This document presents appropriate goals for “Alex,” a 2;10 old English/ Spanish bilingual who was diagnosed with apraxia.
ACADEMIC ACHIEVEMENT, FUNCTIONAL PERFORMANCE AND LEARNING CHARACTERISTICS
Alex’s development of morphology, semantics, and syntax is within normal limits for receptive and expressive language. He does not need articulation therapy as he can produce sounds well beyond his developmental age, including the sounds “b, p, t, d, k, g, w, s, l, z, ch, and sh.” Receptively, Alex labels and knows functions of objects, knows spatial relations, responds to what, who, where, how, and why questions, and follows 2 and 3 step directions. Expressively, Alex uses language in a variety of ways. He speaks in 4 and 5 word sentences with some as long as 9 words. Alex’s difficulty is in sequencing, planning, and production of sounds and sometimes words within sentences, especially vowels and short function words. Individual words at the end of his sentences are intelligible close to 80% of the time given developmental errors. Morphemes are omitted within sentences due to his planning and sequencing deficits, but he demonstrates understanding and production of all age-appropriate morphemes within single word utterances or the final word in a sentence where plurals, possessives, and verb tense markers are present. This sequencing and planning deficit significantly affects intelligibility, which is at least moderately-severely impaired. He is a bright boy with good problem solving skills. His parent reports that he does not communicate much verbally in school.
Alex has great difficulty being understood. His intelligibility is at least moderately-severely impaired.
Measurable Annual Goals
1. Annual Goal: Alex will improve intelligibility and verbal interaction in the classroom with peers and teachers.
1.1 Therapist and parent and teacher will identify certain short sentences, consisting of noun phrase, verb phrase, object, that Alex can use to interact with his peers in the classroom (e.g., “What is your name? Can I play? I want the __ please. It’s my turn. I need a _______”). By November and ongoing with 10 appropriate sentences identified.
1.2 Using a multisensory approach including appropriate emphasized intonation to emphasize length of the sentence and the various parts of the sentence, Alex will repeat the sentences focusing on the different parts of the sentences, e.g., noun phrase, then verb phrase, then object, using a multisensory approach that includes tapping out the noun phrase then the verb phrase then the object. By April with 70% accuracy.
1.3 Where necessary, therapist will give Alex tactile, visual, and auditory prompts to feel/see/hear the sequencing of the parts of the sentence. By April with 80% accuracy without prompts.
2. Annual Goal: Alex will acquire the ability to plan and sequence alternating vowels in V, CV, and CVC combinations. (Note these are to be done as fun speech drills for 5 minutes each day, if possible two times a day, before he goes to school as well as in therapy.)
2.1 Alex will correctly repeat a series of 4 alternating vowels beginning with ah, eh, ee, oh. By February with 80% accuracy.
2.2 Alex will correctly repeat a series of 4 alternating vowels with the same beginning consonant CV CV CV CV, such as bah, beh, bee, boh, then alternating all age appropriate consonants including p, t, d, k, g, s, sh, ch, l. By February with 80% accuracy.
2.3 Alex will correctly repeat age-appropriate CVC combinations first with the same consonants and then with variable consonants. (Bab behb beeb bohb. Bad behd beed bohd, etc.). By April with 80% accuracy.
2.4 Alex will correctly repeat age-appropriate CVC combinations varying the vowels and the consonants so he can repeat 4 varying CVC combinations. By April with 80% accuracy.
3. Annual Goal: Alex will repeat the repetitive phrases from his story books with 100% accuracy given his developmental age.
3.1 When being read aloud a story book in therapy and at home, Alex will repeat the repetitive line of the story using a multisensory approach including overemphasized intonation for spacing and timing, tapping, and emphasis on the sounds (e.g., E. Carle, From Head to Toe, the repetitive sentence “I can do it!”). By December with 80% accuracy.
3.2 Same goal as 3.1 but if the repetitive phrase contains sounds or clusters that Alex cannot produce that are developmentally appropriate, the focus is on acquiring the sequencing, planning, and production of the sounds he can make—NOT articulation goals for those other sounds (e.g., “Click Clack Boo!” is developmentally appropriate for Alex to say as “Kick Kack Boo”). By April with 80% accuracy.
4. Annual Goal: Alex will increase the number of words he says clearly that he can use in his life, especially in school.
4.1 Therapist, mother, and teacher on an ongoing basis will create a list of words that Alex might use on a regular basis to communicate including nouns, verbs, adjectives, and adverbs. Ongoing throughout year with a list of at least 10 words each week.
4.2 Therapist organizes the list to include certain vowels, certain consonant beginnings, or certain word endings, which therapist and Alex’s parents create a game out of drilling every day on the week’s “magic words.” If there are sounds and clusters that are not developmentally appropriate for Alex, these are not targeted as errors. The focus is on sequencing, planning, and production of the words. By February with 70% accuracy.
4.3 Alex and therapist will talk weekly and parents will talk daily with Alex about when he could use the words and ask if he used any of the week’s “magic words.” Ongoing with 80% identification and use of “magic words” during the week.
5. Annual Goal: Alex will use his developing intelligible language with a peer of the same chronological age.
5.1 Therapist, teacher, and parent will identify appropriate communication partners for Alex in the school who will be accepting and supportive of Alex. Two or three children identified by November.
5.2 Therapist, teacher, and parent will work with Alex to develop strategies to begin and join conversations and play interactions using his new sentences and words. By February with 5 strategies that Alex can rely upon.
5.3 Therapist, teacher, and parent will work with Alex to develop strategies to increase his intelligibility in social situations in general, and especially with peers, when he is initially not understood. By February with 5 strategies that Alex knows and implements 50% of the time.
5.4 Alex will use his new sentences and words to communicate verbally with his communication peers in the classroom. By February with a 50% increase from baseline.
5.5 Alex will use his sentences and words to communicate verbally with other peers in his classroom. By April so he is communicating verbally at the same level as his classroom peers without IEPs.
For all of the above:
Criteria: 80% accuracy over year
Method: Observational checklists
Schedule: By end of each marking period
Model Eval: 2;10- English/Spanish- Verbal Apraxia