How to Write Neurodiversity-Affirming Speech Therapy Goals [with goal bank]

What is Neurodiversity?

The concept of neurodiversity acknowledges that brain differences are natural and that conditions like autism, ADHD, or stuttering are variations of the human brain, not deficits.

This concept is crucial to recognize in our field, as many speech-language pathologists (SLPs) treat individuals who identify as neurodivergent and are also the ones who provide support to their caregivers/families.

More recently, many SLPs have deliberately made the "switch" to a neurodiversity-affirming approach, which obviously includes goal writing! Part of implementing this approach involves educating oneself on the meaning and scope of neurodivergence and the experiences of neurodivergent individuals.

A message for clinicians who are exploring this approach for the first time: If you are unfamiliar with neurodiversity-affirming principles, that is okay! Changing a method of therapy that you’ve been accustomed to and formally educated on can take time and understanding. Many, if not all of us have been there. The important thing is that you are here and that you are interested in learning more to better your practice and increase your connection with your clients. Here, you can read more about what it means to be a neurodiversity-affirming therapist!

Tips for Writing Neurodiversity-Affirming Speech Therapy Goals

In the world of speech therapy, adopting a neurodiversity-affirming approach is not just a method but a philosophy that respects and values the differences in how individuals communicate and perceive the world. Therefore, it is important to remember that there isn’t a ‘set’ rule of thumb as to how neurodiversity-affirming goals should be written, but more of a general guideline of principles to consider when you sit down to write your goals. These principles focus on ways to look through a lens that highlights our client’s differences as strengths versus acknowledging these differences as disorders that need to be fixed.

Considerations when writing neurodiversity-affirming goals:

Goals should be…

Personalized to the individual

Goals should focus on what is most meaningful and useful to the individual (this translates to: target what is most functional, and/or skill areas the client expresses interest in working on). For instance, how can you write a goal for a client who expresses an interest in better understanding social cues so they can feel more comfortable knowing when to exit a conversation? Perhaps try one that involves learning to make environmental inferences. Why? For one, it is a functional skill that can be applied across contexts and secondly, this may also support the client’s understanding of the different variations of body language/phrases that are consistent with leaving an interaction.

Empowerment-focused versus "normalizing":

Goals should refrain from pushing neurodivergent clients to conform to "typical" speech patterns and focus on empowering them to communicate in ways that are most effective for them. For example, a client who has had limited success with therapy goals that solely focus on communicating via oral language (verbally), may benefit from exploring augmentative and alternative communication (AAC), such as a speech-generating device. This client may have an increased quality of communication and effectiveness when using other communication modalities that are more suitable for their needs.

Inclusive and collaborative:

Whenever possible, involve the client and/or their families in the development of their goals/treatment plan! This collaboration can contribute to a sense of assurance with a focus on goals that are aligned with the client’s individualized aspirations and needs. The role of the client and family ensures that the plan is individualized, goal-oriented, culturally and contextually relevant and that it empowers the client within their unique communication journey. We like to use our PDF fillable ethnographic interview to help obtain some of this personal information about our clients' home lives and routines.

Flexible and adaptable (if needed):

Goals should be worded/sequenced in a way that recognizes that needs and preferences can change over time. Therefore, goals should balance between being adaptable while also recognizing that future goals may go in a different direction. In addition to goals being adaptable, we as clinicians should also be adaptable! For example, you may have a client who has an interest relating to baking; however, you’ve received input from his family that this interest has recently decreased. Rather than writing the client’s goal to say, [Name] will notify an adult by stating/pointing to an unexpected problem/unexpected event, within a kitchen/food prep setting, in 4 out of 5 opportunities, you may want to consider making it more adaptable to other contexts/settings. You could try something like, [Name] will notify an adult by stating/pointing to an unexpected problem/unexpected event, within a natural home setting (e.g., kitchen, living room, bedroom, etc.), in 4 out of 5 opportunities.

Writing Neurodiversity-Affirming Goals

In this article, we focus on writing goals speech therapy goals that are consistent with a neurodiversity-affirming approach. Below we have provided goals that reflect a traditional (sometimes referred to as ableist) approach to treatment, followed by those that are neurodiversity-affirming. First, we will dive into how these goals can be structured:

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 request additional information related to a subject area of interest

CONDITION Statement

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

Example: within different academic environments (e.g., classroom setting)

CRITERION Statement

How the client’s performance will be measured.

Example: in 80% of opportunities

DO + CONDITION + CRITERION

Complete example: [Client] will request for additional information related to a subject area of interest, within varied academic environments (e.g., classroom setting), in 80% of opportunities.

There you have it! An example using our Goal Writing Formula containing the DO + CONDITION + CRITERION (don’t forget to think about consistency!) for writing neurodiversity-affirming goals.

Neurodiversity-Affirming Speech Therapy Goal Bank

Below, check out some of our neurodiversity-affirming goals for various areas of treatment. They include what a traditional approach to writing the goal may look like, followed by neurodiversity-affirming examples.

Perspective Taking

Traditional Approach: Teach standard ways of interpreting social situations and only consider the perspectives of others.