Monday, March 14, 2011

A critical look at goal writing in school-based occupational therapy

For those who are not aware, IEP Direct is a proprietary Internet-based software package that many school districts use for IEP writing. One value of this kind of tool is that there is more uniformity and subsequent adherence to regulation when IEPs are created in this format. However, a serious negative is that therapists often over-rely on the canned goals that are part of the drop down menus in the software.

I am not sure who writes/approves the canned goals in IEP Direct but some of them are rather silly.

Being a former full time educator myself I know that academic programs spend quite a bit of time teaching students how to write appropriate goals that are both functional and measurable. Something seems to happen between the classroom and practice because the quality of many goals that I see written for children in school settings is very poor.

This is not new but is a perennial rant because the situation does not ever change. Programs like IEP Direct have now compounded the problem because it perpetuates the thinking that "if the computer has it listed as a well-written goal then it must be ok."

The offending goal today is:
Joey will demonstrate a consistent hand preference and appropriate grasp on a crayon to trace basic shapes and letters using correct sequencing with 1/4" accuracy.
The problem with this goal is that it attempts to measure too many things with too little specificity. There are at least six goals in this single goal:
  1. Joey will demonstrate a consistent hand preference
  2. Joey will use an appropriate grasp on a crayon
  3. Joey will trace basic shapes
  4. Joey will trace basic letters
  5. Joey will trace with correct sequencing
  6. Joey will maintain accuracy within 1/4"
Also, what is an appropriate grasp? What shapes? What letters? What does 'correct sequencing' mean?

My favorite point of silliness about this goal is accuracy within 1/4". Here is a picture of the letter 'A' drawn correctly and also drawn within 1/4" accuracy. Obviously, the absurdity scales when the demand for writing within a more confined space increases - but this is a scaled size that a kindergarten student might attempt:

Would you feel as though your child had achieved this goal if they produced a letter that looks like the 'letter' on the left??

I would like to encourage school-based therapists to be a little more thoughtful when writing goals or when clicking the silly drop down menu options when writing IEPs.

I promise all practicing therapists that parents are getting very tired of trying to understand what the goals mean and how they are supposed to know if a child is really making appropriate progress.


Karen said...

I like your point on IEP goals and I would love to see you give a few specific examples of goals that you DO find well-written in handwriting etc.

Chris said...

Hi Karen,

The problem with providing examples of 'well-written' goals are that there are a multitude of local rules that are in effect - and that will cause people (in any given locality) to state "YOU CAN'T WRITE A GOAL LIKE THAT!!!"

As an example, for many years in a local district it was completely legitimate to write a goal like:

Johnny will cut construction paper with scissors on an 8" line with 1/4" accuracy, 90% of trials, by the end of the school year.

This year that goal is no longer appropriate because 'scissors use' is a regular part of the curriculum and related services goals can't replicate the typical curriculum. I know that sounds a little nutty, but that is why I am using it as an example.

Anyway, any given district will interpret their state regs a little differently and require different things in their goals. At a minimum, and with nutty rules aside, I think that goals should reflect a functional skill that is rather discrete. There should be some well-defined parameters that are measurable and behavioral so that anyone can see if a goal has been achieved.

It is also important to remember that goals are not methods. So, it is not a goal for a child to engage in sensory play for 'x' minutes. That is not functional, it is not specific, it is not clear, and actually it might be an intervention strategy and not an actual functional goal.

Finally, it is important to remember that goals are not intervention. A goal is often one example of a functional skill that you want to see expressed after an intervention period is completed. So... the scissors goal does not mean that all we do is cut with scissors every day. Intervention should never be a mirror image of the goal that was written.

I hope that helps some.


Anonymous said...

Your example is incorrect. It says will trace with 1/4" of a line. Therefore, your attempt should be placed directly over the letter A and if you go a 1/4" outside of the line then you have not met the goal.

Christopher Alterio said...


Anonymous said...

This is such an important topics in peds. Many of the goals that would be ok several years ago I am being told are no longer fuctional. For instance I have been told by my supervisor that grasp is not a functional goal, because it doesn't matter how you hold a marker as long as you can write. I was told there is no such thing as a correct grasp. I was also told who cares what type of grasp a child uses. Iam not sold on the idea that grasp doesn't matter, Because the child I am writing this goal for has a grasp so poor that he is unable to imitate a shape or copy a letter correctly because of the way he holds the marker. thank you for the thread.

Anonymous said...

If the child cannot imitate a shape or copy a letter correctly, then the goal should be to do that. And perhaps the intervention is to facilitate a more functional grasp?