How do therapy providers involve people with autism in goal setting? 

Therapy is most effective when autistic people are fully involved in choosing what they want to work on. According to NICE, children, young people and adults should have the opportunity to shape their goals using person-centred, strengths-based and communication-adapted approaches. NHS England also embeds shared decision-making as a core principle of autism pathways, encouraging providers to focus on what matters most to the autistic person. 

Person-centred and shared decision-making 

NICE guidance for both children (CG170) and adults (CG142) emphasises that autistic people have the right to be involved in decisions about their care. Practitioners are encouraged to explore how each person prefers to participate, offer options, and adapt to discussions so that choices are accessible. Shared plans are developed collaboratively with the individual and with families or carers when appropriate while respecting autonomy and preferences. 

Communication adaptations for goal discussions 

Goal setting only works when communication is accessible. NICE recommends using plain language, avoiding metaphors, checking understanding, and providing written or visual information to support discussions. Speech and language therapy guidance from the RCSLT highlights the importance of offering AAC, visual support and alternative formats so that people can express priorities in the way that suits them best. Allowing extra processing time and reducing unpredictability also helps reduce anxiety and support participation. 

Strengths-based and interest-led goals 

Therapies increasingly draw on strengths-based models that respect autistic communication styles, sensory needs and identity. The RCOT advises focuses on meaningful, functional goals that build on the person’s strengths and interests, rather than aiming to “normalise” behaviour. Research on neurodiversity-affirming approaches and NDBIs models also shows that families and autistic advocates prioritise goals linked to participation, comfort, autonomy and interest-driven social engagement. 

Involving families and using supported decision-making 

For children and young people, families often play a central role in shaping therapy goals. NICE recommends involving parents and carers in planning and reviewing interventions while ensuring the child’s own wishes are included wherever possible. In adult services, NHS guidance clarifies that supported decision-making should be used when communication or capacity challenges arise, helping people express their preferences in a way that feels safe and understood. 

Goal setting across therapy types 

• SLT: Prioritises functional communication goals across settings, honouring preferred modalities such as speech, AAC, sign or writing. 

• OT: Focuses on co-created goals related to self-care, routines, sensory regulation and community participation. 

• CBT/mental health: Uses structured agendas, visual aids and collaborative planning to target anxiety or low mood while respecting autistic identity. 

• NDBI/social-communication therapies: Embed goals within play, routines and family life, following the child’s lead. 

Takeaway 

Involving autistic people in goal setting is essential for meaningful therapy. According to NICE, NHS England, RCSLT and RCOT, the most effective approach is collaborative, strengths-based and supported by communication adjustments, ensuring every person has a genuine voice in shaping their therapy journey.