Functional Goal Writing: It Doesn

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Functional Goal Writing It Doesnt Have to be
so Hard

• The Sixth National Early Childhood Inclusion
  Institute
• July 2006
• Peggy Freund
• Center for Child Development
• Vanderbilt Medical Center

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This Session

• Define function in the context of
  person-activity-environment fit
• Propose 3 key areas of child functioning
• Brief discussion about the need for a focus on
  functionality
• Review preliminary data related to goal
  functionality
• Present a method for identifying and writing
  functional goals as well as a method of
  monitoring goal functionality

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Goals/objectives/outcomes

• Expectations for goal writing vary
• Suggest specificity
• Behavior
• Context
• Useful criterion

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Function formally defined

• The dynamic relationships among persons, their
  activities/tasks/routines, and their environments

Person
Activities, Tasks, Routines
Environment

• Biological and
• physiological
• Abilities and skills
• Preferences (e.g.,
• values, interests,
• goals)
• Experiences

• What people do
• Activity, task, or
• routine
• -characteristics
• -demands
• Developmentally appropriate

• Physical
• Social
• Cultural
• Political
• Economic
• Institutional

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Function Good FitPerson Activity
Environment
Quality of Life Balance, Satisfaction, Contentme
nt
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Function is a relative term . . .

• What is functional for one person might not be
  functional for another person
• Need to consider interrelationships
• Person
• Activity/Task/Routine
• Environment

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Child Functioning - 3 Key Areas

• Any Guesses
• Engagement
• Independence
• Social Relationships

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Engagement

• Synonyms
• Participation Involved
• Attending Focused
• Busy
• Definition
• The amount of time children spend involved with
  their environment (adults, peers, or materials)
  in a way that is appropriate given their age,
  abilities, and surroundings
  (McWilliam Bailey, 1992)
• 4 key points

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Why Is Engagement Important?

• Compared to peers without disabilities, children
  with disabilities spend
• More time passively nonengaged
• Less time interactively engaged with adults
• Less time attentionally engaged with peers
• Less time in mastery-level engagement
• with materials (McWilliam Bailey, 1995)
• Important precursor to learning
• Improving engagement leads to positive changes in
  childrens
• Behavior
• Interactions with others
• Thinking and reasoning skills
• (Favell, Favell, Reid, Risley, 1983 Favell
  Risley, 1984 Fisher Berliner, 1985)

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Independence

• Synonyms
• Self-reliance Self-sufficient
• Self-determination Freedom
• Autonomy
• Important for children with disabilities to learn
  how to function independently in their
  environments.
• Independence enables the children to access
  materials, to move about within the environment,
  to interact with others, to develop feelings
  of competence, and to have a sense of
  accomplishment.

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Social Relationships

• Components
• Communication
• Interactions
• Significant link between social/ emotional health
  and development and other areas of development
  very important to school readiness (Shonkoff
  Phillips, 2000)
• Children with developmental disabilities often
  have difficulty developing peer-related social
  competence (Guralnick, 2001)

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Why Should We Focus On Functionality

• Generate more meaningful plans
• More likely that everyone will follow through
• More likely that child will be motivated to
  practice and acquire the priority skills
• Assist in the development of instructional plans
  that tell us
• Specifically what to teach
• How to teach it
• Where to teach it priority routines

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How Do Your Goals Measure Up

• Do your goals consider the person, activity, and
  environment
• Do they address engagement, independence, and
  social relationships
• Ever encountered goals like these?
• ____ will imitate bilabial consonant phonemes
  (m, p, and b) in isolation and nonsense
  syllables 70 of the time with moderate verbal
  and tactile cues.
• ____ will tolerate a variety of sensory
  stimulation in order to participate in preschool
  activities.

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Goal Functionality
Rate your goals on a scale from 0 to 9
Round 1 Pre-training Round 2 Post-training
States 11 11
IEPs 40 25
Goals 305 235
Mean (SD) 1.67 (1.88) 3.2 (2.37)
Range 0 to 6 0 to 9
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Where Do Goals Come From?

