Positive Approaches Journal, Volume 10, Issue 2

Volume 10 ► Issue 2 ► August 2021

Using Goal Attainment Scaling to Measure Progress and Make Instructional Decisions

Jordan Hollander M.Ed BCBA

Abstract

Goal Attainment Scaling (GAS) is a method to standardize and measure outcomes for individualized goals. This article will review the core features of GAS and provide an example of how to develop a GAS chart, determine the Level of Attainment, and make instructional decisions based on that level.

As we continue to return to the community after over a year of lockdowns and limited gatherings related to the COVID-19 pandemic, it is important we take a moment to reflect. For many of us the goals we had for ourselves have changed significantly over the past year. Things that seemed to be urgent might now seem unimportant, while other seemingly trivial activities might now feel essential to our well-being in a still uncertain future. As we reflect on what has changed for ourselves, it is just as important to help the people we support reflect and reframe what is important to them moving forward.

A part of this reframing, especially for those who have had major changes to their routines, health, or social network, should be to revisit service outcomes and goals with the individual. This process will look different depending on the individual and their preferences. Some may prefer a more formal meeting, such as an Individual Support Plan (ISP) meeting, to review their outcomes or goals while others may prefer a more informal discussion before having a discussion with a larger support team. No matter how the discussion begins, it is important that the focus is not only on setting goals that are meaningful to the individual, but also developing a method to plan for and evaluate expected progress towards those goals.

Goal Attainment Scaling

With such individualized goals, it can be challenging to assess whether supports are effective in achieving the intended results. Goal Attainment Scaling (GAS) provides a solution to that challenge.

At its core, GAS is a criterion-referenced method to standardize and measure outcomes for individualized goals. Developed in the late 1960’s by Thomas Kiresuk and Robert Sherman to evaluate program effectiveness in mental health settings, GAS has since been adapted for use in a variety of health and school-based settings^1,2,3. In Pennsylvania, the Adult Autism Waiver and Adult Community Autism Program have been using GAS to measure and report on individual outcomes since 2016.

The GAS process includes three basic steps, (a) identify an individualized goal (b) develop an individualized GAS chart, and (c) implement strategies and determine the Level of Attainment to report on progress ¹.

Goal Setting

Collaborative goal setting is an essential component of effective service delivery but can often lead to vague and overly generalized goals that make it hard to track progress and determine if services are effective in achieving the goal³.  GAS requires that goals be individualized and measurable¹. The individualized component focuses on goals that are meaningful to the participant and in line with their values and vision for the future, while the measurable component ensures that a reliable GAS chart can be developed^3,4.

In practice this can play out in a variety of ways, but typically it will begin with a conversation about what is important to the individual and what they want to get out of the service they are receiving. Once a general goal is identified, the support team needs to help refine this goal into something specific and measurable. This requires (a) knowledge of the individual’s current abilities related to that goal, as well as (b) an understanding of a reasonable expectation for the progress the individual will make towards that goal during the period for which the GAS chart is developed³.

Though not always practical, when obtaining knowledge about the individual’s current abilities, it is best to observe the individual demonstrating the skill to obtain baseline data. Another way to determine the individual’s current abilities is by identifying their Stage of Learning.

The Stages of Learning include (a) Skill Acquisition, (b) Skill Fluency, and (c) Skill Maintenance or Generalization. To identify an individual’s stage of learning for a specific goal, the team can start by asking a few questions. Has the individual ever done the skill before? Do they rely on others to begin or finish the skill? Does the individual know when they completed the skill? Is it realistic for the individual to learn this skill independently or will some support always be needed?

Once the goal is developed in this manner the expected outcome is discussed and an agreement is made between the individual and support team that this is important to the individual and a realistic expectation of what is likely to be achieved by the end of the GAS chart date^4,5.

