The aphasia goal pool at UNC is a way to help speech-language pathologists share experiences and knowledge about treatment planning for aphasia across the continuum of care. Since May 2015, we have collected goals from speech-language pathologists who work in many different settings and have varied levels of experience. We share these goals and information about them in a variety of ways. Scroll down to see some of what we have learned so far and be sure to check back as we continue to update this resource.
Contributors are asked to share sample goals from their practice or answer questions about the way they write goals. As a thank you to all who contribute, we share unedited examples from the goal pool. These examples are organized in different ways to highlight strategy, focus, and problem solving. We share 25 to 100 goal examples with each goal pool contribution. As the pool expands and becomes increasingly diverse, we are able to share more and more examples of practice excellence and innovation. Please remember that all contributions are valued. We do not critique or revise the goals you share with us. Instead, we work to reflect the clinical excellence that exists within our community of aphasia practitioners and to challenge and support one another to offer the best services we can to people living with aphasia.

Research

We are conducting a brief research survey about goal writing (UNC IRB# 18-1923). If you are an interested speech-language pathologist or student in speech-language pathology, please click on the blue button to answer questions about how you write goals for aphasia intervention. Participation is anonymous and takes 5-10 minutes. When you have finished, we will share with you 25 examples of goals that you may not have thought to include in your practice.

The grey button will take you to a form for submitting to the aphasia goal pool. When you submit 3 intervention goals you have used in your practice, you will receive a list of 30 intervention goals that are written in a specific style. You can participate anonymously or share your name (A list of acknowledged contributors is at the bottom of this page). We hope you will consider submitting goals many times to the pool and that you will check back often for new challenges. We anticipate the next goal challenge will be posted in February 2019.

Aphasia Goal Pool Observations 

Participants for the first 34 months:

  • 155 student or CF-SLP (465 goals) 203 CCC-SLP (609 goals)
  • Most certified SLPs worked in outpatient and subacute rehabilitation settings
  • Others worked in acute care and home health
  • University clinics and aphasia centers were also represented
  • 65.5% reported more than five years work experience (as SLP)

Focus: Communication Goal

  • “The client will initiate a phone call once a week”

Prong 1: Skills and Abilities

  • “The client will independently identify the superordinate category and select 2 same-category members out of a field of 10 written choices for a written concrete noun with 80% accuracy across 2 consecutive sessions”

Prong 2: Intentional Strategies

  • “The client will utilize trained word finding strategies (SFA, circumlocution, etc.) for 2 minute description of recent event with at least 80% accuracy with min cues over 3 consecutive sessions”

Prong 3: Environmental Supports

  • “The caregiver will demonstrate comprehension and appropriate application of communication supports to promote participation and decision-making at home”.

Prong 4: Motivation and Confidence

  • In order to nurture post-stroke identity, the participant will print five photos of choice indicative of his/her interests”

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.

 

Strategies You Shared with Us 

“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.”