A Clinician’s Guide to Smarter, More Effective Goal Setting.

With the start of a new year, it’s the perfect time to check in, reflect, and set both yourself and your clients up for success. For many clinicians, this means creating a therapy plan that outlines medium-to-long-term goals for the year, along with the short-term steps needed to achieve them.

But goal setting can feel overwhelming- figuring out what to focus on, and when, isn’t always straightforward.

This is where understanding developmental milestones can make all the difference. Taking a step back and looking at the bigger picture allows you to create goals that are functional, achievable, and tailored to support a child’s development.

Developmental milestones are often seen as a rigid checklist- something that can feel limiting, especially for neurodivergent clients (or any client, really!). But in reality, understanding how skills can develop over time provides the flexibility to create goals that genuinely align with a child’s unique needs. It helps you see how goals connect to everyday life, making it easier to support a family’s functional priorities. Plus, when you understand how skills build on each other, you can confidently adapt goals—stepping up or scaling back as needed based on how a child presents on any given day.

But there's more to it than that.

When you're confident in developmental milestones, you can explain therapy goals to parents with greater clarity—helping them understand why certain goals are important. When families see the value, they’re more likely to stay engaged and follow recommendations, leading to faster progress and better outcomes. A win-win for everyone!

So today, we’re diving into three key ideas that will not only help you set goals that are functional, foundational, and balanced for your clients but will also make the goal-setting process clearer and easier for you as a clinician.

1. Function First: Using Milestones to Set Meaningful Goals

Developmental milestones aren’t just checklists; they represent the essential skills children need to navigate their world at different stages of development.

Each skill emerges at a particular stage because it aligns with a functional need in a child’s life. For example, a child’s ability to follow directions like ‘wait’ or ‘stop’ often emerges when they become more mobile and their need for safety increases. Understanding this connection helps guide goal setting in a way that aligns with both current and future developmental demands.

When selecting goals, consider how they relate to a child’s everyday life or an upcoming stage of development. For example, if parents are preparing for toilet training, it might be the perfect time to focus on concepts like wet and dry. Aligning goals with functional needs makes therapy more relevant and practical—setting children up for success in their daily routines.

2. Building Blocks: Laying Strong Foundations for Progress

Skills don’t develop in isolation; they build on what’s already in place. Each new milestone—whether in communication, play, or motor skills—relies on earlier abilities.

Take early communication, for example. For a child to master more complex skills- like answering ‘what doing’ questions, understanding object functions or sorting items into categories- they first need to develop foundational abilities- such as joint attention, picture-object matching, noun vocabulary, verb vocabulary, what questions, yes/no questions, and basic instructions like ‘show me’ or ‘point to’.

Without these early abilities, progressing to more advanced skills can be challenging. Strong foundations allow children to take on new challenges with confidence and success.

Simply put, these early skills aren’t just stepping stones—they’re the solid foundation for every milestone to come.

3: Balanced Growth: Working Across Developmental Stages

When setting goals, it can be tempting to focus on one category of skills at a time—working through them sequentially one after another until the goal is ‘ticked off’. But taking this approach can create an uneven skill set, where a child may grasp more advanced concepts in one area while missing the basics in others. Not very functional, right?

Instead, it’s important to work across a child’s developmental stage, ensuring they build a balanced foundation across key areas like vocabulary, basic concepts, questions, sentence structure, following instructions, cognitive skills, and play.

This holistic approach helps children build the foundational skills they need to use their abilities in real-world situations. For example, teaching spatial concepts is far more meaningful when a child also has the vocabulary and sentence structure to talk about location, and the cognitive skills to understand why it matters in everyday tasks.

A Couple of Things to Note

• When we talk about working across a child’s 'developmental stage,' we’re referring to their current functional level—regardless of chronological age. For many children, this may mean focusing on foundational skills that are often associated with younger ages. It’s important not to overlook these early skills, as they provide the building blocks needed to support more complex learning and development down the track.
• For clinicians navigating goal setting, developmental norms serve as a valuable tool. They offer a structured way to identify what skills may come next and provide a helpful starting point for planning therapy. However, it’s important to remember that these norms are primarily based on neurotypical development, and every child is different. Viewing them as a flexible guide—rather than a rigid checklist—allows us to create goals that truly align with each child’s unique strengths, challenges, and functional needs. When used thoughtfully, developmental norms can provide valuable insights while still allowing for an individualised approach to therapy.
• Developmental norms are not a one-size-fits-all solution. While they highlight key skills that support development, therapy should always take a holistic approach that considers the child’s unique circumstances, strengths, and everyday challenges. Some skills may emerge earlier or later than expected, and focusing too rigidly on milestone charts can overlook what is most meaningful and relevant to the child and their family. The key is to balance the guidance developmental norms provide with flexibility—ensuring that therapy goals are practical, adaptable, and focused on real-world application.
• Progress isn’t always linear, and children develop at their own pace. Staying adaptable in goal setting allows us to respond to their evolving needs and circumstances, ensuring they can apply their skills beyond therapy sessions and into their daily lives. By keeping therapy functional and meaningful, we can better support children in reaching their full potential.

Putting It All Together: Goal Setting with the Bigger Picture in Mind

Goal setting isn’t just about choosing what comes next—it’s about taking a holistic approach to ensure therapy goals are functional, foundational, and balanced. Developmental milestones provide a valuable guide, helping us align therapy with real-life needs, build strong skill foundations, and create a well-rounded approach that supports meaningful progress for each child.

While every child develops at their own pace and in their own way, stepping back to see where they are in their developmental journey helps us set meaningful goals that build on existing strengths while addressing any gaps. Viewing developmental norms as a flexible guide—rather than a rigid checklist—allows us to tailor therapy to each child’s unique needs and ensure their goals are practical and achievable.

By focusing on functional, real-world applications and considering the child’s individual circumstances, we can create therapy plans that are both relevant and impactful.

This ensures therapy always meets children where they are, providing them with the skills they need to thrive in their world- exactly as it should!

What’s your approach to goal setting?

Do you find yourself moving from one goal to the next without a clear roadmap, or do you feel confident in your ability to see the bigger picture and align goals with your clients’ overall progress? Or perhaps you’re somewhere in the middle—balancing immediate needs while trying to keep the big picture in focus?

I’d love to hear from you—what’s been your biggest challenge with goal setting, and what approaches have you found most helpful in your practice? Feel free to share your experiences in the comments!

#Healthcare #AlliedHealth #Therapy #Goals #Growth

P.S. If you love this content, then check out my email newsletter- Therapy Unpacked. It's a must-have resource full of practical tips and tricks for allied health clinicians:

If you want to connect with more like-minded clinicians, be sure to join our Facebook group- Thriving Therapists for Kids:

And finally, if you have families who are looking for tailored advice and support to help them navigate the challenges of raising happy and healthy children, please be sure to share my email newsletter- EmpowerED. It's designed to empower parents with valuable information and strategies to help them get the most out of therapy: