objectives, objectives, objectives€¦ · sam will attend at least 2 social outings in the...
TRANSCRIPT
Objectives, Objectives, Objectives
Amy Alford, M.Ed.Clinical Consultant
Bureau of Autism Services
Agenda
Initial ISP Goal Development Provider Roles Objective Components Entering Objectives into HCSIS Types of Objectives SC roles in reviewing objectives Using the Objective Cheat sheet to Review
Objectives
Initial ISP Goal Development
Initial ISP Goal Development
Initial ISP team created goals Goal Phrase Goal Statement Concerns Related to Goals
Goals are linked to services, based on Assessments Participant Desires Team Input
Service Providers develop objectives once services begin
Provider Roles
Provider Roles
Review ISP in HCSIS Review Goals related to service you are
providing Develop short-term objective(s) that are
observable and measurable. Email objectives to Supports Coordinator. Monitor progress toward goals when
providing services
Objective Components
Objective Components
Condition When/where the participant will perform the
behavior. What staff or others may have to do or present
to the participant. May contain a description of assessment
material that will be used to evaluate the outcome.
Clearly Defined Behavior Performance Criteria
Condition
Examples On Sundays, when
presented with newspaper…
When entering the supermarket with staff…
Given a request to get dressed…
Given staff direction (e.g. What do you want to do next)…
Non-examples When Bob feels like it…
Why? – Should be more specific. When Bob feels like doing what?
With the assistance of staff, Marc will prepare for an interview… Why? – The behavior is
listed as part of condition. What does assistance look like? What else can be added?
Objective Components
Condition Clearly Defined Behavior
Contains information related to what is expected from the participant written in observable, measurable terms.
States exactly what the participant will do. Performance Criteria
Clearly Defined Behavior Examples
Michael will read and circle at least two job listings he is interested in pursuing…
Alicia will select the items from the grocery list and put items into the cart…
Chris will greet the person behind the counter and order food of his choice…
Non-examples Ben will understand
the rules of the game… Why? What does
“understand” mean? Marissa will
demonstrate how to do laundry… Why? How will she
“demonstrate?” Sarah will find a
job… Why? What steps are
needed to find a job?
Objective Components
Condition Clearly Defined Behavior Performance Criteria
Contains information related to how well the participant must perform the skill.
Contains specific information that will determine mastery.
Specifies how frequently the participant will be assessed.
Performance Criteria Examples
… with only one prompt from his staff, for 8 out of 10 consecutive times searching the newspaper.
… at least 30 minutes per day for one consecutive week.
… 5 out of 5 consecutive visits into the community for one month.
Non-examples … 80% of the time.
Why? Criteria needs to be more specific than just 80%
… When he feels like doing it. Why? Not measurable
to collect data … Everyday.
Why? Is it possible for the behavior to be observed daily? How will it be measured?
Performance Criteria
Other criteria possibilities # times out of total # of times With # of % of accuracy With “x” movement on a prompting hierarchy With no more than “x” occurrences of… With an “x” or better on “x” rating scale With “x/x” points on an assessment checklist
Let’s walk through some more examples, putting the
components together
Objective ExamplesCondition Behavior Criteria
1. When prompted by staff to bring her basket of dirty laundry to the wash room,
Carrie will wash her clothes in the washing machine following the steps of her task analysis
8 out of 10 steps of task analysis Independently, 1 time per week for 1 month.
2. When verbally presented by staff to choose between two activities in the community (e.g. bowling, movies, shopping, etc…)
Matt will verbally select one activity and begin within 15minutes of arriving to location
Trying activity for at least 30 minutes with less than 2 prompts from staff to remain with activity for 5 total activities.
3. When in the community (e.g. visiting the mall, at a restaurant) and it is getting crowded and noisy,
Mary will ask to find somewhere quiet to take a break instead of yelling or hitting staff
4 out of 5 visits into the community for two months.
4. With staff assistance, after creating a resume and setting up an interview with at least one potential employer,
Nathan will practice for interview by verbally answering mock questions from staff
For at least 15 minutes per potential job, every other day, until job interview.
