DYSPHAGIA GOALS Lona TERM GOALS SWALLOWING ‘lent will malntaln adequate hydration /autsition with optimum safety and effency of ‘swallowing function on P.0. intake without overt sign and symptoms of aspiration forthe highest appropriate eet level {Gent will utiize compensatory stratepes with optimum safetyand efkiney of ‘wallowing function on P.O. intake without overt sgn ad symptoms of pration forthe highest appropriate det evel ‘Mascaton Paint will astiate food adequately to safly consume regular, mechanical soft, pureed etc) diet with verbal, visual and tactle cues we Coordination /Snsstion ‘he patient vl eomplete dally ora-motor exercise to neease buccal tension to within ‘unconal limes 0 eiminate pocketing of food inthe anterior an aterl sei with verbal vail and tact cues ond‘ effectiveness “ine patient wl complete daly ora-matorexerce to neeace Improve jaw closure and reduce anterior sso koep focdiqui nthe mouth while eating wth —_% verbal, visual ndtactie cues and Nefeciveness Paint wll complete diy orabmotor exercise to increase ol sensitivity toa functional level for bolus formation and optimus safety with_% verbal tactile and visual cues with —wetectveness “The patient wl demonstrate a swaow delay of oni 1-2 seconds following thermal ustatory stimulation an 10/20 erapeute tals to recue the risk food esdue fallng Into the aieay Lip coowdination/Sensaton ‘The patient wl complete daly ora-motor exercise to increas abil Fnctionwith_% ‘verbal facie and visual cues ith effectiveness to prevent fod ar qld silage from the eraleauty ‘Te patient wil complete daly ora-motor exerci to inreate ngal range of maton, srength and coordination with_% verbal tacile and viual cues with effectiveness {or eectve bos formation and to reduce the ik of fod rsa fling nto the 207 ‘The patient vl complete daly ora-motr exercise to increase kngual strength and range of tmotion for adequate ngual elevation and antec to posterior nawerent with -® vba, tactile and val ces with elfactivenest reduce the rik of food resid alg into the araay ‘he patient wl demonstrate det upgrade walswihout signs and/or symptoms of aspiration with 10/10 ils Patient will demonstrate adequate use of ___technique suprafottic swallow, Mendelson maneuver effort swallow, et) eliminates ryngel penetration andor aspiration o [pureed mecnaneal sof ete) det) huis with 9% ‘verbal cues suring 80% of ot oF 10 sais) therapeutic as‘he patient wll demonsrate a swallow delay of ony 1-2 seconds folowing thermal tactle stimulation on 10/20 therapeutic rial to decrease aspiration rk Patient will demonstrate adequate use ofthe following compensatory strategies chin tuck, ‘tiple svalows, hed tum, et to climinte s/s of ryngel penetration sna iprtion of (puree, mechanical sof, et) et/ quis with verbal ‘ies dung Saf ok of 10 salons] therapeu “The clont wil demonstrate the ability to adequately sf-menitor swallowing sil and perform appropiate compensatory techniques to reduces of aspiration ‘The patient wil alternate liquids olds bts to ler stass through buccal coy of residue with Susy and ate cuesLANGUAGE, COGNITION, TBI & DEMENTIA ‘ent wil develop functional, cogntve-tingusticbased sis and uiire compensatory strategies to communicate wants and neces effectively maintain safety during ADUs and paripate socially in funetonal ving environment Chant wil se external memory ais and crmpensatory strategie to vecal routine, personal Informason and recent events ta improve oentatin to time & recall daly events ith % securacy and cues. Cent wlimprove orientation by communicating mental awarenes of dally routines, personal Information nd recentevene with. eaecurseyand cute SHORT TERM GOALS - ATTENTION The patent willeomplete2_(wstined, selective alternating, cde tention tak wth ro mere than number of redirecions when given in ___(verbel sual tate) cues with 3% The patent will demonstrate adequate attention to therapy tasks with no more than ___surberof erections in 45-60 min session when puen min cues with secure. The patent wil attend to therapy tasks for x numberof minutes when ahen no more han» umber of redeectins with x aecuracy ‘SHORT TERM Goals -sequencing The patent wl verbally communicate sequences/steps an perform mult-evel dail ivng tasks with verbal, aval and tactile cues