Chart Development

GAS measures goal attainment by establishing criteria for an expected outcome and then developing a 5 point rating scale based on that criteria. The scale ranges from -2 (much less than expected) to +2 (much more than expected) with 0 being the expected level of attainment. After the period specified, the goal attainment is rated using the GAS scale based on the criteria achieved during that period^1,2. (See Figure 1.)

The information collected during the goal setting step will be used to fill out two of the points on the GAS chart. The information about the individual’s current ability or baseline data should go into the scale for level -2, as the intent is for the individual to make progress from where they were at the start of this goal. The realistic expectation of what is likely to be achieved by the end of the GAS chart date goes into the scale for level 0 as this is the expected level of outcome for the period. Level-1 is then filled out with a criterion point that would indicate some progress above the baseline that does meet the expected level. Finally, Levels +1 and +2 would include criteria that indicates the individual has made more progress than expected^1,2,4,5. (See Figure 2.)

Level of Attainment

Once the goal is set and the GAS scale is developed, the individual begins working on the goal with their support team and data are collected for the set period. This data can be captured through observations, rating scales, or other self-reporting methods. The data that is captured should provide enough information to identify all the components of the criteria listed for each level in the GAS scale. At the end of the set period, the data is reviewed, and Level of Attainment is assigned based on the criteria for the corresponding level in the GAS scale. ^1,2 The team can then use this information to make instructional decisions about the goal. If the individual has not made expected progress, this should prompt conversations about the goal, its importance to the individual and potential changes to how any teaching or support components of the goal are implemented by supporters.

GAS Example

Ted is a 25-year-old man who receives waiver services. Before COVID-19, Ted had a job working at a small coffee shop cleaning tables, washing dishes, and cleaning the bathrooms. The coffee shop closed their indoor dining at the beginning of the pandemic and is set to reopen in the next few weeks. Last week, Ted’s boss reached out to let Ted know that they want him to come back to work but asked if he would be willing to work a morning shift instead of his usual afternoon shift.

Ted is excited to go back to work but is concerned about switching his shift times. Ted is used to having all morning to get ready for work and is concerned about having to wake up earlier and potentially being late or rushing and forgetting to complete steps of his morning routine. Hearing this, Ted’s support team works with him to set a goal. Ted’s original stated goal is to avoid being late to work, and his team helps him to break the goal down into something more specific. They determine that for Ted to complete his morning routine and make it to work on time he needs to wake up by 6 AM and leave by 8 AM. Ted and his team work together to figure out the supports that Ted will towards this goal. They help Ted set an alarm, make a task list for his morning routine, and go over some strategies around sleep hygiene. For the next week, Ted agrees to try and complete this routine as an experiment, even though he does not have to go to work. After a week, Ted was able to wake up at 6AM, complete his morning routine and leave by 8AM on two out of five days with some prompting from his brother. Ted and his team agree it is realistic that he can improve to 5 days per week, but Ted thinks he will still need some prompting from his brother. The team also agrees not to use waking up at 6 AM as part of the goal criteria, if Ted completes his morning routine and leaves the house by 8 AM, but Ted agrees to continue to track what time he is waking up. Using this information, the team creates a GAS chart (see Figure 3) as well as a way for the team to keep track of when he wakes up, how much of his morning routine he completes and when he leaves the house.

On September 30th, the end of the GAS Chart date, the team will review the data and determine a Level of Attainment for the period and use that information to update the goal and support strategies related to the goal as necessary.

Conclusions

References

Biography

Jordan Hollander M.Ed BCBA is a Senior Clinical Consultant for the Office of Developmental Program – Bureau of Supports for Autism and Special Populations. He has been working for the past 12 years to help people on the Autism Spectrum identify goals, and work towards achieving them through a person-centered approach that utilizes the principles of Positive Behavioral Supports. Jordan has worked in various Direct Support Professional (DSP) roles as well as in Clinical and Operational management positions for various service providers throughout Southeastern Pennsylvania.

Contact Information

Jordan Hollander M.Ed BCBA

c-jholland@pa.gov