Do you work with people with aphasia who use AAC (no tech, low tech, or high tech) to aid in communication? Check out our comprehensive AAC goal bank. This goal bank covers a variety of areas, from linguistic uses to operational competencies. Find it on our site or Teachers Pay Teachers store! You can also check out our blog post, How to Write AAC Goals.

Find it on our site or Teachers Pay Teachers store.

Aphasia: about

Aphasia is a communication disorder that affects one’s ability to understand and/or express speech and language. It does not affect one’s intelligence.

Aphasia is always secondary to a brain injury (e.g. trauma or stroke) of some kind and is not genetic in nature. Depending on the region of the brain that is impacted, it can affect each person in different ways. Most often, aphasia affects the left hemisphere of the brain. Our left hemisphere houses the centers that help us understand and express speech and language.

Generally speaking, aphasia is often categorized into two broad types: receptive and expressive. Receptive (fluent) aphasia is having primary difficulty understanding spoken language or reading. Expressive (non-fluent) aphasia is having primary difficulty producing spoken language or writing. However, in some severe cases, patients can demonstrate the presence of both types. It is important to determine a differential diagnosis so that you are approaching treatment with the highest level of consideration for the client and their needs. Find a comprehensive aphasia chart here.

Additional considerations for assessment and treatment for individuals with aphasia:

According to Hinkley (2020), one of the most important steps in treatment when you are working with an individual with aphasia is that they receive adequate information about what aphasia is. It seems pretty basic, but providing the client and caregiver(s) education regarding their aphasia diagnosis is key for general understanding, advocacy, and expectations for treatment. Speaking of caregivers, family members of the client should also be included in the rehabilitation process. Caregiver/family cooperation increases the success of communication partner training (CPT) in the future. CPT is shown to increase activities and life participation. Lastly, it is important that once a client leaves treatment that they have a means to communicate or have a plan outlining their goals for future communication.  

Creating goals for the treatment of aphasia should take this key information into consideration. Below, we have outlined how to write aphasia goals and provided examples of what goals may look like.

Writing aphasia goals

​​Below you will find our Communication Community Goal Writing Formula that we use for writing all communication goals.

As seen above, speech goals should be written with 3* components in mind: the DO statement, the CONDITION statement, and the CRITERION statement.

*Also commonly included is consistency (we incorporate this!). Aka does the individual have to meet a specific criterion more than once? A common example of this may include across 3 consecutive sessions. This is usually something understood by the therapy organization/service provider and is sometimes/sometimes not included in the written goal itself. This is to ensure that the skill has been generalized and provides more reliable data that the skill has been properly mastered.

DO statement

What the client is actually going to DO and the specific skill they will be working towards.

Example: will answer 4 personal identification questions (e.g., "What is your full name?")

CONDITION statement

The specific setting and/or context your client will work on this skill.

Example: when asked by familiar and unfamiliar individuals

CRITERION statement

How the client’s performance will be measured.

Example: with 80% accuracy

DO + CONDITION + CRITERION

Example: [Client] will answer 4 personal identification questions (e.g., "What is your full name?"), when asked by familiar and unfamiliar individuals, with 80% accuracy

There you have it! An example using our Goal Writing Formula containing the DO + CONDITION + CRITERION (don’t forget to think about consistency!) for persons with aphasia.

Aphasia goal bank

It is difficult to make a “general” aphasia goal bank because person-centered care is best practice. According to ASHA, person-centered functional goals are considered goals that are identified by the client, in partnership with the clinician and family, that allow participation in meaningful activities and roles. We advise clinicians who are referencing these goals to take that message into consideration and modify goals accordingly to best suit your client and their personal needs.

Receptive

Example #1: [Client] will point to the items (e.g., functional household items) denoted by the speaker, when given a field of 4 real objects/pictures, with 90% accuracy.

Example #2: [Client] will follow a multi-step functional sequence, pertaining to [related-life skill] given visual prompts, with 80% accuracy.

Example #3: [Client] will answer [#] comprehension questions relating to [functional written text], during a structured task, given visual prompts, with 80% accuracy.

Expressive

Example #1: [Client] will label 10 different household items, when pointed to by the clinician within a familiar setting, with 90% accuracy.

Example #2: [Client] will respond to “yes/no” questions relating to [functional skill/activity], when asked by familiar and unfamiliar individuals, in 8 out of 10 trials.

Example #3: [Client] will make a request to gain access to [preferred activity/materials], to a familiar individual, in 80% of opportunities.

Strategies

Example #1: [Client] will produce a minimum of 4 different features, when presented with a word using semantic feature analysis (SFA), given verbal prompts, with 75% accuracy.

Example #2: [Client] will use an AAC system to produce [intended message], across familiar contexts and settings, with 75% accuracy.

Example #3: [Client] will utilize principles from the Supported Conversation for Adults with Aphasia (SCA) approach, when participating in conversations during community outings, 5 times across the treatment period.

Aphasia Advocacy

Example #1: [Client] will present his/her/their aphasia card when appropriate, within a community setting, in 90% of opportunities.

Example #2: [Client] will gesture (e.g., hold up finger) to request more time to process information, within communicative interactions, in 80% of opportunities.

Example #3: [Client] will disclose that they are a person with aphasia, to unfamiliar communication partners, in 75% of opportunities.

If you live with or are caring for a loved one with aphasia, you are not alone! The National Aphasia Association has several online communities and supports.


Looking for more?

  1. Aphasia Speech Therapy Activities
  2. How to Write AAC Goals
  3. How to Write Expressive Language Goals
  4. How to Write Play Skills Goals

Want to know how we prep ourselves for goal-writing (and more)?

These are some of our favorite resources for working:

  1. Clipboard with storage- we use ours ALL THE TIME!
  2. Some really nice pens - the feel of a pen that writes so well...priceless.
  3. Blue light glasses- for when excessive screen time is just...necessary

Happy writing!

This post contains some affiliate links and we may be (slightly) compensated if you use them, but all opinions are our own. We appreciate the support!

Additional Goal Resources

Our comprehensive goal banks for AAC and fluency are available on our site or Teachers Pay Teachers store! These are great for children and adults. We also have goal banks for school-aged language and Early Intervention & preschool.  

Save time creating goals with over THOUSANDS of possible goal combinations. Select your own combination of DO + CONDITION + CRITERION (and consistency) statements to develop personalized and measurable goals for your caseload.

Find goal banks for language, AAC, EI, and fluency on our Resources page!

Citations/further resources

Aphasiaunited.org

Aphasiafriendly.co

https://www.asha.org/siteassets/uploadedfiles/icf-aphasia.pdf

https://www2.asha.org/PRPSpecificTopic.aspx?folderid=8589934663&section=Treatment

https://www.archives-pmr.org/article/S0003-9993(10)00771-9/pdf

Where Do I Start My Client with Aphasia, J. Hinckley (2020)