inorder to complete ates of daly Bung HORT TERM GOALS - AUDITORY COMPREHENSION The pation wl demonstrate the abit to comprehend uiling verbal presentation of —_simple/comple..cise-ended, open-ended question) with x verbal, sual and tactile {erin function ving environment The pater wil gesture appropiate use of functional tems wth __Sulsual verbal and tactle ues in order to increase gestural expresion of wants and needs ih functional living enszonment The pater wl demonstrate the abe to flow multstep directions elated to funcional Wing femvironment with verbal, vsual nd actle cues inorder to neease functional tration, SHORT TERM GOALS ~ PROBLEM SOLVINGY SAFETY The patent wll demonstrate funcional problem solving andsfety awareness wth _s verbal, tact ac vial ces fr dally Ing tasks inorder to increar safe interaction with environment ‘nd decreaced asetance from caregivers ent wil complet simple complex reasoning tasks to improve problem solving snd safety arenes with so aeeuracy and cues Cent wil complete convergent catgartaton tasks with 6 accuraey eves LONG TERM GOALS - MEMORY & SPACED RETRIEVAL ‘The cient will use appropiate memory strategies to schedule and recall wecklacties, express needs and recall names to maintain Safety and participate Socially in functional ing SHORT TERM GOALS - MEMORY & SPACED RETRIEVAL‘The patent wll demonstrate eal af functon Information following 2/an(mmeclate, nor term, longterm) delay with cuesin order to increase functonal integration ito The patent will demonstrate the abit to plan schedule and follow through with evets/ actitis with _Saecuracyand_—_ cues The pater wilcomolete a mental manipulation task with__% acuracy and _cueing inorder tormereare functional integration nto envionment The patent will ecall facts from (sentence, paragraph, several paragraph page length material with accuracy and — cueing Cent will denonstrate aby to allow a written tilt complet function tat with S05 ecuracy Cent il respond to visual cus in oder improve Sequencing to complete daly ask & recall tiretons with 80% aecuray. Cent wil recall and demenstrate strategy of responding o sal cues to Improvereading sls {compensate for visual efits during atts with 80% accuracy. Theclent willidonty orders with Jb accuracy andes Theclent wil match (word to werd, picture word) with __Seaccuracy and_eves ‘ent wil race shapes, number, ané letters with 90% securcy Cent wil generate name, adress, ana phone number in writing with 0% securaey let wil we steps to complet a given ask wih aD% accra. Cent wi epbly/eompletety writes grocery, todo, et) wth 80% accuracy. Cent wil wie letter and addess an envelope to a ven person wth 80% accuracy, Cent wil demonstrat funcional wring hls at Sentence level using compensatory strategies tocomplet daly activities during 80% of tals ‘ent wil develop functional, cogntive-tinguisti-based sis and ulize compensatory strategies to communicate wants and neecs effectively to diferent conversational partners, ‘maltain safety and participate socal in functional living environment SHORT TERM GOALS = EXPRESSIVE LANGUAGE Naming The patent will name objects, pitures, people andor acttes verbally with _ verbal, tactile ‘The patient wil perform sntence/phrase completion ass flated to AOL's and safety verbally wien sua, ace and verbal cues to increase automatic verbalaations in functonal Ning ‘ent wil formulate sentences with given word related tohis/her personal needs, ADL's and safety with effectiveness. Concsation & Pragmatics Cent wil intiate and maintain 1-3 conversational exchanges related to hsfher person needs wien one other faa Istener wih 80% scuraey. Patient wil use short phrases / 3-8 sentences to communicate memories of familiar obees ane past experonces with 60% effectiveness (6 of 10), Fesdent will make 10 appropriate verbal uterances during 335 minute conversation in responce to pros and minimal verbal cues by caregivers to reduce socal soation Chant wil crrectly entity and match facial expression & body language related to ‘moads/feting wth BOR accuracy to improve neracton & conversation with aly & tll Cent wil demonstrate appropriate turn taking &tope maintenance abies during, inacualeroup sessions with cuesAnswering questions The pater wl espond to__(simple/omple..wh-questons, yes/no