Therapy is individualized based on the result of the assessment taking into consideration the child's core vocabulary, level of functioning, needs, strengths and weaknesses as well as parental concerns and desired outcomes. The overall goal is for the child to be a functional communicator. Therapy is mostly play based. The precursors of motivation and joint attention are addressed as they are crucial to motor learning. The parent / caregiver is encouraged to be an active participant during the session. Speech therapy focused on production of speech rather than oral motor exercises. Therapy is based on the motor learning principles and use of Dynamic Temporal and Tactile Cueing (Edyth Strand,) along with multi-sensory input and cues (including PROMPT -tactile proprioceptive kinesthetic cues,) visual cues (e.g., Speech EZ cues by Lynn Carahaly,) sound metaphors, and natural gestures. Phonological awareness is also targeted along with motor speech programming. Therapy targets include words and phrases that have been selected based on functionality and the child's ability to manipulate his environment (power words). Since the therapy process is a collaborative one, speech motor targets are reinforced by the parents so that there is generalization of the skills. Visuals are also included as needed (e.g., visual schedules, sentence strips, communication books, activity specific communication boards). Phonetic placement is used to achieve target articulatory configurations.