How to Prioritize Treatment Goals in ABA
- Ashleigh
- 1 hour ago
- 5 min read
As a BCBA, imagine you're conducting an initial ABA assessment. During observations and direct assessment, you identify numerous areas of need. When interviewing the family, they share an extensive list of things they want therapy to address. With so many potential targets, how do you decide where to start?
When BCBAs develop treatment plans, prioritizing goals is an essential step. This can be a complex and nuanced process, as there are many factors they must consider. Not every skill deficit or behavioral excess requires direct intervention, and when a learner presents with multiple areas of need, behavior analysts must decide which goals will have the greatest impact on the individual’s current and future functioning and well-being. Below, we’ll explore a goal prioritization framework that behavior analysts can use to make thoughtful, data-informed decisions about where to focus intervention efforts.
Safety and Health Come First
Above all else, prioritize the learner’s health and safety, as well as the safety of others. Behaviors that pose a risk of harm, such as self-injury, aggression, or unsafe elopement, must take precedence. Similarly, address skill deficits that compromise the learner's safety or well-being, such as the inability to communicate pain, follow basic safety instructions, or navigate their environment.
Addressing these skills and behaviors first establishes a stable foundation for learning and ensures the learner can participate safely in therapy, school, and community activities.
Ask yourself:
Does this behavior pose an immediate or potential risk to the learner or others?
Are there skill deficits that, if not addressed, could increase the likelihood of harm?
How might this behavior or skill deficit jeopardize safe participation in daily routines, learning, or community activities?
Would addressing this goal first enable other treatment targets to be taught more safely or effectively?
Incorporate Caregiver and Client Input
Caregivers’ priorities should play a central role in shaping treatment goals and protocols. They often reflect what will make the greatest difference in the learner’s daily life. Additionally, incorporate the learner’s own preferences and goals, if they're able to communicate what they hope to gain from therapy.
Ask yourself:
What goals or skills are most important to the caregiver and why?
How can I incorporate the learner’s preferences and interests into the treatment plan?
Are the parents'/client's goals realistic?
Do the parents and client clash or align in their priorities?
Prioritize Functional Communication
Functional communication is foundational for autonomy and a positive quality of life. Learners who cannot express their wants, needs, or feelings often communicate through challenging behaviors instead. Early intervention should focus on teaching adaptive ways to communicate, whether through speech or augmentative and alternative communication (AAC).
Ask yourself:
Does this learner have delayed functional communication skills?
How might communication deficits be contributing to challenging behaviors?
What functional communication goals would make the greatest impact on the learner and the family's day-to-day life?
Address Behaviors That Impact Quality of Life
Some behaviors may not pose safety risks but still interfere with learning, social participation, or family functioning. For example, "tantrums", property destruction, and spitting can all greatly impact a family's daily interactions and result in more restricted environments for the learner.
Ask yourself:
Which behaviors, though not unsafe, meaningfully limit the learner’s participation in daily routines or learning environments?
Which behaviors, though not unsafe, affect family dynamics or add to caregiver stress?
Does this behavior interfere with the learner’s ability to build or maintain social relationships?
Would reducing this behavior open opportunities for greater independence or inclusion?
Consider Age-Appropriateness
It's essential to consider the learner's developmental stage when selecting goals. Some behaviors may be frustrating to caregivers but are developmentally typical. Similarly, certain skill acquisition goals may be desirable but not yet age-appropriate. For example, if your three-year-old client's mother wants you to write a goal to teach them to tie their shoes, would you do it because the family requested it or politely decline, as teaching a three-year-old to tie their shoes isn't developmentally appropriate?
Aligning goals with developmental expectations ensures interventions are realistic, meaningful, and supportive of overall growth. Many graduate-level ABA programs don't explicitly teach developmental norms, so this is an important area to seek mentorship in during supervised fieldwork.
Ask yourself:
Is this behavior excess, including not only its topography but also the measure of it (e.g., magnitude, frequency, duration), typical for the learner’s age?
Is the skill deficit typical for the learner's age? Is it a true delay or a skill that's not reflective of developmental expectations?
Would targeting this skill now be developmentally appropriate, or might it be better addressed later?
How could developmental expectations guide the selection of alternative or prerequisite goals?
Focus on Building Independence
Fostering autonomy is an essential area of focus for ABA clinicians. Our hope is always to work ourselves out of a job by empowering the client (and their family) with the skills needed to thrive without ABA. Goals that address not only independence in specific tasks but also broader skills that promote self-sufficiency, decision-making, and community participation can have a lasting impact on quality of life.
Cultural and environmental factors must be considered, as independence may look different across families and contexts.
Ask yourself:
Which skills could enhance the learner’s independence in daily life?
What are the barriers to independence for the learner?
Are there cultural or environmental factors that influence how independence is defined for this family?
What payor or funding considerations might affect targeting adaptive living skills?
Evaluate Generalization and Maintenance
Goals are most meaningful when they generalize across settings, people, and time. If your learner masters a program in a sterile clinic setting, but can't demonstrate that skill where it matters most, then the true purpose of the intervention has not been met.
Ask yourself:
Will this goal generalize to the home, school, or community environment? If not, what barriers would prevent this? (If the goal is otherwise important, troubleshoot solutions)
Are caregivers, teachers, or other team members prepared to support skill practice and reinforcement outside of therapy?
Keep Long-Term Significance in Mind
When you look at a toddler or preschooler, chances are you're not thinking about them as a teenager or an adult. But one day, they'll be just that. Treatment planning should involve consideration of the learner’s future, including their experiences in school, work, independent living, and social interactions.
While goal planning should entail prioritizing goals that are needed to address now, don't neglect to take a step back and look at the greater picture.
Ask yourself:
How would this goal prepare the learner for future life stages?
Are the skills targeted foundational for long-term success in school, work, or community participation?
How might prioritization differ for this learner now versus X years from now?
Does my treatment plan reflect the goal of working myself out of a job?
Pay Attention to Prerequisite Skills
When creating any goal, BCBAs must consider whether the learner has the necessary prerequisite skills to be successful. No matter how critical a particular skill is or the impact it would have on the learner, they won't acquire it if there are missing prerequisite abilities.
Ask yourself:
What are the prerequisite skills for the skill I'm considering targeting? Does my learner have those foundational skills necessary to achieve this goal?
Would targeting a prerequisite skill first lead to faster progress?
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