questions open-ended questions) with —_% verbal visual and tactile cues and compensatory satepes to increase fommnicatons within functional vingenvironment ‘other ent wil verbs express items belonging to given categories wth semantic and phonemic ves with 0% accuracy ‘ent wil recall and demonstrate use of compensatory strategies fr Lside neglect toimprove reading & writing sls in functional activities ‘ent wil leatn& recall strategies to compensate for frontal lobe defi to improve abit to artipate in daly tasks & participate appropriately in conversation T= Ghent wl develop functions cognitive ingvaticchased sls and utlrecompensstory strates to communicate wants and needs effectively, maintain safety dring AU's and Partipate socially in funcional ivng environment esent wil express wants, need and feelings trough establishment of an effective ‘maintenance program to maximize functional communication Reskent wll appropritly interact wit staf/ pees ven assist for ntation, turaking, and topiemaintenance fr communication Resident ul demonstrate appropriate behavior to meet needs wth sta and support of tenmunicalion needs ‘SUORT TEaM Goals pexscnia lent wl eal strategy of lcsting and ulzing personal memory booko improve crientaton ‘reduce repetsve question asking behavior 82% of til Patient wil learn effective use of memory book o compensate for residual memory problems wh a accuracy. Pation wil use external memory aid with 80% accuracy with verbal and tect eves to maximize memory sis Patient wil flow mole one-step directions uizing compensatory strategies with 90% Pation wil express wans/needs when presented with two verbal options with 80% accuracy Pation wil answer yes/ne question with 80% accuracy Patient wilexhibt no more than 2 in 0 minutes time gen structured reinforcement program by careers for thee conaraive days Patient wil engage conversation witha least 3 tr ven asst from caregivers 3 days Patent wil generat wh-questins to meet needs gvencuesorompt with __ass from ‘arogvers wth 20% accuracy Patient wil respond to wh- questions gvn two verbal options wth a0% accuracy Pation wil utile audible vie in environmental noe for tre settings over period of three days Pationtwlinite communication exchanges 3times/y wth staftfamiy/pers for three consecutive days| Patient wil vluntariy/ulingy partciate in 3 soc setts a wee for 2 weeks Patient wil luntariyrlingy be avasble for sei interaction with tapers for 30 minutes aay overtnree das, Patient wil demonstrate copnte linguistic baseline kil for design and implementation of functional maintenance program king exchanges isa group settingMOTOR SPEECH GOALS ‘Cent wil develop functional and intelligible speech and wtsze compensatory strategies ‘ivough the use of adequate labial and lingual function, increased articulatory precision and speech prosody Cent wil develop functional motor programming, articulator proficiency and utize compensatory strategies to express wants and need fr itellzble speech and functional, prosody in the functional ving envionment SHONLTERM.GOALS-APRANA & DYSARTHRIA The pater wl utilize phonation at the_(word, phrase, sentence) evel with _ verbal, visual an tactile ces n functional ing envionment in oder to increase functional speech Intlignity esication The patent wil improve espatory support anathe use of respiration forthe production of ___Iwords, phrases, sentences with verbal and woul insteuctions/evesin netionl ing ‘ronment im order to ncreae funcional peecnitellgilty ration The patent wil atiuate consonants a the _(word, phrase, Sentence) evel with Sveral island tactile euesin are ta nerese artculstry precision and ineigbilty n ‘erversational speech The pater will demonstrate adequate __{tongue control for tongue bp sounds Vip Contra fr aba and bibl sounds m,p,b& w/ eral an cal muscle controVja contrl to produce 20 understandable and functional (words, phases, sentences) related to base ‘edie, perronal and hygienic needs The patent will demonstrate the abit to produce clear vocal tones sufient to support. ___Iword, phrase, sentence production to execute sucess ende/eceiver communication Te tuncioal ing environment VOICE & TRACH/VENT GOALS‘lent will demonstrate breath contro fos minimum of 3 seconds when expressing personal needs