Saturday soapbox: It's an IEP not a grocery list.

My Soapbox Saturday this month has been focused on my goal pet peeves.  Sometimes these are goals that I've inherited; sometimes these are goals that I've written without thinking things through.  Ultimately, poorly written goals end up taking up more of my valuable time in treatment planning and documenting progress.

I work in both outpatient pediatric settings and schools.  With medically-based, habilitative therapy you are writing your short term goals for 60-90 days.  Within the schools, you are writing your goals to be met over the course of one year, but you may set your objectives to be met within a shorter time frame.  

Children who qualify for either services have a multitude of different goals that they could work on to strengthen their language skills.  I think we are afraid that we will forget to work on these skills, so we just write down all of these areas as goals.  A better idea is to keep a log of future therapy goals in your student folders.

Years ago, I received an IEP that contained 14 objectives for a student who was seen for 30 minutes 1x/week.  The prior level of function reported that the student was making minimal progress towards therapy goals.  Was this because the student was plateauing or because we weren't giving adequate time to each goal for the student to learn? How much progress should we expect when we are giving approximately 2 minutes 26 seconds per week for each goal?  

How much time do you need to accomplish a goal?  
This depends on a lot of things including the child's learning capabilities, how often the services are provided (frequency), how long the service is provided for (duration), what intensity level the services are provided for and the types of goals you are addressing.

CHILD'S LEARNING STYLE/CAPABILITIES:  Is this a student that seems to pick up on new skills quickly?  For articulation, are they stimulable to produce the sounds?  Are they able to hear the difference between correct/incorrect productions in your or their own speech?  If they are, we may consider that they are going to progress at a faster rate.  For students who are unaware that they are making errors, who need multiple cues to produce phonemes, we are expecting that they may take longer to learn.  Do they have good attention to therapy tasks, are they compliant in therapy?  These would suggest that they will learn at a faster rate.  Students who need frequent cues for attention or for whom we may need to work on behavioral intervention plans/motivation plans first may progress a little slower.  Is the student able to retain information from session to session or do you need to reteach the skills?  If this is the case consider adjusting the frequency.  

FREQUENCY:  Frequency refers to how often a service is provided.  In terms of service provision, we are really looking at how often they need to practice or learn a skill in order to retain it from session to session.  In terms of therapy, I might write more goals for a student who is coming twice a week than one who is coming 1x/week.

DURATION:  Duration refers to how long you are working on a skill.  I would consider writing more goals for a student who I am seeing for 60 minutes per week than a student that I am seeing for 15 minutes per week.  In terms of planning sessions, I often feel like students with are working on articulation at the sentence level need less duration but more frequency than students who are starting to learn articulation sounds or students with language impairments.  

INTENSITY:  Intensity refers to how you are going to address the goals.  Are you pushing in to the classroom, providing small group instruction or individual therapy.  Is the service direct or indirect?  SI there any family carryover?  Consider how you are structuring your small group sessions.  Are you working together as a group, using choral responses, and getting a lot of responses and opportunities for practice?  Or is the group structured more where you take turns and spend time individually with each student.  Are the groups goals similar or are they working on distinctly different skills?  In thinking of goals, I would consider writing more goals for a student who is in individual therapy than a student in a small group setting.  Some of the research coming out now is suggesting that there is little difference in service delivery and how students are making progress.  I think this is important to remember when you are planning your IEP's and schedules too!  

TYPES OF GOALS: The last thing I would look at in terms of goal setting is what goals the client is working on.  Some goals are so specific that you could add a larger number of them or you may be very confident that the child will be able to accomplish them quickly.  For example, I might write a lot of functional language goals.   (Perhaps one for each communicative function.)  I would probably have a lot more indirect minutes too to focus on staff training throughout the day. When I am working on higher level language skills I would write less.  Once I received an IEP for a student who had one goal-to greet independently.  The student had 20 minutes of direct services per week.  This is probably going to the opposite extreme.  I still giggle picturing a 20 minute session focused on saying "hi" and "goodbye" for one year.  

There are a lot of different factors that can go into determining how many goals to write for a client or student.  I tend to use the 10 minute rule.  I try to give myself 10 minutes per week to work on each goal.  For a student who has 40 minutes per week, that means I'm working on about 4 objectives per student.  If they meet their goals or objectives sooner, I can always call an additional IEP meeting.  I  don't think families are usually upset if there children are making better progress than expected.  What about you?  How many goals do you try to write for each student?  Next week I'm going to wrap up some other ideas I have about goal writing.

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