I begin all of my therapy sessions with a new client by first building rapport and establishing a routine in therapy. At MMTA, we often use a “circuit approach” to combine structured tasks (sitting at the table) and unstructured tasks (in play) to help generalize skills. Upon assessment of motor speech skills (including assessment of articulation/phonology, motor speech assessment, oral mechanism exam, and diagnostic therapy), I determine the client’s phonemic inventory and begin to build on the sounds they already have to help shape more complex syllable shapes. Working closely with parents, I gather a list of functional, meaningful, and highly motivating words and phrases to target in therapy, taking into account the length and complexity of the targets. While treatment for each client with childhood apraxia of speech (CAS) is highly individualized, I most often work from the framework of Dynamic Temporal and Tactile Cueing (DTTC), making adjustments in cues based on the specific child’s needs and learning preferences while taking into account principles of motor learning. The majority of our clients with CAS also have an autism diagnosis, so work on strengthening social engagement skills (which is imperative for CAS treatment) is also often incorporated into therapy sessions as needed. Clients with CAS have specific goals to target motor speech deficits written in a treatment plan. Data is taken every session and progress is reviewed every 3-4 months.