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 4

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 Clearly Defined Behavior 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 Non-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 Non-examples … Everyday. … 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 Examples Condition 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. Goal- completing household task Goal- choosing and participating in community activities Goal- (Behavior)- requesting to leave community when noisy Goal- Job related skills

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. Reference back to earlier sections of the training for specifics of condition, behavior, criteria

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. Condition On Tuesdays when staff comes to Mark’s house and prompts “Please choose a recipe,” Behavior Mark 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. Comment Mark 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

The Objective Drives Instruction!! Types of Objectives Incremental independence/Skill building Multiple skills required Whatever type of objective(s) is developed, please remember… The Objective Drives Instruction!! 24

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. Mention a BSS-Follow up training will be scheduled soon for additional information

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). SHOW CHEAT SHEET

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

Sam will participate in activities that he finds interesting 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 Sam’s Revised 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. 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.

Peter will learn how to cope with his irritable bowel syndrome issues 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. 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.

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 Peter’s Revised 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. 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. 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.

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 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. 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.

Example 4- Sarah Sarah will learn good decision making skills. 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 Sarah’s Revised 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. 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 Chris’ Revised 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. 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 Information and Training Provider Support Mailbox ra-basprovidersupprt@state.pa.us Virtual Training Center http://bastraining.tiu11.org/ Provider Information and Training

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