Entering Objectives into HCSIS
Entering Objectives
Plan > Manage Plan > View/Modify Plan Details > Goals > Add Objectives
New screen will appear – Select “Add Objectives” again Only enter 1 objective at a time Select “Add” each time to enter a new
objective
Goals Screen in HCSIS
Objectives Screen in HCSIS
Additional Reminders
Each of the 5 areas on the Objectives screen should capture different information: Objective: The entire condition, behavior, and criteria
statement Condition: Only the section of the objective that pertains to
how or when the participant will perform the behavior Behavior: Only the section that pertains to exactly what the
participant will do Criteria: Only the section that states how well the participant
is to perform the behavior Comment: Any additional information not captured in areas
mentioned above that are important to remember.
An example…
Objective
On Tuesdays when staff comes to Mark’s house and prompts “Please choose a recipe,” Mark will look through a cookbook and circle 1 main dish and 1 side dish he is interested in making for dinner, following 8 out of 10 steps on a task analysis independently, one time per week for 10 out of 12
consecutive weeks.
ConditionOn Tuesdays when staff comes to Mark’s house and prompts “Please
choose a recipe,”
BehaviorMark will look through a cookbook and circle 1 main dish (e.g. chicken, beef, fish) and 1 side dish (veggies, potatoes, rice) he is interested in
making for dinner.
Criteria following 8 out of 10 steps on a task analysis independently, one time per week for 10 out of 12 consecutive weeks.
CommentMark needs to learn to plan for a variety of different meals for himself so
that he can be healthy and continue to live on his own. He enjoys cooking and can use most appliances with little support.
Types of Objectives
Types of Objectives
Incremental independence/Skill buildingMultiple skills required
Whatever type of objective(s) is developed, please remember…
The Objective Drives Instruction!!
Incremental Independence/Skill Building
Breaking down a goal into component parts that require independence in one part prior to graduating to the next e.g., Participant wants a job at a baseball stadium, but
has difficulty holding conversations with loud noises around him. Objective 1: Spending small amounts of time in
different settings with loud noises to overcome anxiety-provoking situations**Once skill is obtained, then work on Objective 2**
Objective 2: Focus on spending time at a baseball stadium when a game is going on
Multiple Skills Required
Identifying several steps needed to reach a certain goal e.g. to get a job, participant may need to
(1) search for a job, (2) fill out an application, and (3) participate completing interviews
e.g. to live independently in an apartment, participant may need to (1) prepare simple meals, (2) perform basic household chores, and (3) learn how to pay bills each month
SC Roles in Reviewing Objectives
SC Roles in Reviewing Objectives
After objectives are submitted to SCs, but BEFORE objectives are entered into HCSIS, SCs will review objectives following a “cheat sheet”
developed by Clinical Team Cheat sheet can be found in VTC under “SC Docs”
SC may ask for revisions to objectives Once objectives are entered in HCSIS…
The clinical team will review and provide additional feedback, if needed.
A Few Comments about BSS
IF there is a behavioral goal, the Behavior Specialist can copy and paste the Desired Behavioral Outcome that is developed in the BSP into the “Goals” screen as an objective. The BSP/CIP screens are specific to Behavior Specialist
Services.
Behavior Specialists have the role to enter and upload BSP/CIP information directly into HCSIS.
Objectives MUST be submitted to SCs, as providers do not have the editing role to enter objectives.
Objective Cheat Sheet
Objective Cheat Sheet
Objectives are appropriate steps to reach the long-term goal (goal statement).
Objectives are clearly linked to the needs identified within the ISP.
Objectives should be either incremental independence/skill building OR multiple skills.
Each section of the objective contains a condition, clearly defined behavior, and performance criteria.
The requirements of one section (e.g. Condition) are not captured in another section (e.g. Behavior or Criteria).
Objective Cheat Sheet Condition
Contains information related to when/where the participant will perform the behavior is included within this section.
Contains what staff or others may have to do or present to the participant
Behavior Contains information related to what is expected from the
participant written in observable, measurable terms, stating exactly what the participant will do
Criteria Contains information related to how well the participant must perform the
skill is included within this section. Contains specific information that will determine mastery and how
frequently the participant will be assessed (If “XX% of the time” is listed, additional information is needed to determine what XX% of the time looks like)
Using the Cheat Sheet to Review Objectives
Example 1- Sam
Objective Sam will attend at least 2 social outings in the community each month with peers or friends.
