I have been buried in assessments lately.

With a sudden influx of new clients, I’ve been setting so many goals and objectives that I am beginning to look at my non-work to-dos through the objective lens.

Natalie will clean out the dishwasher out 6/7 nights of the week from a baseline of 3.

As a parent or care giver, you are familiar with goals like this. For children with autism, goals like taking turns, using socially appropriate greetings, inviting a friend to play and more are commonplace. For adults in long term care, socialization, sharing a story, completing a task without becoming agitated and maintenance of cognitive and physical skills are frequently used. But why?

Being in the midst of all this brought me to the topic of today’s post: how therapists arrive at goals and objectives.

  1. The Assessment: The first thing that takes place is a full assessment of your child or loved one. This will most likely include time spent in session with the person receiving services, a review of history from other therapists, and an interview of the care giver. To put it extremely simply, the goal of an assessment is to get to know what my client can already do, what they need help doing, what they love, and what they hate. If the sound of the guitar causes my client to scream, I need to know this!
  2. Analysis: The areas that are found to be doable, or in need of assistance tend to fall into broader categories. Communication, Social Skills, Emotion, Motor; all of these are categories, or domains of functioning, that each individual skill falls under. Your therapist categorizes these (and actually likely has them precategorized on whatever assessment tools they use) to get a full picture of the client’s needs and strengths.
  3. Prioritize: If someone is struggling to run one mile, setting a goal to run a marathon doesn’t seem too reasonable- unless they set lots of smaller goals in between their current level and the goal level. The same holds true with goals in any domain of functioning. The initial goals that your therapist sets are the ones that need to be met before moving to more difficult tasks.

Example: Freddy is a 6 year old boy with a diagnosis on the Autism Spectrum. He is verbal, cognitively high functioning, and enjoys music. Freddy plays instruments at the same time as the therapist, but will push the therapist away and play alone after 5 seconds of parallel play. Freddy will occasionally take turns with therapist with a large amount of verbal prompting, modeling, and hand over hand assistance.

What goal would we set for Freddy? We want him to take turns with others since that is a valuable and necessary social skill, but before we can do that, he has to permit the therapist to play in parallel with him.

This method for goal setting is prevalent everywhere! Think about the last time you set a difficult goal for yourself to achieve. Did you get there all at once?