speechpathology

Why does she want to come back? I'd ask her what her specific goals are and go from there.

She requested to come back. Her concerns are auditory comprehension. More specifically, taking phone orders from customers.

Right on about be specific to the patient's needs- ask her what she wants to accomplish, where's she having difficulty, specific to her ADL. You can read a newspaper article out loud and ask questions (have her take notes, request clarification), watch youtube vidoes/news reports with a question component, have her call in somewhere with a dial menu (press one for english, please hold, press one for reservation, press two for booking information, etc. She doesn't actually have to need to do anything with it, although it's more functional if she does, but just to practice the real life component). Sometimes comprehension goals might lead to something else- i.e. being aware of attention that leads to better comprehension. Role play a "bad" scenario (shuffling papers, fan on, loud noise from tv, people talking) vs good and have her id ways to fix the bad after you discuss strategies.

I like your ideas! Especially the sabotage ideas (maybe it's just my school, but we're big into sabotage haha). Thank you for these!

Do you think for a long term goal (we're talking a semester, so, 3 mos.?), that I would be looking at more than one goal, or just.. one? This is where I'm most stuck.

I think it never hurts to set up more goals/objectives, because you're always able to discharge if they are met or add on, if needed and as you learn more about the patient (you're not going to be able to figure everything out in the first session!). Sometimes it helps you get a well rounded idea/approach to where the pt needs help, if you set up more opportunities for them to work on things. That being said, depending on the patient, they may only have one or two areas of concern. You can keep it at one goal, as long as the wording of the objectives are relevant to that one goal (i.e., a not a goal written for auditory comprehension turns into a goal to manage attn strategies). I like to think of long term goals as the big categories we're focusing on: i.e. will improve auditory comp in ADL activities with min assist during structured tasks, with objectives being "will answer questions from ___ presentation", "will utilize strategies (list strategies) to improve aud comp with fewer than xx cues"). HOWEVER, you can also write a long term goal that is really broad (will improve aud comp, attn, cog ling fx to improve independence and safe completion of ADL) and then be more specific/broad with your objectives (improve aud comp by doing xx, improve attn by doing xx). It all depends on the needs of the patient. Sorry, this is really confusing!! If I have a pt with a lot of broad needs, I tend to do a broad goal with broad objectives and make sure I cover everything. If the needs are really localized/specific, I tend to do specific category goals with different strategies/activity objectives relating to that one goals (different contexts, levels of support, strategy knowledge/application). Does that make sense? Having more goals will help YOU ID/separate where the pt is experiencing breakdowns, while one major one tends to save space and outline the general concerns with ADL completion. If you message me I can send you some more examples.

I know one of the games on Big Brain Academy on the Wii involves taking phone orders at a restaurant... could be fun!