Condition Sam will participate in activities that he finds interesting
Behavior Sam will attend and participate in social activities with peers or personal friends.
Criteria The individuals Sam socializes with should be those of his choosing, not only friends of his parents.
Feedback for Example 1- Sam Objective
Appropriate to reach long-term goal Clearly linked to needs Related to skill-building Missing the condition; Behavior/Criteria incomplete
Condition Does not indicate where/when skill will be performed Unclear if staff or others need to present information
Behavior Also state he will choose the activity, not just attend and participate
Criteria Information from “Objective” should be captured within this section (e.g.
at least 2 outings per month) Elaborate on the level of mastery required
Sam’s Original Objective
Objective- Sam will attend at least 2 social outings in the community each month with peers or friends.
Condition- Sam will participate in activities that he finds interesting
Behavior- Sam will attend and participate in social activities with peers or personal friends.
Criteria- The individuals Sam socializes with should be those of his choosing, not only friends of his parents.
Sam’s Revised Objective
Objective- When presented with a choice to participate in a community activity with same-age peers, Sam will choose, attend, and participate in the activity for at least 30 minutes, 2 times per month for 4 months.
Condition- When presented with a choice to participate in a community activity with same-age peers,
Behavior- Sam will choose, attend, and participate in the activity for at least 30 minutes,
Criteria- at least 2 times per month for 4 months.
Example 2- Peter
Objective
When Peter has a desire to engage in picking behaviors, he will utilize alternative behaviors (use of a fidget item, seek out
adult to discuss urges) in 3 out of 5 opportunities.
Condition
If Peter’s inappropriate behaviors continue, he will not learn how to communicate effectively and will not improve
relationships with people around him.
BehaviorPeter will learn how to cope with his irritable bowel syndrome
issues
Criteria Behavioral Specialist will continue to monitor progress and issues and keep SC and team updated.
Feedback for Example 2- Peter Objective
Appropriate to reach long-term goal Clearly linked to needs; Related to skill-building Contains all 3 components, minor tweaking required
Condition This section should state what is listed under Objective (When Peter has a
desire to engage in picking behaviors) Does not specify where the skill will be performed (e.g. home/community)
Behavior Should focus on the specific behavior Peter would do (e.g. select and
engage in alternate activity) to refrain from picking, as stated under Objective
Criteria Information under Objective should be included here (e.g. 3 out of 5
opportunities) Unclear what the mastery level would be
Peter’s Original Objective Objective- When Peter has a desire
to engage in picking behaviors, he will utilize alternative behaviors (use of a fidget item, seek out adult to discuss urges) in 3 out of 5 opportunities.
Condition- If Peter’s inappropriate behaviors continue, he will not learn how to communicate effectively and will not improve relationships with people around him.
Behavior- Peter will learn how to cope with his irritable bowel syndrome issues
Criteria- Behavioral Specialist will continue to monitor progress and issues and keep SC and team updated.
Peter’s Revised Objective Objective- When Peter has a desire
to engage in picking behaviors in home or community, he will select and engage in an alternative activity (use a fidget item, seek out another person to talk to) instead of picking in 3 out of 5 opportunities for 2 weeks.
Condition- When Peter has a desire to engage in picking behaviors in home or community,
Behavior- he will select and engage in an alternative activity (use a fidget item, seek out another person to talk to) instead of picking,
Criteria-. in 3 out of 5 opportunities for 2 weeks.
Example 3- Bob
Objective Bob will work on ironing his clothes to ensure that his clothing is neat and appropriate when going into the community.
ConditionBob will do this with prompts and reminders and assistance
from staff.
Behavior Bob currently will wear whatever clothing is available
Criteria Bob will iron clothes and pick out appropriate clothing.
Feedback for Example 3- Bob Objective
Appropriate to reach long-term goal Clearly linked to needs; Related to multiple skills Criteria was not included; revisions needed to condition/behavior
Condition Should include “When going into the community” as stated in Objective. Should indicate when he should perform this task (e.g. in the morning)
Behavior Should explicitly state what Bob will do (e.g. choose appropriate clothing,
iron as needed) Information from Objective should be included (Iron clothes to ensure they
are neat and appropriate) Criteria
Does not specify how well Bob must perform skill or what determines mastery.
