Aphasia Goals

Participate in our collaborative goal writing project!

It is challenging to write meaningful intervention goals. Everyone knows that achievement requires focus and time. Unfortunately, the power of individualized goal setting can be missed because speech-language pathologists and people with aphasia are unsure how to address communication in life settings. Sometimes we have different ideas about what matters. Often, we struggle to capture what is really meaningful with language that is objective and measurable. On this site, we share resources that will hopefully make the planning and documentation process a bit easier. 

Operationalizing and measuring goal outcomes

Goal construction handout from a presentation at the 2015 ASHA convention (Haley, Richardson, Jacks, & de Riesthal).

Current needs and realities

Check back to participate in a brief survey about goal writing obstacles and resources.

Insights and experiences from aphasia goal pool participants

Check back for words of wisdom from your colleagues.

Perspectives of people with aphasia

Check back for words of wisdom from people with aphasia.

Goal Pool

If you are a practicing speech-language pathologist, we invite you to participate in the development of goal pool with examples from diverse clinics and settings. This link takes you to a brief and anonymous survey. You will be asked to share 3 goals you have used in your practice with people who have aphasia. When you have entered your sample goals, you will receive a list of 100 goals other speech-language pathologists have submitted and a challenge to expand the content of future goals a bit beyond your current practice. The summary will be updated weekly as we receive more and more diverse examples. By building the goal pool together, it will continue to grow and help us learn from each other.  To make the pool as credible as possible, we request that you submit only goals you HAVE USED in our practice.

The goal summary you receive is organized according to a simple model we have found useful in diverse clinical settings. It is an adaptation of the broader A-FROM (Kagan et al., 2008) and WHO (2001)  frameworks. We hope it will help you think about concrete ways to improve communication in real life settings. Some of the features are:

  1. "Communicative Life Participation" is placed at the center of the model to remind us that long-term goals must be evident in real life communication. This means that "generalization" is planned and mandatory rather than something to hope for.
  2. Only modifiable aspects of environment and person are considered. We call them"change mechanisms." Although many factors affect life with aphasia, some are more powerful intervention targets, and those are the ones we want to address.
  3. "Intentional Strategy" has been added as a powerful change mechanism when cognitive abilities in non-language areas are strong. The mechanism refers to communication strategies people with aphasia initiate and strategies they use to learn and grow in their communication skills and experiences.
  4. The four change mechanisms are envisioned as building blocks for a given topic or communication act (see schematic below). Our experience has been that this design encourages people to think about multi-pronged intervention in a very focused way. Based on the schematic, we have developed planning materials for speech-language pathologists as well as for people with aphasia.

model4

There is a bit more background in a poster we presented at the 2015 AphasiaAccess Leadership Summit (Boston MA, March 13-14).

See also a handout we prepared for a presentation at the  2015 ASHA convention about how the model can be applied in outpatient rehabilitation.

We are currently using the model to guide collaborative goal setting in both outpatient and acute care settings. In these applications. Our preliminary findings are that people with aphasia and their communication partners find the approach intuitive and motivating and that it helps them predict and prepare for real-life barriers and opportunities. 

We welcome your input about the project. Please email if you would like to use some or our other resources or want collaborate on some of these ideas. Be sure to check back soon for additional resources!

 

References

Kagan, A., Simmons-Mackie, N., Rowland, A., Huijbregts, M., Shumway, E., McEwen, S., Threats, T., Sharp, S. (2008). Counting what counts: A framework for capturing real-life outcomes of aphasia intervention. Aphasiology, 22, 258-280.

World Health Organization (WHO) (2001). International classification for functioning, disability and health (ICF). Geneva, Switzerland: World Health Organization.

 

Acknowledgments

Many thanks to the following speech-language pathologists, who shared their experiences and helped us develop the first version of this resource (in alphabetical order): Lisa Amundson, Miranda Babiak, Jennifer Barry, Darci Becker, Celeste Blackmon, Amy Bland, Karen Brady, Roberta Brooks, Linda Bryan, Amanda Byrd, Heather Coles, Melinda Corwin, Nannette Crawford, Kevin Cunningham, Lisa Danyo, Michael de Riesthal, Natalie Douglas, Sherry Drummond, Samantha Ecker, LaToria Elliott, Lynn F. Gabos, Seles Gadson, Valeria Gary, Lori Geist, Holly Hamilton,Alecia Heissenbuttel, Tassani Hoskyn, Audrey Holland, Rachel Howard, Aura Kagan, Alana Krieger Cohen,  Anne Marie Kubat, Jaime Lee,  Selene Lewis-Brady, Dana Marek, Benjamin Marshall, Keely McMahan, Antje Mefferd, Marilyn Munk, Catherine Off, Kim Payne, Scott Putman, Jessica Richardson, Marcia Rodriguez, Mady Sandwell, Nina Simmons-Mackie, Abbe Simon, Betty Soto, Karen Thomas, Melissa Watts,  Leigh Wallmeyer, and Joanna Wyckoff.