• Standardized measures
• Deficit model
• Built on model of typical development
• Little consideration for context
• Families main concerns
• Well meaning but insufficient

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A Better Alternative Functional Approach

• The first and most important step is functional
  intervention planning
• Semi-structured needs assessment
• Carefully considers context home, school, and
  community
• What the child and family actually need in
  everyday activities and events
• Promotes family and child success
• Supports practice in real-life situations
• Routines-Based Interview (McWilliam, 1992)

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Second Step Priorities to Goals

• Preserve what the family and teacher want
• Broad enough for multiple learning opportunities
• Specific enough to know what is expected

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Goals 101 Goal Components

• 3 parts
• 1. Acquisition Statement (observable behavior)
• Should state clearly what the child is to do
• Examples
• Will use a word to make a request
• Will stay in circle
• Will walk forward 5 steps

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Goal Components

• 2. Normalized Context
• - The normalized contexts in which the goal will
  be useful should be clear, or the goal should
• Identify the activities or routines in which the
  behavior is expected
• Examples
• At meals, circle, and moving from activity to
  activity
• To sit at a table and to know where to put his
  belongings
• 3. Criterion
• Should represents a useful level of the behavior

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Criteria for Functional Goals

• Reflect the priorities of the family/teachers/othe
  r caregivers (RBI)
• Reflect real life situations
• Understandable
• Measurable

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1 Does the goal reflect the priorities of the
family/caregivers/teachers?

• Ask yourself
• Is the goal useful and meaningful to the family
  and other caregivers?
• Why should the child work on this goal?
• The answer should be immediately apparent
• Does it address
• engagement
• social relationships
• independence

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2 Does the goal reflect real life situations?

• Ask yourself
• Can the goal be addressed by
• multiple people,
• at multiple times of the day,
• during normal routines activities?
• Is the context clear?

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3 Is the goal understandable

• Ask yourself
• Does it make sense?
• Can most anyone understand what is expected?
• Is it free of jargon?

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Be Clear! No Jargon

• Instead of
• Ambulate
• Mean length utterance
• Pincer grasp
• Oral-motor skills
• Verbal exchanges
• Minimal physical assistance

• Use
• Crawl or walk
• 3-word phrases
• Thumb and finger
• Bite, chew, or swallow
• Back and forth
• With only
• a little help

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Be Specific Use Functional Words

• Write
• Name
• Say
• Play
• Point
• Go to
• Ask

• Share
• Draw
• Put away
• Stay in/with
• Approach other children

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Words to Avoid

• Improve
• Increase
• Tolerate
• Understand

• Initiate
• Exhibit
• Receive
• Become involved
• Begin to

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4 Is the goal measurable?

• Ask yourself
• Does it state what the child is to do?
  (acquisition statement)
• Not too general, not too specific
• Will everyone know when the skill is acquired?
• Does it include a clear criterion?

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Different Types of Criterion

• Acquisition
• Child demonstrates the behavior/skill
• 3 times per week
• 5 times each
• Generalization
• Child demonstrates the behavior/skill across
  time, places, people, situations, and materials
• In the classroom and on the playground
• With mom, teacher, and babysitter
• When playing with three different toys

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Different Types of Criterion

• Maintenance
• Child demonstrates the behavior/skill for a
  reasonable period of time
• For 8 weeks
• During 5 trips to the library
• Fluency
• Child performs the behavior/skill smoothly and
  efficiently
• Within 2 minutes
• Keeping up with other children

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Good Criteria

• A good goal statement actually has three criteria
  
• Acquisition and maintenance paired with a
  criterion for generalization or fluency
• Example
• 2 times each (acquisition) in 2 different
  settings (generalization) over 2 weeks
  (maintenance).

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Examples

• Instead of this
• Tiana will ambulate using her walker
• Kisharra will activate switch toys.

• How about this
• Tiana will walk, using her walker, to and from
  all activities inside the classroom and from the
  classroom to the playground, keeping up with her
  friends for 3 consecutive days.
• Kisharra will use at least 3 switches hooked to
  different toys to play by herself for at least 5
  minutes at school 3 times each.

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Group Practice 1Step 1 Acquisition Statement

• José will use 3 to 4 word phrases to make
  requests of adults
• Is it functional? Why is it important?
• Social relationships communication
  interactions

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Group Practice 1Step 2 Identify the Context

• Is the context clear?
• José will use 3 to 4 word phrases to make
  requests of adults
• Consider when this will be most important
• What routines will provide several opportunities
  to practice this skill
• during meals, self-care routines, and when
  moving from one activity to another
  
• at home and school

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Group Practice 1Step 3 Criterion

• Ask yourself, What frequency, duration, or rate
  would be an acceptable level of the behavior?
• José will use 3 to 4 word phrases to make
  requests of adults during meals, self-care
  routines, and when moving from one activity to
  another at home and school
• 2 times a day
• Then ask yourself, If he did it only one time
  would that be OK?
• If not, ask yourself, How often, in how many
  routines, with how many people, in how many
  places, or over what amount of time would I need
  to see the skill used to be convinced?
• on 5 separate days