Information within this section would be an appropriate goal statement
Bob’s Original Objective
Objective- Bob will work on ironing his clothes to ensure that his clothing is neat and appropriate when going into the community.
Condition- Bob will do this with prompts and reminders and assistance from staff.
Behavior- Bob currently will wear whatever clothing is available
Criteria- Bob will iron clothes and pick out appropriate clothing.
Bob’s Revised Objective Objective- Every morning, when Bob is
getting dressed to go into the community, he will choose appropriate clothing for the weather and iron clothes as needed following the steps of a TA, with no more than 2 verbal prompts/reminders, daily for 1 week.
Condition- Every morning, when Bob is getting dressed to go into the community,
Behavior- He will choose appropriate clothing for the weather and iron clothes as needed following the steps of a TA,
Criteria-. with no more than 2 verbal prompts/reminders, daily for 1 week.
Example 4- Sarah
Objective Sarah will learn good decision making skills.
Condition Sarah will increase her ability to make decisions without showing frustration when presented with a question.
Behavior Sarah will learn and utilize appropriate coping methods
Criteria Sarah will learn to make decisions between two choices.
Feedback for Example 4- Sarah Objective
Appropriate to reach long-term goal Clearly linked to needs; Related to skill building Information within this section would be more appropriate as a goal
statement, not necessarily an objective. Condition
“When presented with a question” would be appropriate Information related to behavior should be captured in the next section Who presents the question? What types of questions would be asked?
Behavior Additional information is needed to explicitly state what Sarah will do
(e.g. what coping strategies specifically) Criteria
Does not indicate how well Sarah must perform skill and what would determine mastery
Sarah’s Original Objective
Objective- Sarah will learn good decision making skills.
Condition- Sarah will increase her ability to make decisions without showing frustration when presented with a question.
Behavior- Sarah will learn and utilize appropriate coping methods
Criteria- Sarah will learn to make decisions between two choices.
Sarah’s Revised Objective
Objective- When staff asks a question to make a decision btwn 2 items (e.g. where to eat, what to do) and Sarah becomes frustrated, she will use a coping strategy (e.g. ask for help) and make the decision within 5 minutes of the question being asked, 2 out of 3 opportunities for 1 month, with less than 2 verbal prompts.
Condition- When staff asks a question to make a decision btwn 2 items (e.g. where to eat, what to do) and Sarah becomes frustrated,
Behavior- she will use a coping strategy (e.g. ask for help) and make the decision
Criteria-. within 5 minutes of the question being asked, 2 out of 3 opportunities for 1 month, with less than 2 verbal prompts.
Example 5- Chris
Objective Chris will complete job/volunteer applications.
Condition When working with staff
Behavior Chris will complete and submit job/volunteer applications.
Criteria Chris will complete and submit one application at least twice a month until placement is found.
Feedback for Example 5- Chris Objective
Appropriate to reach long-term goal Clearly linked to needs; Related to multiple skills Information within this section would be more appropriate as a goal
statement, not necessarily an objective. Condition
More information is needed to explain what staff will be doing. Where and when would Chris perform this skill?
Behavior What does it mean to complete and submit applications? Will he do this via
pen and paper, on the internet? Will staff write for him? Criteria
This would be an appropriate criteria statement for this objective. Once this objective is mastered (e.g. when placement is found), the next objective to work on may be to “maintain employment.”
Chris’ Original Objective Objective- Chris will
complete job/volunteer applications.
Condition- When working with staff
Behavior- Chris will complete and submit job/volunteer applications.
Criteria- Chris will complete and submit one application at least twice a month until placement is found.
Chris’ Revised Objective Objective- When prompted by staff to
complete a job/volunteer application on the computer, Chris will type the answers in each field with the assistance of staff and submit via the Internet, completing at least one application twice a month until a placement is found.
Condition- When prompted by staff to complete a job/volunteer application on the computer,
Behavior- Chris will type the answers in each field with the assistance of staff and submit via the Internet,
Criteria-. completing at least one application twice a month until a placement is found.
Additional Resources
Provider Support Mailbox [email protected]
Virtual Training Center http://bastraining.tiu11.org/
Provider Information and Training
Next Week
Thursday Afternoon Adult Autism Waiver Provider Training:
Assistive Technology: Part 2Amy Goldman