Patient wil demonstrate aby to produce cles ocaltones sufficen tsupport words elated to medical needs with 70% accuracy (70 of 100) Patient wil demonstrate abit to produce two tones above and two tones below optima teh when communisting bose medial needs Patient wil demonstrate the ably to delat cuff nd aply speaking vale prior to oral intaketo Increase airway protection ving the swallow with 20% effectiveness aout of 10) Patient wil demonstrate abit to increase airway protection during swallow by independently lcclucing tracheostomy tube during swallow with 80% efecsveress (8 of 10) Patient wil demonstrate proper actvation/ deactivation of eletrolarmxin conversational speech wit 80% consitoney by (date) (0 Without vsval ve, tener wil understand pation’ conversational spech with 80% consistency by (at) Lv Patient wll demonstrate prope placement of electro larynx with O% casi ney during 424 word response task by (te) Patient wil ere proper technique for battery charging x3 by (eat) Patient wits electrolanmgeal peechin conversation without audible toms noe with 90% tensistency by (at) Patient wil demonstrate proper placement of elecrlarynx with 90% constency by ate) eaksneesh {Given visa cue from ventiator and verbal ue from cinkan the patient wil demonstrate the bit to restrict alow trough the gots on insiration (maintaining peak insiatorypresture (of 25em H20} with 705 consistency by (at) Patient/Careger will demonstrate ay to independently defate and inate tracheostomy tube ctf 93 By (te Potion wil demonstrate abit to speak on exhalation na phrase repetition tak ven vu tue rom ventator with 70% consstncy by (te. ¥) Caregiver wil independenty demonstrat proper five stops toward cuff deflation associated with providing patent th verbal communication by date} () Patient wil tolerate cul delation oxygen saturation of >50% a minutes by at) ) Patient wilindependently perform 3 adduction exercises 110 by (date (4) respiratory ate of 16( or 15 “aling Tracheostomy Tubes Patient wil demonstrate proper activation of gs supply wth 705conssency by (ate) Patient wll maintains volume rating of>3 (rating scale 3 to: 2rpoor, Svexcllen) wth 80% consistency by tel ¥) Pation wl achieve vocing with aking tracheostomy tube with SO% consistene by ate] ¥) Patient wil respond to yes/no questions within 3 seconds begining with hand in neutral postion with 88% consistency by (date e) Caregiver wil emonstrate proper daring procedure for talking acheostomy tube 3 ven writen instruction by (ate) Caregiver wil demonstrate the ability to instruct and asst in patent’ completion of 10 or ‘exer ivan writen instrutions by (ate, 9) Patient wil tolerate one-way speaking valve (demonstrated by an oxygen saturation of 98K) for 20 minutes by ate)Patlen/carepve wl demonstrate the ality to Independent apply and remove one-way speaking valve x by date) Given verbal cues, patient will demonstrate the ability to clean one-way speaking vale by ate) Pation/caragiver wll demonstrate the ability to independently inate a deflate tracheostomy tube ctf 3 by (te) Patient wil demonstrate adduction technique during one way word responses to questions with 0% accuracy by (att) Liven writen ces, the patient and/or caregiver wil demonstrate the sity to make ehangesin vertlater settings to accommodate the one-way speaking valve x3 by (te) Indias goas canbe used fr other methods of communication e-alectrolaynn leskspeech taking wacheostomy tube ¥-one way vabe AAC GOALSDemonstrate ability to master basic maintenance and operations af deve (on alusting menu features such as oie and display) with 100% accuracy (thin 2 weeks) Demonstrate ably to program stored messages independenty with 100% accuracy within 2 weet) Convey basi needs/make requests to caregivers, by speling or rtrieving pre-programmed rmessageon device, ndependenty and wth 100% accuracy (thin 2 weeks) Inte social greetings offer information, ak questions express feeings ana opinions trough speling and etrving stores messages on devi, during 1:1 and group stuatons with Famlst ‘nd unfair portnersindependenty ana with 100% accuracy thin 3 week Use strategies on device to expedite message praducton when sharing information or aking ‘usstlons of medial personnel, independenty and with 200% accuracy (within 3 week)