Goal attainment scaling as a clinical measurement technique in communication disorders: a critical review.

UNLABELLED: Evaluation of client progress is an important topic in communicative disorders research and clinical literature. Goal attainment scaling (GAS) is a technique for evaluating individual progress toward goals. Despite recognition of GAS as a clinical-outcome assessment technique in other clinical professions, the current debate on measuring client progress and outcome measurement in communication disorders has largely ignored GAS. The purpose of this paper is threefold: (a) to introduce GAS to the field of communication disorders, (b) to offer a critical review, and (c) to explore directions for harnessing the value of GAS for the field. In addition to the ability of GAS to evaluate individualized longitudinal change, it offers the following positive attributes: (a) grading of goal attainment, (b) comparability across goals and clients through aggregation, (c) adaptability to any International Classification of Functioning, Disability, and Health levels and domains, (d) versatility across populations and interventions, (e) linkage tied to expected outcomes, (f) facilitator of goal attainment, and (g) a focal point for team energies. The unique value of GAS could render this technique as a welcomed addition to the present set of options available to clinicians interested in assessing progress and evaluating change. Reliability and validity of GAS will be discussed. Finally, directions for harnessing the potential of GAS for communication disorders are offered for clinical practice and clinical-outcome research. LEARNING OUTCOMES: (1) As a result of this activity, the participant will be able to delineate the steps involved in GAS. (2) As a result of this activity, the participant will be able to describe the positive attributes of GAS as a method for assessing client progress. (3) As a result of this activity, the participant will be able to identify issues that enhance the reliability and validity of GAS.