The implementation of goals is essential in all aspects of AAC support. Goals enable us to measure change, guide future directions of intervention and help align all parties involved in the care of an individual. With such importance being laid on goals it is imperative that the designing of them is discussed.
First and foremost, we want to ensure that every goal is a SMART goal. SMART stands for:
- Specific – Ask, what specific skill do we want to achieve? The more specific your goal is, the more likely it will be achieved. For instance – "Jeremy will use his device" vs "Jeremy will use his device in the morning to request for cereal using two words". There is a much higher chance for success with the second goal as there is a clear destination point.
- Measurable – Ask, what exactly am I going to feel or hear? Being measurable means, we can track progress. For instance – "Jeremy will independently request cereal" vs "Jeremy will independently request cereal 5 out of 7 days during the week using two-word utterances". When we know Jeremy has reached 80% success then we can up the goal to something more challenging. Without being measurable we wouldn't know when to increase the goal.
- Achievable – Ask, is the goal that we are setting achievable for this individual? Many individuals starting out with AAC are at a sensitive point in their journey and many small successes are vital for continual and motivated use.
- Relevant – Ask, what is actually relevant for this individual right now? We want to ensure that we guiding relevant goals to the individual's current situation. Requesting for "more cookie" may be motivating goal for the individual but if there are significant behaviours involved, perhaps a way to protest appropriately would be more relevant.
- Timely – Ask, when do we want to achieve this? This depends on the individual and family involved, you may need smaller more quickly achievable goals or you may have longer term goals. The important thing is that a timeline is set.
Goal Attainment Scaling (GAS) is an individualised, criterion-referenced measure of change. It involves defining goals and specifying a range of functional outcomes. For example, communicative functions and operational competence. GAS has a five point rating scale which allows measurement of small changes. This is particularly useful during a device trial where time is limited and the amount of change expected may be small but significant. The scale is based on the current level of skill and expected performance with each level in the scale changing by one variable.
|GAS 5 point rating scale|
|Score||Predicted Attainment Scale|
|-2||Much less than expected outcome|
|-1||Less than expected outcome|
|+1||Greater than expected outcome|
|+2||Much greater than expected outcome|
For academic readings on GAS:
Kiresuk, Thomas J.; Robert E. Sherman (1968). "Goal Attainment Scaling: A General Method for Evaluating Comprehensive Community Mental Health Programs". Community Mental Health Journal. 4 (6): 443–453
King, G.A., McDougall , J., Palisano, J.G., Gritzan, J. & Tucker , M.A. (2000). Goal Attainment Scaling; It’s use in evaluating paediatric therapy programs. Physical & Occupational Therapy in Paediatrics , 19 (2), 31-52.
Cover multiple communicative functions
We want our AAC users to be competent communicators. This means that they will be able to say whatever they want, whenever they want to say it. To achieve this, we need to ensure our goals cover multiple communicative functions.These include but are not limited to:
- Requests: "more cheese please"/ "I want"
- Protests: "Don't want"/ "no more"/ "stop"
- Commands: "Go away"/ "get ball"
- Comments: "nice hair"/ "yummy food"
- Social comments: "Hello"/ "goodbye"
For a more extensive list of communication functions by Gail Van Tatenhove -click here.
Normal language development hierarchy
With AAC intervention we set our goals in line with the normal language development hierarchy. Which means, goals are designed with the individuals current language skills in mind and progressively work our way up from there.
The AAC Language Lab- Language Stages Charts are a useful resource, as well as this article "Normal Language Acquisition & Children using AAC Systems" by Gail M. Van Tatenhove
Consistent prompting across environments
Consistency is key to success with AAC intervention. Ensure that all therapists, teachers, parents and all other communication partners are providing the same degree and level of prompting and modelling. To achieve this, prompting and modelling instructions should be clearly stated in all goals.