Full Goal

Given a confrontation-naming task or structured connected-speech prompt, with the SFA grid (group, use, action, properties, location, association) available as a visual scaffold initially and then faded across sessions, patient will retrieve the target content word, using the SFA scaffold spontaneously or with minimal cueing with 80% accuracy on trained items AND ≥20% improvement from baseline on a probe of untrained items from the same semantic categories, as measured by SLP scoring of confrontation naming (e.g., 30-item probe of trained + 30-item probe of untrained from matched categories) at baseline, mid-treatment, and discharge.

Individualization Guidance

Before using this goal, verify:

• Anomia is the dominant impairment. SFA is most-evidenced for word retrieval deficits in fluent and non-fluent aphasia. Patients whose primary deficit is auditory comprehension, syntactic processing, or apraxia of speech need different primary goals — SFA may still help anomia secondarily but should not be the main target.
• Semantic versus phonologic profile. SFA leverages semantic-network activation. If error analysis suggests primarily phonological retrieval failure (correct semantic field but distorted forms, frequent tip-of-tongue with phonemic paraphasias), pair SFA with phonologic-component analysis or consider PCA as primary.
• Generalization probes are the whole rationale. SFA’s evidence base distinguishes it from drill-only naming therapies precisely by its predicted generalization to untrained items in trained categories. A goal without untrained-item probes loses the SFA rationale and becomes drill.
• Category selection matters. Train on items the patient cares about — work-related vocabulary, family members’ names, hobby-specific words. Generalization to untrained items in the same category is the mechanism; if the trained category is meaningless, the generalization is meaningless too.
• Scaffold fading is structured. The SFA grid is taught explicitly, then faded systematically. The end state is the patient running through the features mentally without external support. Document the fading hierarchy in your treatment plan.
• Chronic versus acute aphasia. SFA has the strongest evidence in chronic aphasia (≥6 months post-onset). In acute and subacute aphasia, spontaneous recovery confounds treatment-effect attribution. SFA can still be appropriate but the rationale and expected outcomes are different — document this.
• Co-treatment with PWA-led approaches. Conversation-partner training, Life Participation Approach to Aphasia (LPAA) goals, and aphasia communication groups complement SFA. A goal bank with SFA alone underestimates what aphasia rehabilitation includes.

Clinical Notes

The dual criterion — 80% on trained items AND ≥20% improvement on untrained — is what makes this a rigorous SFA goal. The 20% untrained threshold is set based on the systematic-review effect sizes for SFA generalization: meaningful but not enormous. Targets of 80% on both trained and untrained items overstate what SFA reliably produces.

Probe both at baseline AND at intervals during treatment. A patient who shows 25% improvement on untrained at mid-treatment but no further gains at discharge has reached a plateau; the goal as written may be functionally met. A patient who shows no untrained-item change at mid-treatment is not benefitting from the generalization mechanism — re-examine target selection or shift approach.

The SFA grid as a teaching tool generalizes when the patient internalizes the strategy. Goals that count only trained-item accuracy can be met by rote memorization without strategy use. The strategy use is the rehabilitative target.

For CMS skilled-service documentation: the SLP’s judgment about category selection, scaffold fading rate, and integration with broader communication goals is the skilled component. Drill-only naming work in a group setting does not require this level of judgment and may not meet skilled-service criteria.

This goal is for the chronic phase. Acute-aphasia goals look different and include more impairment-level work and family/partner education.

Related Goals

• Orientation to Person, Place, Time, and Situation — Subacute TBI — different cognitive-linguistic population (TBI), useful contrast in goal structure
• Executive Function Strategy Use in Functional Tasks — adjacent metacognitive-strategy goal for cognitive-communication