To begin therapy, the clinician (e.g., speech-language pathologist, reading specialist, learning disabilities teacher) identifies those skills and behaviors that need to be strengthened or learned. The clinician will want to use all sources of information available such as previous clinical reports, diagnostic testing, school reports, and, importantly, your report about your child to determine which behaviors to target.

Therapy must be goal-based. See Principles of Effective Dyslexia Treatment.

What is a Target Behavior?

A target behavior refers to the skill or action that the clinician wants to teach your child (i.e., strengthen phonemic awareness, improve reading comprehension, or learn spelling patterns). We prioritize specific targets because there will most likely be many areas that we need to teach and we need to maximize our time with your child in therapy. The clinician has to determine which target skills will be most effective and beneficial for your child to learn. By choosing fewer targets initially, we can work on the most attainable targets first, building steps to work on more difficult ones, and building confidence along the way. With older students and adults, the client should have input in the target selection.

When working with a client regardless of age, targeting words that are functional to his or her environment, such as subject or work-related vocabulary, will be most beneficial. The clinician will most likely want your input on this. Underlying skills must be trained first. For example, the dyslexic who has difficulty with phonemic awareness will need to strengthen those skills in order to gain success in learning spelling patterns. Targets must be re-assessed periodically throughout all stages of treatment, with new behaviors targeted as appropriate.

How do we select target behaviors?

There are two main approaches to target selection: using normative data, and the client-specific approach. The traditional method is using normative data to establish targets that are typical of a child of a certain age. Thus a child who is not performing specific language skills by age 6 would then be trained to produce those specific targets (e.g., phonemes, vocabulary, grammar).

The client-specific approach adheres to the tenets of the normative data approach, but also targets those skills that are most meaningful to the client in the environment to meet his or her communicative and learning needs. The professional will obtain information about the needs of your child in school or at home or, if applicable, at work to determine the optimal target behaviors. This approach involves the client and those closest to him to assist in the process of developing target behaviors.

Ideally a combination of these approaches would be most beneficial, although one needs to take into consideration the developmental level of the client. The following guidelines are based on the client-specific approach.

Target Behavior Selection Guidelines

The clinician will:

  1. Select behaviors that make the most immediate and socially significant difference in your child’s communication and reading skills. Those targets that have the most social or personal relevance are referred to as functional targets. Example: choosing target sounds in children that improve reading or spelling the most.
  2. Select targets that are the most useful and can be readily produced and reinforced in his or her natural environment. This will assist with carryover and maintenance of behavior. Thus, functional targets are best accomplished in the natural environment for improved carryover.
  3. Select targets that can be expanded and modified. For example, first work on isolating the syllables in words—"snowman" becomes "sno" and "man" (a task of analysis) and then move to the more difficult task of isolating the individual sounds in a word. Or, begin with combining the two words of snow and man into one word and then move to a three syllable word (a task of synthesis).
  4. Select words, language structures, and pragmatic targets that relate to your child's environment and culture. When working with a person from a different culture, they may want your input about the topics, words, and interests that are most important for your child to express.

The final target selection depends on several factors. The practitioner must take into consideration: your child’s diagnosis, current levels of performance, communicative and learning needs, the environment, and—particularly important for the older client—his or her wishes.

Remember, treatment that is matched to your child’s needs and interests and incorporates her strengths will be most beneficial for her and fun and rewarding for everyone!