52. Language Goals Are 80% of Your Outcomes (Stop Wasting Time on Prepositions)

If you work with children with language impairment, this will be a game-changer. Treatment goals are the food that drives 80% of your therapy outcomes—so why are we still writing goals like it’s 2004?In this episode, Kelly Vess (SLP, author, researcher) shows you how to choose game-changing, life-changing goals that improve 10+ domains at once—instead of sweating the small stuff with decontextualized, discrete skills.Inside:Why narratives beat prepositions, morphemes, and WH-Q drills (10-for-1 impact)Activity-based + movement-based goals (why sequencing cards don’t work)Challenge + verbal working memory: the hallmark deficit of LIMultimodal cueing in language (not just speech)How to stop the 17-year research lag in your IEPsYour treatment target doesn’t just matter a little. It matters most.00:00 Why language goals drive 80% of outcomes03:00 The speech vs language “first-half/second-half” strategy06:30 The big problem: outdated, discrete goals12:00 Why WH-Q drills sabotage engagement16:00 Narratives: the 10-for-1 supergoal22:00 Activity-based & movement-based goals vs cards & screens27:00 Verbal working memory: the hallmark deficit32:00 Multimodal cueing for LI (not just SSD)39:00 Building self-efficacy: filling the backpack for the mountains ahead45:00 A responsive approach for anxious kids52:00 How goals naturally cascade: simple → complex → narratives58:00 The “sprouted bread” mindset for treatment planning