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The Example All Together

• José will use 3 to 4 word phrases to make
• requests of adults (acquisition statement) during
• meals, self-care routines, and when moving
• from one activity to another at home and
• school (context and criterion for generalization
  across routines)
• 2 times a day (criterion for acquisition) on 3
• separate days (criterion for maintenance across
  time)

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Group Practice 2Step 1 Acquisition Statement

• Jake will correctly recognize (locate, point to,
  name) his printed name
• Is it functional?
• Why is it important?
• If not clearly evident add an in order to
  statement
• in order to know when it is his turn during
  circle, to know where to sit at a
  table, and to know where to put or retrieve
  his belongings
• Additional consideration
• Any conditions needed
• when his name is moved around

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Group Practice Step 2 Identify the Context

• Jake will correctly recognize (locate, point to,
  name) his printed name in order to know when it
  is his turn during circle, to know where to sit
  at a table, and to know where to put or retrieve
  his belongings when his name is moved around
• Can you clearly identify the context?
• Circle
• Meal time other table activities
• Arrival and departure
• Thinking of function can help you identify
  critical context

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Group Practice Step 3 - Criterion

• Ask yourself, What frequency, duration, or rate
  would be an acceptable level of the behavior?
• Jake will correctly recognize (locate, point to,
  name) his printed name in order to know when it
  is his turn during circle, to know where to sit
  at a table, and to know where to put or retrieve
  his belongings when his name is moved around
• 5 times in one week
• Then ask yourself, If he did it only one time
  would that be OK?
• If not, ask yourself, How often, in how many
  routines, with how many people, in how many
  places, or over what amount of time would I need
  to see the skill used to be convinced?
• for 3 weeks

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The Example All Together

• Jake will correctly recognize (locate, point to,
  name) his printed name (acquisition statement) in
  order to know when it is his turn during circle,
  to know where to sit at a table, and to know
  where to put or retrieve his belongings when his
  name is moved around (function, context,
  condition, criterion for generalization across
  routines) 2 times in one week (criterion
  acquisition) for 3 weeks (criterion generalize
  across time)

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McWilliam Goal Functionality Scale II (McWilliam,
2005)
Is this skill GENERALLY USEFUL (i.e., can you answer why and who cares broad enough yet specific enough)? If YES, 5
2. If NOT REALLY USEFUL, 4
3. If NOT AT ALL USEFUL, 3
R. A. McWilliam
Vanderbilt Center for Child Development
2005
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McWilliam Goal Functionality Scale II
(McWilliam, 2005)

• Generally useful
• Something most children would need to be able to
  do
• Something that makes participation in routines
  possible
• Something that can be done independently
• Something that would support social relationships
  

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GFS II Positive Attributes
Addresses Duration Persistence
Construction Communication Social Interaction
Friendship Participation Independence in
routines
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4. Addresses duration of interaction with people or objects (E) 1
5. Persistence (E) 1
6. Developmentally and contextually appropriate construction (E) 1
7. Pragmatic communication (SR) 1
8. Naturalistic social interaction (SR) 1
9. Friendship (SR) 1
10. Developmentally appropriate independence in routines (not just a reflection of prompt level) (I) 1
11. Participation in developmentally appropriate activities (E) 1
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GFS II Negative Attributes

• Unknown contexts Purpose not evident
• Makes little sense Unnecessary skill
• Jargon Increase/decrease
• Vague Insufficient criterion
• Criterion does not
• reflect useful level

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12. Cannot tell in what normalized contexts it would be useful -1
13. Purpose is not evident or useful -1
14. Some element makes little sense -1
15. Unnecessary skill -1
16. Jargon -1
17. Increase/decrease -1
18. Vague -1
19. Insufficient criterion -1
20. Criterion present but does not reflect a useful level of behavior -1
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Scoring Jakes Goal

• Jake will correctly recognize (locate, point to,
  name) his printed name in order to know when it
  is his turn during circle, to know where to sit
  at a table, and to know where to put or retrieve
  his belongings when his name is moved around 2
  times in one week for 3 weeks.
• Is it useful
• Does it address
• Duration Persistence Construction Communication
  
• Social Interaction Friendship Participation
  Independence in routines
• Missing pieces
• Unknown contexts Purpose not evident Makes
  little sense Unnecessary skill Jargon
  Increase/decrease
• Vague Insufficient criterion Criterion does
  not
• reflect useful level