A Model of Observational Screening for the

Analysis of Interaction and Communication

GOAL PLANNING FORM

DATE:

Completed by:

THE GOAL IS:

(focus person) will (do what) in (setting) with support in the form of

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FOCUS PERSON

COMMUNICATION PARTNER(S)

ENVIRONMENT(S)

MOSAIC © Andy Smidt 55

 SPECIFY HOW THIS GOAL WILL HELP THIS PERSON IN THEIR EVERYDAY LIFE IN TERMS OF
INDEPENDENCE, PARTICIPATION AND SOCIAL CONTACT:

HOW WILL THIS GOAL BE MEASURED?

• WHAT WILL BE MEASURED?

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• IN WHAT TIME FRAME?

• BY WHOM?

ONCE ACHIEVED HOW WILL THIS GOAL BE USED IN MORE THAN ONE LOCATION OR ACTIVITY?

56 MOSAIC © Andy Smidt