My overall treatment approach is to increase the number of intelligible words and increase overall communication. I begin with parent/family education of the specific therapy approaches to CAS. I encourage frequent home practice and emphasize the importance of frequent imitation/repetition of words. I begin therapy with a list of current words, current syllable shapes, and list of motivating/core words. I will start by building current syllable shapes and increasing the variety of the patients phonetic repertoire in a variety of syllable shapes. I usually start with early developing sounds or sounds that the patient is stimulable for. I will progress from CV and VC words to CVCV (repeating) to CVCV (alternating). I start with early developing sounds and sounds the child is stimulable for. I will work on simple vowels and move to vowel dipthongs and complex consonants (w and y). I start with a list of motivating/core words and I will make pictures (and simplify the words if necessary) for home practice. I use principles from David Hammer and core words, principles from Nancy Kaufman's Speech to Language Protocol and cueing from PROMPT. Depending on the patient, I individualize therapy according to progress with each method. I consider the patient's cognitive level, parental support, and co-existing impairments. I always provide homework with words that the child has been stimulable for in therapy or at least provide 2-3 "power words" for home practice. I incorporate carrier phrases frequently in to therapy. I focus on frequency of word practice and incorporate drill in to therapy sessions. Sounds are given names (e.g., "lip sounds, popping sounds, tongue tappers, etc) that are appropriate for the child and age/cognitive level and names are used in therapy sessions and provided for home use.