I typically begin my play-based therapy protocol by developing a trusting relationship with the child and their family. I also begin by incorporating the sounds that the child is already saying on their own, both consonants and vowels. I then ask for a list of words that are important to the child and are important to functionally communicate, such as the child's favorite toy or a word to request something to eat. If the child is unable to communicate with words, I begin with either a high or low tech AAC system (e.g. iPad with an app or picture exchanges) that the caregivers feel comfortable incorporating at home. If the child is able to imitate speech or simultaneously imitate, I begin by using syllable structures and sound already in their repertoire and expand from there after initial proficiency is established via a DDTC-based approach with principles of motor learning and a variety of cues specific to the child's needs.