Foundational Skills for Goal Inspiration

People are often not not fully prepared when it comes to goal ideas for our kids with the most complex communication disorders, particularly those that are complicated by reduced vision/hearing or by motor limitations. Here are some ideas for foundational goals to work on.

I can anticipate what's going to happen

Anticipation shows an understanding of the environment

- In a repeated, predictable game or activity I react in a way that shows I'm anticipating what will happen next

Example ways this might be communicated: vocalizing, getting quiet, muscles getting tense, smiling, eye gaze, depends on person

Example activities: Peek a boo, tickles, cause and effect toy play, etc

- I show an anticipation of the next steps in my routine

Examples: Tensing before being transferred, starting to wiggle or turn head away upon perceiving an object associated with an aversive activity, opening mouth when they see a chewy or spoon, etc

I can explore my world

It's hard to communicate about something if you don't know it exists. Promoting exploration helps clients learn on their own.

Looking:

I look towards a new visual stimulus

I can visually track objects

Ways to scaffold these: Vary color, movement, familiarity with object, etc

Listening:

I react to sounds

I seek to determine where a sound is coming from

Ways to scaffold these: Vary volume, distance from listener, familiarity of sound, etc

Movement:

I reach for objects

You can scaffold these - familiar, unfamiliar, length of time before reaches, distance of object, etc

I attempt to interact with objects

You can scaffold in various ways, such as if the objects are already touching them, aren't touching them but they can see/hear/feel vibration from, are near vs further away, familiar/unfamiliar objects, etc

- I attempt to move closer to preferred objects/people/experiences

- I seek to retrieve a dropped item

Misc:

I preferentially look at or touch objects I like

I seek out a preferred object/person after I watch it get hidden

I understand my world

- I can distinguish between objects

- I show a positive reaction to seeing/hearing/feeling preferred items or people

- I understand object permanence

- I manipulate objects in a way that shows understanding of their function (spoon or chewy brought to mouth, wiping at hands, tapping on tablet, etc)

- I understand essential ideas of how the world works (schemas).

Schemas for understanding the world that are learned through play include:

1. Trajectory - I understand that both objects and myself can move in space (throwing, dropping, etc)

2. Transportation - I understand that both objects and myself can be moved from one place to another (carrying)

3. Rotation - I understand that both objects and myself can be turned or spun

4. Enclosure - I understand that both objects and myself can be put into boundaried areas. [Objects can be put in and taken out of other things, like containers, I can build a barrier, etc]

5. Enveloping - I understand that both objects and myself can be covered up

6. Orientation - I understand that things can be physically seen from a different point of view (upside down, sideways, etc)

7. Positioning - I understand that objects can be arranged in particular ways (lined up, separated by color/size, etc)

8. Connecting - I understand that objects can be put together or separated (velcro, Legos, links, etc)

9. Transformation - I understand that objects can be changed (play do can be manipulated into a different shape, cookies can crumble, food coloring can change water, etc)

I can interact with others

Communication is based in interaction

I react to others' expressions of feelings in a way that shows I understand them

Examples: Start smiling/laughing when someone else is smiling/laughing, show concern or attempt to comfort when someone is sad/tired/sick, etc

I react when someone tries to interact with me

You can scaffold this on if they react to touch, react to sound of someone talking, react to proximity, etc

I show the foundations of turn taking during play

This is very basic turn taking. For example, maybe they wave their hands in the air and you copy them, then they take their "turn" then you take yours, etc. The classic "I drop my toy you pick it up" game is an example of this. You'll notice anticipation in them in the form of expectant pauses, as well as an understanding of what their "turn" entails by them repeating generally the same sort of action (doesn't have to be an exact match) that shows you they're continuing with the game

I can try to copy something I see someone else do

I understand others

Understanding furthers the ability to learn and also builds the foundation for expressive communication

I can tell when someone is talking to me

May show by vocalizing/moving/looking more when someone is talking to them instead of to another adult, for example

I react to what others say (or to symbol communication) in a way that shows understanding

Examples: Looking at an object when it's named, showing anticipation, etc

I can communicate with others

This is expressive communication and the foundation for more advanced skills like expressing wants and needs

- I attempt to get others' attention

- I vary the method I use to get attention (voice volume, reaching, etc) based on how close or far away the person is from me

- When a preferred and non-preferred familiar item are simultaneously presented, I will look at and/or reach for the preferred item.

Vocalizing

- I make vocalizations

- I engage in vocal turn taking

- I have vowel sounds in my vocalizations

- I have consonant sounds in my vocalizations

- I combine vowel and consonant sounds in vocalizations

I can eat by mouth

You can start working on many of these goals before any food or liquid is even introduced. You're not trying to force them to do anything they don't want, just introducing them to new experiences.

- I can open my mouth when prompted (with spoon, bottle, food, touch, etc)

- I can bring objects to my mouth

- I can put objects in my mouth

- I explore mild flavors

These are extremely mild flavors and working on it doesn't require actual food or water. The extremely lightly flavored lemon glycerin swabs - which are actually for helping with oral hygiene - are an example of a way to target this with no food/drink

- I explore "stronger" flavors and/or a variety of flavors

Note that the flavor is only "strong" from the perspective of a child who doesn't eat by mouth; what is strong to them may actually be quite mild to us. For instance, one family told me that they gave their grandson some icing on his birthday and were surprised when he didn't like it. It makes sense when you realize sweetness is a flavor and can be quite intense for someone who hasn't eaten by mouth.

- I explore cold / warm sensations in my mouth.

For cold you can put a lemon glycerin swab or metal spoon in the fridge. Warm can be a metal spoon you put in warm water to warm up, or a wet washcloth you've heated slightly.

- I can help bring a cup/bottle to my mouth

- I can help bring a spoon to my mouth

- I can chew