A session note says "Participation: 3 out of 5." Next month it says "Participation: 4 out of 5." What did the student do differently? Without a description of each number, nobody can say.
Some goals cannot be counted. How well a student joins a group, how much help a student needs with a task, how clear a student's writing is: these are real skills, and therapists measure them with rating scales. A rating scale is fine for an IEP goal as long as it is built so that the number means something. This guide shows how.
What the rules ask for
Section 300.320 requires measurable annual goals and a description of how progress toward them will be measured and when families will receive progress reports. So the measure is not a private choice. If a goal is measured by a scale, the scale has to be clear enough that a parent, a teacher, and a reviewer could read the result.
AOTA's decision guide for school OT lists the steps of progress monitoring: identify the student outcomes to be measured, select a measurement strategy that is quantitative, qualitative, or both, collect baseline data, and document contextual features that may affect the student's performance, such as distractions in the environment and cues provided. A rating scale sits on the qualitative side of that list, and it needs the same baseline and the same conditions as any other measure.
When a scale fits
| Use a count when | Use a rating scale when |
|---|---|
| Trials are clear and separate | The skill is a whole performance, not a series of trials |
| A response is right or wrong | Quality or independence varies in degrees |
| The goal names a number correct | The goal names a level of performance |
| Example: correct sounds out of 10 | Example: participates in a group task |
If you can count it, count it. A rating can sit beside the count as a second view, but the count is easier to explain.
Write every level
A usable scale has levels that describe what the student does, not how the clinician feels about it. Here is an invented scale for a goal about joining a small-group activity.
| Level | What the student does |
|---|---|
| 1 | Stays in the group area but does not take a turn, even with prompting |
| 2 | Takes a turn only after two or more adult prompts |
| 3 | Takes turns with one prompt, and watches the other children's turns |
| 4 | Takes turns without prompts and responds to another child's turn at least once |
Notice what the levels do. They name behaviors someone could see. They separate prompts from independence. And no level uses a word like "good" or "poor."
Scoring the same way every time
A scale is only as steady as the person using it. A few habits help.
- Print the scale on the sheet. Do not score from memory.
- Score at the same point in each session. For example, at the end of the main activity.
- Record the conditions. Activity, setting, and cues, as AOTA's guide advises. A 3 in a quiet room is not a 3 in the cafeteria.
- Pair the number with a line of evidence. One sentence on what the student did.
- Check yourself. From time to time, score a session alongside a colleague and compare. If you disagree by a level, the description needs work.
What goal attainment scaling looks like in practice
Goal attainment scaling is a way of turning a goal into a scale with written levels from less than expected to more than expected. It has been used in school therapy research. In a 2016 study in Pediatric Physical Therapy, school physical therapists converted each student's IEP goals into scaled subgoals at the start of the school year and scored them at the end. In that study of 296 students, students exceeded their expected level for primary goals.
That is one study of one profession, and it does not set a standard for your caseload. The idea worth borrowing is the structure: levels written in advance, so that the score at the end is compared with something decided at the start.
What to record in the note
| Weak | Stronger |
|---|---|
| "Participation 3/5" | "Group turn-taking: level 3 on the goal 3 scale. Took turns with one prompt and watched peers' turns." |
| "Better today" | "Level 3, up from level 2 on Oct 8. Needed one prompt instead of two." |
| "Did well with independence" | "Dressing task: level 4, no physical help, one verbal cue for the zipper." |
The stronger versions name the scale, the level, and the behavior, and they point to a comparison.
Reporting it to a family
A rating alone can confuse a family. When you report progress, give the goal, the starting level, the latest level, and the description of what changed in plain words. "At the start of the year, he joined the group only after two or more prompts. Now he joins with one." That sentence carries the same information as the numbers and is easier to read. See progress data sheets for IEP goals for how to lay out a sheet.
Scale problems to watch for
- Adjective scales. "Poor, fair, good" tells a reader nothing about behavior.
- Changing the scale partway through the year. If the scale needs to change, tell the team so the goal can be rewritten.
- Scoring from impressions at the end of the day. Score when the session ends.
- Leaving out conditions. The same score under different conditions is not the same performance.
- Using a scale where a count would do. Counts are easier to defend.
For where baselines come from, read baseline data for IEP goals. For the structure of a note that holds a rating, see SOAP notes for school SLPs. Terms are in the glossary.