Functional Pediatric Occupational Therapy Goals

Recently I have been getting requests for help writing functional pediatric occupational therapy goals and objectives. Let's take a look at what writing functional OT goals for pediatrics really means. This is my opinion as a pediatric occupational therapist with many years of experience, in what makes pediatric OT goals functional.

First, let's define the term functional.

Functional

1. pertaining to or fulfilling a function

So better yet. Let's define functional activity.

Functional activity

1. A task or act that allows one to meet the demands of the environment and daily life.

2. An activity that is essential to support the physical, social, and psychological well-being of a person and allows that person to function in society.

So Function is:

1. an activity or purpose natural to or intended for a person or thing.

For Occupational Therapy:

Function: the tasks a person needs to do every day.

What are Functional Pediatric Occupational Therapy Goals?

First, let's ask the question:

What are Functional Activities in Occupational Therapy for Children?

For a child, that can be moving around their environment, or the abilities and skills required for play, self-care, or school. Functional activities for infants, toddlers, and children will change as the child grows. Therefore what is considered functional activities will change over time.

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Writing Functional Pediatric OT Goals

Let's think about what occupations the child needs to participate in.

Occupation. According to the World Federation of Occupational Therapists “In occupational therapy, occupations refer to the everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do.”

Even if the goal addresses an underlying skill needed to participate in a functional occupation, if the goal does not mention the functional skill, it is not functional!

Goal Format for Functional OT Goals

I believe the best format for writing truly functional goals is the COAST goal format. Many OTs also write smart goals.

Is a goal for a child to stack blocks functional? NO! However, a child requires the skills required to stack blocks for play.

Coast Goal Format: To demonstrate improved (Goal Domain) to (Occupation) Child’s Name (Goal) with (Assistance) while (Specific Criterion), 80% of the time by (Time frame).

Functional Pediatric Occupational Therapy Goals Examples

To demonstrate improved bilateral coordination for cutting, Sam will move the paper with his non-dominant hand while cutting with min A while seated at a table, 80% of the time in 6 months.

To demonstrate improved motor planning for gross motor play, Maggie will jump forward with both feet independently while on the playground, 80% of the time by December 1st, 2022.

Are these OT Goals Functional?

Ben will complete a 3-step obstacle course 3 out of 4 times during therapy sessions. NO.

To demonstrate improved motor planning during play activities, Ben will climb playground equipment with min A 80% of the time. YES!

Anna will copy a cross (+) from a model, 80% of the time presented. NOPE!

To demonstrate improved visual-motor abilities for pre-writing tasks, Anna will copy a cross from a model, 80% of the time presented. YES!

Sensory Processing and Reflex Integration

Goals that focus on improving sensory processing or reflex integration (such as STNR) are not functional. The goal must focus on the functional deficit the difficulty in sensory processing or reflex integration is causing. Then strategies to improve the underlying difficulties of sensory processing and reflex integration can be part of treatment interventions or activities.

Do All Your Occupational Therapy Goals in your OT Treatment Plan Need to be Functional?

Well, that is going to depend on your setting, insurance reimbursement, and company. While it may not be possible to write all your goals as functional, it is good to always think about function. The best practice is to write as many of your goals as functional as possible.