Best Practices for Setting Realistic Goals in ABA Therapy and at Home

BCBAs Share Tips for Creating Short- and Long-Term Goals for Children with Autism

With a new year often comes new resolutions and intentions, but at Hopebridge, we never stop setting them. Rather than approaching them one time a year, we work with our families to set, reevaluate and achieve goals year-round.

There is a science, and some might say an art form, to setting goals with autism. Our Board Certified Behavior Analysts (BCBA) are educated and trained in working with caregivers to create personalized plans that reflect each individual child’s and family’s goals.

Our clinicians have extensive experience building short-term to long-term goals for children with autism spectrum disorder (ASD). We connected with our team of BCBAs to share some of the top tips for parents who want to play an active role in goal-setting for their children who participate in applied behavior analysis (ABA therapy).

BCBAs Answer: ‘How Should I Approach Goal-Setting for My Autistic Child?’

Parents play a key role in ABA therapy, especially at Hopebridge. In our centers, we collaborate with our patients’ caregivers from the start, plus continue to check in and discuss the programs of care during ongoing parent training sessions. A crucial piece of these plans and sessions centers around goals.

How can you work with your BCBA to set up your child for success? Here are some recommended steps and considerations to approaching measurable, achievable goals from the start.

1. Get a baseline of your child’s development without judgment.
   Before putting objectives in place for your own child, research the standards and developmental milestones for a neurotypical child of the same age. For parents who have other children, especially neurotypical children, it can be helpful to review the siblings’ development for a non-judgmental comparison. Think about how many words typically developing children are expected to have at this point. Do they imitate others? Are there certain gross motor actions expected? Can they complete any activities of daily living by themselves, such as washing hands? Are they showing signs of being ready for toilet-training, such as being bothered by soiled clothing or staying dry for at least an hour and a half?
   
   For example, at 3 years old, most children can walk up a stepstool and turn on the water. Maybe a child can walk up the stool, but does not yet have the strength to turn on the water. Once caregivers have the ability to know the developmental guidelines and look at where their child currently is, they can then determine whether it is a short or long gap and how long it could take to teach this skill.
   
2. Be realistic.
   Having a baseline allows families to have a more realistic picture of their child, which in turn helps build achievable goals. For instance, if a child is completely non-speaking, is not skilled in using an AAC device, and not yet using the restroom independently and the parents tell us they would like him to be talking and in a typical kindergarten class next year–that might not be possible. This can be tough for some caregivers to hear, but it is so important keep in mind for their progress and overall development. In these cases, we may instead choose to start by celebrating the smaller victories that will eventually make a big impact.
   
3. Zoom out to look at the big picture.
   We focus on early intensive behavioral intervention at Hopebridge, with many of our kids starting as toddlers or preschool age, but it is essential to look at the broader picture. We understand that the day-to-day can be rough and some parents have a difficult time seeing beyond the next week, but if you want to have a goal-oriented view and collaborate with the BCBA to create goals, try to look ahead to the future. It is helpful for clinicians to know where you see them in regards to schooling, jobs and independent living. That can seem strange when speaking about a 5-year-old, but time flies! You don’t want to be a year out and think, “what are we going to do now?”
   
   Viewing the larger picture also helps your child create foundational skills now. For example, if we believe a child can be integrated into a typical classroom, we might aim for school preparation skills like working at a table and raising their hand rather than always allowing them to do their work on the floor. On the other hand, if we have an older child with severe aggression and transition challenges, we can have them do their work on a beanbag because their family envisions them within a smaller, contained classroom where that would be more appropriate.
   
4. Think about your specific family culture.
   Each child and family is different with varying needs. Because of this, we choose to focus on what we call “socially significant skills.” Just because a box is empty on an assessment, doesn’t mean we’re going to teach it. If the child is not going to be able to use the skill, it is better that we place our attention on something else. If there is something that is significant for your family that you would like your child to do, that is something we want to know.
   
   For instance, our team has worked with families of African descent where the mealtime includes everyone sitting on the floor with a large bowl and eating with their hands. They didn’t regularly use utensils, so instead of focusing on spoons and forks, which were not appropriate for their culture, we taught the children how to get a little bit of food and wipe their hands and mouths.
   
5. Consider natural reinforcement.
   In the clinic, we contrive reinforcement as part of therapy. We conduct assessments to find out what our kids are interested in and motivated by, then every time they do a certain number of tasks, we give them a gummy, iPad time or another reinforcer. That is a good starting point for us, but unfortunately, that’s not how the real world works.
   
   To build upon goals, we must also consider whether we are going to be able to decrease our artificial reinforcement enough to match how it will be in a natural environment. Will the child learn that social and vocal praise or another form of secondary reinforcement is good? Are we going to be able to teach these skills in a way that once we remove reinforcement, the skill still happens? You can teach a willing child almost anything, but if it won’t be reinforced enough, it won’t stick.
   
