A lot of therapists have asked for help writing goals, so we put together this goal-writing guide for you!
Throughout this post, you’ll find tips for writing reasonable and person-centered speech therapy goals—with examples.
If you’re looking for even more goals, check out our goal bank for adult speech therapy.
More Popular Articles
- 21 Practical Cognitive Tasks
- Swallowing Exercises & Strategies
- Goal Bank for Adult Speech Therapy (150 goals!)
What Makes a Therapy Goal Excellent?
1. Appropriate and relevant, given each patient’s unique situation
3. The right level of challenge—not too hard, not too easy
6. Within an appropriate time frame
7. Medicare-friendly (useful for some of us!)
What to Include in Your Goals
1. The Specific Issue You’re Working On
First and foremost, your goal will address an issue that the evaluation has determined is a significant area of concern for the patient.
Example of Specific vs Unspecific
a) “Safely swallowing teaspoon amounts of thin liquids” or “Swallowing sequential straw sips of thin liquids”
* Specific! You can measure it!
b) “Drink liquids”
* Not specific enough. How much? What type of liquids?
More Examples of Specific Skills
-“cup sips of thin liquids”
-“writing at the sentence level”
-“simple short term memory tasks”
-“multisyllabic words containing /k/ final”
2. Include Accuracy level
Typically 80%-90% accuracy.
There are differing opinions on how to measure goal accuracy. Research suggests that accuracy less than 80% can be ineffective in helping patients reach goals for some goals. BUT, performance above 90% shows mastery, which is most often not our role.
That said, it depends on your patients, and there are certainly times to use percentages outside of the 80-90% accuracy range.An example is 100% accuracy for safety goals, such as swallowing safety or medication management.
For more personalized goals, you may also consider the Goal Attainment Scale.
3. Include Amount of Cueing
Cueing can be measured in percentages, time units, and/or frequency (e.g. rare, occasional, frequent, etc.)
It’s up to you to decide how to calculate your cueing level. For example, you may choose to calculate cues Per Question or cues Per Set of Questions.
Just remember to be consistent with how you calculate cues from session to session!
1. Providing Cues in a Task Set
- Minimal: 1-25% of the time
- e.g. Patient required cueing for 1 to 4 questions in a set of 10 questions)
- e.g. Patient required cueing for 1 to 4 questions in a set of 10 questions)
- Moderate: 26-50% of the time
- Maximal: 51% or more of the time
2. Providing Cues Per Question
Cues per question may be a more subjective way of measuring cues.
Example of cues Per Question:
Your patient is attempting to calculate the cost of a $75 item, after-tax.
Minimal cue: Your first cue, “What does 8% look like in decimals?”
Moderate cue: Your second cue, “The decimal amount is 0.08 and the item costs $75. How much money is 8% of 75?”
Maximal cue: Your final cue, “Tax is $6. What is the total price of the item, after adding tax?”
3. Providing Cues Per Time Unit
Cues per time unit work well for attention goals and high-level language goals.
Example of cues Per Time Unit:
“The patient will sustain attention to a simple visual scanning task for 5 minutes with 10 or fewer minimal verbal cues” or
“The patient will participate in complex conversational speech for 10 minutes with 5 or fewer minimal visual cues.”
Include Type of Cueing
Types of cueing include verbal, visual, written, tactical, phonemic, and/or articulatory placement.
- Verbal cues include verbal instructions of how to produce an accurate response.
- Visual cues include hand gestures, such as pointing up to remind your patient to increase her volume. Or tapping the calendar to remind your patient to use aids to recall the date.
- Written cues include providing models for writing therapy, written instructions for how to complete a complex task, or writing out numbers for math problems.
- Tactical cues are when you provide touch in a way that helps patients achieve accuracy. This is helpful for severely apraxic or dysphagia patients.
- Phonemic cues are different from verbal cue in that you only provide specific sounds during aphasia or motor speech therapy, versus providing instructions.
- Articulatory placement cues are different from visual cues in that you only provide specific positioning cues, versus providing hand gestures.
