m when given an faded model and faded visual and verbal shaping instruction (e.g “put your lips together” while looking in a mirror and showing how to produce the sound) 

4. Consistently uses bilabials p, b, and m when given an initial model and occasional visual and verbal shaping reminders

5. Consistently uses bilabials p, b, and m when given an initial model and no visual/tactile prompts

6. Consistently uses bilabials p, b, and m with no prompting by the clinician

These steps will look very different for different types and levels of objectives. They will also vary depending on your methodology and approach (e.g. drill/shaping, motor learning, or phonology approaches such as multiple oppositions). 

Take away message:

 When writing objectives be sure that you know what you are doing, how you will measure it, and think of the next clinician – will they understand what you are trying to achieve and where to start?

Development is a moving target – you can always change your objectives if you have erred on the side of too easy or too hard. 

Adult Clinic Objectives 

SLP GOAL BANK 

Using the “ABCDEF” Model 

 Goals should:

• Identify the person who will perform the activity (Actor)

• Contain a description of the task or activity that the actor will perform (Behavior)

• Specify the conditions or circumstances under which the behavior will be carried out (Condition)

• Be objective in order to determine if the goal has or has not been achieved (Degree)

• Have a specified time for achieving the goal (Expected Time)

• Be functional or related to a functional activity (Function)

Questions to ask when creating goals:

1.     What activity does the patient want or need to be able to do?

2.     What impairments need to be addressed or what strengths does the patient have that may be capitalized on so that the patient is able to perform this activity? Does the environment need to be modified to support the performance of the activity/task?

3.     Why is addressing this impairment/strength or functional activity important?

 A = Actor 

The patient will:

B = Behavior (Describe the activity)

• Name pictures of common objects

• Answer multiple choice questions

• Perform an effortful swallow

• Maintain topic of conversation 

• Identify unsafe situation from pictures

• Make self-understood

C = Condition (Circumstances under which the behavior is carried out; e.g. assistive device, environment)

• With minimal verbal cues

• From a selection of 3

• With observable laryngeal elevation 

• When topic provided 

• Without cue

• To unfamiliar listeners

D = Degree (Objective Measure e.g., 8/10 times, 3 seconds, level of assistance)

• 24 out of 25 trials

• With 90% accuracy 

• After each bite of mechanical soft solids in 10/10 trails 

• Over 6 exchanges 

• With 80% accuracy 

• In 10 sentence-length utterances 90% of the time 

E = Expected Time (How long it will take to reach goals)

• In 2 weeks

• In 3 weeks 

• By 00/00/2010

• In 4 weeks

• In 1 week 

• In 3 weeks 

F = Function (How this relate to patient’s functional status, roles)

• To express basic wants/needs

• To effectively respond to caregiver instructions

• To improve airway protection

• To communicate at the conversational level

• To improve safety awareness

• To increase intelligibility at the conversational level 

Below are sample long term goals (LTG) and a selection of short-term goals that might be appropriate intermediate steps to achieving the long-term goal. 

Swallowing objective examples

Long-term goal (LTG)

• Patient will achieve adequate nutrition and hydration on a regular diet and thin liquids without complication from aspiration in 10 weeks. 

Short-term goals to work towards LTG

• Patient will swallow mechanical soft solids without food escape from the lips in 10/10 trials in 2 weeks.

• Patient will perform tongue sweep to clear pocketing given verbal cues after each bite of food in 2 weeks.

• Patient will perform serial swallows of thin liquid from a straw using a chin tuck given minimal verbal cues 90% of the time in 3 weeks.

• Patient will complete the oral phase of swallow within 2 seconds in 4 weeks. 

Inappropriate tasks for a swallowing goal include performance of exercise, tolerance of a particular diet consistency, and meal consumption. 

Cognition objective examples

Long-term goals (LTG)

Patient will independently create and refer to a personal daily schedule to promote orientation and engagement in meaningful activities in the assisted living environment in 8 weeks. 

Short-term goals to work towards LTG

• Patient will complete simple problem-solving tasks given minimal cues by trained caregivers with 75% accuracy in 3 weeks.

• Patient will use a personal diary to log daily events/thoughts at least 3 times daily in 2 weeks.

• Patient will correctly sequence steps to complete ADLs given visual cues in 8/10 trails in 3 weeks. Patient will name 5 items given the category in 1 minute without cues in 2 weeks. 

Adult expressive language examples:

• Given picture stimuli, XX will verbally generate at least three semantic features of a target word at the isolated word level with 80% accuracy and minimal clinical assistance based on treatment data from three clinical sessions.

• When provided a topic by the clinician, XX will maintain a topic of conversation utilizing at least 2 speaker control strategies in 4 out of 5 opportunities based on treatment data from three clinical sessions.

•  XX wSB will produce functional words/phrases* with 80% accuracy with tactile cues, pictorial representations, and verbal modeling from clinician as measured by three probe sessions. 

•  XX will read paragraph length material (3 - 4 sentences) and demonstrate comprehension by answering questions about the text with 80% accuracy with minimum to moderate clinical assistance based on treatment data from three clinical sessions.

Main categories for SLP goals are:

• Expression

• Reception 

• Cognition 

• Motor Speech Production/Intelligibility 

• Swallowing