I begin by observing what the child is able to do and work from there building off of success, maximizing on behavioral momentum. I identify what motivates the child and what strategies elicit the most gains. Next, I work with the family to identify targets that are meaningful and motivating as "helpful" to the child. We establish a trusting relationship to increase the child's confidence and ability to take risks. Depending on the child and what he or she responds to, I incorporate movement, music, and melody to help the child learn to sequence patterns of sounds and produce these syllables and words with mass production. Cues that I try and find most helpful include saying the word together and slowly, often using exaggerated production and visual and tactile cues. Whatever the child responds to best I utilize and build momentum and then steadily work to fade the cues and increase independence.