- A mixture of cueing types is often helpful. Just remember to record the amount of cueing providing for each type of cue. An example of a mixed cueing goal is, “The patient will write single words at 80% accuracy given minimal verbal cues and minimal written cues.”
* For help writing evaluations, check out our post How to Write an Evaluation Report – with Examples
Tips for Writing Reasonable Goals
Review your patient’s performance on the evaluation
For language, motor speech, and cognition, identify questions where your patient was about 50% accurate, and write goals based on those questions.
For dysphagia, identify the diet level that the patient is currently safe with and write goals for the next diet level.
For example, if your patient with aphasia answered yes/no questions at 80% accuracy but open-ended questions at 50% accuracy, write a goal for open-ended questions.
“The patient will answer auditory open-ended questions at 80% accuracy given moderate written cues.”
Write goals to be achievable within two weeks
You do this to make sure the goals aren’t too challenging and to help measure progress.
It’s encouraging to regularly be able to tell your patient that he’s meeting his goals and can work on bigger and better things!
Measure only one issue per goal
For example, your patient with dysphagia is at risk for aspiration due to reduced hyolaryngeal movement. But they’re also at risk for weight loss due to a slow eating pace.
Write one goal to increase hyolaryngeal movement. Then a separate goal to increase the speediness of meals.
Tips for Writing Person-Centered Goals
Interview the Patient!
- What are their personal goals?
- What’s important to them?
- Social life?
- What does a typical day look like for them and does anyone helps them with these tasks?
Write a Reasonable and Person-Centered Goal
For example, your patient with dysphagia hates her dentures and hasn’t worn them for months, even before her stroke. She prefers soft foods but can only safely swallow pureed foods.
A reasonable, person-centered goal would be, “The patient will consume dysphagia mechanical textures with appropriate mastication in 90% of opportunities given minimal verbal cues to utilize safe swallowing strategies.”
Her final goal can include safely swallowing mechanical soft textures—not regular textures—because of her personal preference (hating her dentures!)
1. Use worksheets sparingly. Worksheets can be great for warm-up exercises or for those who are severely impaired. But, they’re not so functional.
2. Incorporate materials around the house into your goals. What’s more functional than working with the items your patient used at the previous level of functioning? Not much!
These items may include calendars, planners, cell phones, tablets, computers, decks of cards, pens and paper, novels, magazines, newspapers, photo albums, personal letters, etc.
3. Ask yourself Why you chose the goal. Is that Why important to your patient?
Increasing complex math abilities sounds useful, but if your patient didn’t use these abilities at the previous level of functioning, it may not be a person-centered goal for him.
How to Progress Goals
There are many possible routes to consider when helping patients climb towards their goals.
Let’s say that your patient performs at goal level for 3 sessions in a row. First of all, congrats—you’re an awesome therapist! It’s time to progress the goal forward.
Or….they’re not making much progress, despite a solid effort. No worries, you’re still awesome. Let’s dial the goal back, a little.
Keep scrolling for ideas on how to progress goals by varying different aspects of the goals.
How to Vary Dysphagia goals
- Vary liquid textures: thin, nectar thick, honey-thick
- Vary diet textures: regular, mechanical soft, dysphagia mechanical, pure
- Vary presentation: cup, straw, spoon, teaspoon, sequential sips, single sips
- Vary amount: in ounces, meal times, or by food item (e.g. “small side salad” or “one twinkie”
- Vary muscle groups: labial, lingual, buccal, oral, oropharyngeal, pharyngeal, pharyngoesophageal, esophageal.
* Check out our Dysphagia series for free patient handouts. Swallowing Exercises & Strategies is a great place to start.
How to Vary Aphasia Goals
- Vary language comprehension or expression
- Vary presentation modality: auditory, written, gestural
- Vary response modality: verbal, written, gestural
- Vary response length: words, phrases, sentences, paragraphs, conversation, pages
- Vary response time, usually in seconds
How to Vary Motor Speech Goals
- Vary response length: single phonemes, syllables, words, multisyllabic words, phrases, sentences, simple conversation, complex conversation, monologues
- Vary response time, usually within seconds
- Vary phoneme and word position: initial, medial, final
- Vary presentation modality: verbal or written
How to Vary Cognition Goals
- Vary complexity: simple, moderate, complex
- Vary response time, usually in seconds
* See 21 Practical Cognitive Tasks for improved attention, memory, and problem-solving.
