Motor learning principles are key! We practice repetition and multi-sensory learning. There may be comorbid conditions such as hearing loss. Unclear vowels can be improved with direct cues like “open” and gestures or sign language to increase intelligibility. To help sequence sounds we sometimes fingerspell the sounds/letters or use pacing boards. To expand utterances, we use carrier phrases and sentence strips, tiles or manipulatives to visualize each word. For prosody and intonation we sing songs, chant and use biofeedback like recording and rating self-made videos.