Establish rapport and ensure joint attention with the child as it is important for the child to see the therapist's face.

Establish imitation skills of large to small movements.

Simultaneous production of targets first slowly then becoming faster.

Direct Imitation of targets using multimodal cues first slowly then becoming faster.

When the rate is normal and targets are produced without struggle, change the prosody of targets.

Fade out the tactile cues.

Fade out the sign cues.

Produce across environments for generalization.

First therapy starts with blocked mass repetitions of targets and then becomes more varied over time. Shorter less frequent blocks targeting spontaneous production (e.g. answering questions) before adding new targets.

Shorter more frequent sessions are best. For example, 3-4 times a week for 30 minutes.