How to Vary Visual Neglect Goals
- Vary response time, in seconds or minutes
Speech Therapy Goals with Examples!
Now for your mini goal bank!
Be sure to modify the goals to be excellent for each and every one of your patients.
Example Dysphagia Goals
Goals can include swallowing safety, timeliness, and appropriateness.
1. The patient will safely consume 8 ounces sequential cup sips of thin liquids without overt signs or symptoms of aspiration in 100% of opportunities given occasional verbal cues to utilize safe swallowing strategies.
2. The patient will initiate swallow within 3 seconds given single-cup sips of honey-thick liquids given moderate verbal cues in order to increase oral phase timeliness and reduce risk for aspiration.
3. The patient will safely consume an entire regular texture meal within 30 minutes given 5 or fewer cues to utilize safe swallowing strategies in order to increase speediness of meals and reduce risk of weight loss.
4. The patient will complete lingual strengthening exercises (e.g. lateral tongue press with resistance) x30 independently in order to increase muscle strength to reduce oral residue given regular textures.
5. The patient will demonstrate appropriate mastication in 4/5 trials of dysphagia mechanical textures given maximal verbal and maximal tactile cues in order to reduce the risk for aspiration.
Example Aphasia Goals
1. The patient will answer abstract yes/no questions (e.g. “are there 20 hours in one day?”) at 80% accuracy given moderate verbal cues in order to increase ability to communicate with family members accurately.
2. The patient will write sentences in response to verbal prompts with 80% accuracy given minimal written cues.
3. The patient will point to appropriate photos on a simple AAC system at 70% accuracy given verbal prompts in order to communicate basic wants and needs.
4. The patient will reduce response time to 10 seconds or less in response to simple open-ended responses given x1 repetition in order to increase ability to communicate with rehab team.
5. The patient will read paragraph-level information then answer questions about the material at 90% accuracy given minimal visual cues in order to increase ability to read functional material.
Example Motor Speech Goals
1. The patient will produce /h/ initial syllables at 70% accuracy given maximal articulatory placement and maximal visual cues in order to increase ability to communicate verbally.
2. The patient will repeat “r” medial multisyllabic words in sentences at 90% accuracy given occasional minimal verbal cues in order to increase ability to communicate complex wants and desires.
3. The patient will read single velar final words at 80% accuracy given minimal phonetic placement cues in order to increase ability to communicate basic wants and needs.
4. The patient will produce 5 or more words per breath group given moderate verbal and minimal modeling cues to utilize breath support strategies.
5. The patient will increase prolonged “ah” to 16 seconds or longer in 4/5 trials independently in order to increase breath support to produce functional sentences.
Example Cognition Goals
1. The patient will complete a complex word search puzzle within 15 minutes given occasional minimal visual cues in order to increase sustained attention abilities.
2. The patient will be 100% oriented to temporal concepts (e.g. time, date) given moderate verbal cues to utilize visual aids.
3. The patient will fill out a pillbox at 100% accuracy given 5 medications and minimal verbal cues.
4. The patient will recall and complete steps to listen to a voice message at 80% accuracy given minimal visual cues.
5. The patient will listen to multiple paragraph-level information and recall details at 90% accuracy given minimal repetition in order to increase auditory memory ability.
Example Visual Neglect Goals
1. The patient will read page-level information from a novel at 100% accuracy given occasional minimal verbal cues to utilize finger scanning technique to attend to left-most side of page.
2. The patient will complete a simple maze in 10 minutes or less given minimal verbal cues and moderate visual cues to utilize compensatory strategies in order to increase attention to the left side.
3. The patient will eat 100% of the food on her plate given occasional cues to attend to the left.