I typically use a total communication approach to begin to alleviate frustration from challenging verbal attempts. I have a solid ASL inventory/knowledge base so I use signs simultaneously with verbal targets. I want the child's expressive communication to be rewarded so that he/she is willing to put in the effort to progress to challenging verbal attempts. When choosing targets I consult with parents to determine which words are important to the family and which words are motivating for the child. I try to make the word or word combination targets very functional during therapy sessions and encourage the parents to do the same at home. I do use PROMPT strategies in my sessions when it is helpful for challenging or novel targets.