I try to loosely structure my treatment sessions around a theme and book. Within that context, I determine what are motivators/ reinforcers for each child. Therapy is and should be fun as children learn by playing and doing. I have functional word lists that are meaningful for each child (provided by parents) as well as targets specifically chosen based on the child's abilities and current sound inventory. Sometimes it is necessary to teach more intelligible and appropriate approximations in order to improve intelligibility. Use of a variety of hand cues and speech techniques help to shape the correct sounds. These cues will be gradually faded from use. I try to elicit as many repetitions of the target syllables and words as able each session and always send home practice with these targets. As soon as possible I move single words into practical phrases to improve overall communication. If not already in use, I would use functional signs and/or other means of communication, such as pictures or an augmentative communication device.