6. Don’t be shy about reaching out to your child’s BCBA.
   As behavior analysts dedicated to your child’s progress, we do our best to schedule family guidance sessions and create opportunities to collaborate, but if you have a goal in mind, please don’t hesitate to tell us. Maybe your kid started doing something at home that you want to implement into the program—let’s have a call about it! It might seem intimidating for some parents at first, but we want caregivers to be involved and have a say in what their children are learning.
   

How to Build Short-Term and Long-Term Goals with Autism

Once caregivers and the therapy team have an idea of where we want the child headed, the BCBA will create a step-by-step process of how to get there. Sometimes these initial pieces can seem to caregivers like we’re not doing much in therapy, but in reality, we are taking baby steps toward a bigger end goal. These smaller steps can be critically foundational and parents may not realize how much they tie into each other until the individual is much older.

When building out short-term goals for children with autism, caregivers should take a step back and look at the day-to-day routine. Think about what skills the child is not doing that they and your family could truly benefit from them starting to do.

Some ideas include independent dressing, putting clothes away, feeding oneself and showering oneself. There are also chores that kids as young as 3 years old can help with around the house. These are quick goals we can teach them in the center and then transfer immediately to the home. They help increase independence, plus the family has something taken off their plate. Everyone is reinforced by this skill because it’s one-and-done.

When it comes to long-term, parents should think about the future and their end goal. If the child is 3 years old, what is your goal for 5 years old? Maybe it is homeschooling, half-day kindergarten or full-time kindergarten. We will then start piecing together strings and sets of short-term goals together to build up to the long-term goal. Depending on the objective, at 3 years of age, we can start teaching the child how to participate in circle time, sit at a desk, tie shoes, follow directions, participate in a group and get in line.

Whether short-term or long-term, having these goals helps a BCBA with the overall program. I like to reach out to families and let them know what I see as immediately urgent, then find out whether they agree or if something else should come first. Buy-in from the parents is necessary.

Decreasing maladaptive behaviors is usually a main goal of ABA, so we did not touch on them much here, but when building out goals, think about behaviors that are of high concern and dangerous. It is important to place effort on elopement, physical aggression, self-injury and PICA first, versus those others may just find “different” but do not pose immediate harm to anyone. Aggression may not seem urgent at 3 years old, but all of a sudden, the child will be 6 and a lot bigger and stronger, so if it’s not handled early, it will become a larger issue. These types of reduction goals should always take priority over something like a child repetitively asking to go to the store.

Goal-Setting in Action Within ABA Therapy

What does goal-setting look like as part of a real ABA program?

Some of our team worked with one child who took part in varying amounts of elopement. He began to experience a lot of changes at home, from his parents fostering an infant, to quarantining during the COVID-19 pandemic. This is when his elopement in the home began to escalate, and eventually, he ran away from his older sister in the grocery store, which was a big deal.

His parents and BCBA sat down to talk about it. They discussed what it looks like when he elopes, how it happens, what they do when it happens, and how other family members react. Based on this conversation, they were able to put some short-term goals in place.

First, they decided everyone in the family needs instructional control, meaning he knows that when someone tells him to stop, he needs to stop. As part of the program, they practiced playing a stop-and-go game in their backyard. When he stopped, they would run to give him a preferred toy or pick him up and spin him around as reinforcement. This way, not only did he learn to listen to his trusted adults and siblings, but he also knows good things happen when he listens.

They created another short-term goal around hand-holding. Originally, when he would hold his sister’s hand, he would fall to the ground. When she bent down to pick him up, he’d take off running. The team worked on tolerating handholding for varying amounts of time, starting at 30 seconds, one minute, and then moving their way up.

Ultimately, these short-term goals were all directly related to this child’s long-term goal of reducing and eliminating elopement.

Learn More About How Hopebridge Can Help

What are your hopes for your child? Where do you see them in the future, and how can we work with your family to get there?Through ABA therapy, our team can work with you to create an individualized program that helps your child reach their fullest potential. If you’d like to learn more about Hopebridge’s ABA therapy and other services like speech therapy and occupational therapy, please fill out our easy online form to schedule autism testing or an ABA evaluation at one of our centers across the country.

*Informed consent was obtained from the participants in this article. This information should not be captured and reused without express permission from Hopebridge, LLC. Testimonials are solicited as part of an open casting call process for testimonials from former client caregivers. Hopebridge does not permit clinical employees to solicit or use testimonials about therapeutic services received from current clients (Ethics Code for Behavior Analysts 5.07-5.08; BACB, 2020). Hopebridge does not provide any incentives, compensation, or renumeration for testimonials provided by a former client or client caregiver.