Full Goal

Within a DTTC hierarchy (simultaneous production → immediate imitation → delayed imitation → spontaneous production), beginning with simultaneous production and fading temporal/tactile support across sessions, [Student] will produce a curated functional word set (10-20 personally meaningful targets) with accurate syllable structure, segmental accuracy on present phonemes, and lexical stress with 80% accuracy at the spontaneous-production level on at least 70% of the target set across 2 consecutive sessions, as measured by SLP transcription with separate scoring for (a) syllable structure preservation, (b) segmental accuracy, and (c) lexical stress accuracy.

Individualization Guidance

Before using this goal, verify:

• CAS diagnosis is established. DTTC is for motor-planning disorders, not phonological process disorders. CAS diagnosis requires the three consensus features (inconsistent errors on repeated productions, lengthened/disrupted coarticulatory transitions, and inappropriate prosody/lexical stress — ASHA 2007). Without these, a traditional or phonological approach is more appropriate.
• Target selection is functional. DTTC targets are words and phrases the child needs — names of family members, key requests (“more,” “go,” “help”), favorite items, short routines (“hi mom”). Not developmentally early sounds in nonsense syllables. The motor patterns the child practices are the ones they will use.
• DTTC is movement-focused, not sound-focused. The treatment principle is whole-word motor patterning across syllables, with attention to coarticulation and stress. Goals that score segments in isolation miss the whole point. Score on syllable structure and stress separately from segmental accuracy.
• Tactile cueing is graded. “Tactile” in DTTC includes touch cues to articulators, mandible support, and chin/neck cues for breath support — not just PROMPT-style touch placement. Train your hands-on cueing or document the variant you use.
• Mass practice with high reps. DTTC is intensive. Recommended dosage in the literature is 60+ trials per session, multiple sessions per week. A 1×/week schedule with 15 reps is not DTTC even if your stimuli match. Match dosage to the evidence base or document the deviation and rationale.
• Lexical stress is part of the goal. CAS produces inappropriate or equalized stress patterns. Targeting only segmental accuracy and ignoring stress leaves the diagnostic feature untreated. Score stress on every probe trial.
• AAC is not failure. A robust AAC system in parallel with DTTC supports communication during the years that motor planning is developing. Children with CAS who have AAC available often produce more speech, not less. Do not gate AAC on a fluency-of-speech threshold.

Clinical Notes

The DTTC hierarchy is the active mechanism. Goals that say “the child will produce [word] with 80% accuracy” without specifying the DTTC level miss what is being trained. A child producing a word with simultaneous SLP support is in a different motor state than producing it spontaneously — they need to be scored separately and tracked across the hierarchy.

The three-part scoring (syllable structure, segments, stress) is non-negotiable for CAS. A child who produces “banana” as “nana” has preserved a 2-syllable structure but lost a syllable. A child who produces it as “ba-NA-na” has correct segments but inappropriate stress. These are different errors with different next steps. Collapsing them into a single accuracy percentage loses the diagnostic signal.

The 70%-of-target-set criterion is more meaningful than 80%-of-all-trials in CAS because individual target words may consolidate at very different rates. A child with 10 mastered words and 5 still-emerging words is in a different place than a child with low partial accuracy across 15 targets, even if the trial-level percentages match.

CAS prognosis varies widely. Document baseline severity (using a validated rating like the Mayo Clinic CAS Rating Scale or descriptive characteristics from Shriberg’s work) so progress can be interpreted against the entering profile.

This goal is for early-to-mid intervention. Later-stage CAS goals target connected speech, intelligibility in conversation, and prosodic variation across pragmatic contexts. Write those as separate successor goals — don’t try to fold them in here.

Related Goals

• Initial /s/-Clusters via Complexity Approach — phonological approach for contrast with motor-planning approach