Goal writing as a pediatric OT can be difficult. You want to do your best to make sure that what you present is tailored to each of your kiddos and truly captures what you want them to achieve. However, that can be difficult to achieve and often leaves you drawing blanks.
You know that your goals are going to drive your patients’ progress, but that they also need to be flexible enough to still be relevant when you hit bumps in the road. Creating goals that are specific and yet not so detail oriented that they don’t lose focus on what’s important – your patients’ progress – requires careful thought.
Often, this can seem like an insurmountable task. Fortunately, a good framework can help you process your patients’ needs and lay out great goals in a timely manner. Today, we’ll explore a few frameworks pediatric occupational therapists can use to write better goals for your patients faster.
We’ll explore several options to help shape the goal creation process as well as a set of questions to help you write pediatric occupational therapy goals on a more practical level.
SMART Goals: The SMART goal method is used to set goals for people in many different industries, from marketing strategists to occupational therapists. It’s a well-known framework and provides us with high-level guidance by encouraging an emphasis on time-bound, measurable goals.
S – Specific: What are you going to do, why are you going to do it, and how will it be accomplished?
M – Measurable: What will be the measure of this goal’s success? When will you know it’s been achieved?
A – Attainability: Is this goal something that can be achieved by your patient with some work or is it too easy/difficult?
R – Relevant: Does this goal target useful skills/behaviors?
T – Timely: On what time-frame will this goal be achieved?
Fusion SLP Sarah Getman, MS, CCC-SLP has created an in-depth presentation to make goal writing easier with SMART goals. You can find that free download here.
However, in recent years, goal frameworks that are more specific to occupational therapy have emerged. These offer us goal setting methods that are better tailored to occupational therapy.
The RUMBA Framework: This framework for goal writing was introduced by the 11th edition of Willard & Spackman’s “Occupational Therapy”. It’s particularly helpful for making sure the goals you’re setting for your patients are helpful to both you and the family – making sure you’re setting understandable and measurable goals.
R – Relevant: What function is this goal aiming to achieve?
U – Understandable: Will the child & their parents understand this goal?
M – Measurable: How will you measure this goal?
B – Behavioral: What behavior occurrences will the goal address?
A – Achievable: Can you reasonably expect your patient to achieve this goal within the stated time?
COAST Goals: The COAST method for goal writing was introduced in Gateley & Borcherding’s text “Documentation Manual for Occupational Therapy”. This framework is great for ensuring that you’re addressing a specific occupation with your goals and establishing specific timelines for goal achievement.
C – Client: “Client will perform…”
O – Occupation: What occupation does this goal target?
A – Assist Level: With what level of assistance or independence will the goal be achieved?
S – Specific Condition: Under what conditions will the goal be achieved?
T – Timeline: When will the goal be achieved?
Any of these three goal-writing methods can be useful for pediatric therapists, and anyone would work to help ensure that you’re writing useful goals. However, they aren’t necessarily the most practical approach to goal writing. They tend to be a little abstract. How do you take these guidelines and turn them into great goals?
To write great goals for your patients in a timely manner, it’s helpful to treat each goal like a worksheet. Using a series of simple questions to address each piece of the goal individually makes each goal easier to create.
What questions can we take from these frameworks to efficiently build better goals? First, we want to make sure we address your patient and their occupation. Will this goal help them play with others, find autonomy in an ADL, or something else?
Q: “Who is this goal for and what occupation or task do I want to target with this goal?”
Now, we want to establish how we’ll measure this occupation or task. Do we need to measure success in sets or reps? Do we also need to track assistance level? We should consider how the child is doing with this task now and set a goal for this measurement that is reasonably out of reach.
Q: “What measurement constitutes success for this goal? With what degree of assistance should this goal be accomplished?”
Finally, we want to set a timeline for this goal. Setting a target end date gives you and your patient something to strive for and puts the goal into context.
Q: “When should this goal be accomplished?”
If you answer each of these three questions, you’ve created a sound goal for your patient. Now, we just have one more concern. Are you going to be able to clearly communicate this goal to your child and their parents? If not, you may want to take some time to rephrase your goal in simpler terms.
Q: “Will my patient and their parents be able to quickly understand this goal and its significance?”
Using these questions as a guide can help you quickly create great goals for your kiddos on a practical level. Each of these questions is rooted in important principles from the most common goal building frameworks in occupational therapy, but they’ve been distilled to their most practical level.