The severity of the CAS will be the indicator of where to start treatment. I typically start with a small group of functional words or phrases (typically 5-10) that will be the most meaningful to the child. This requires working closely with the parents/caregivers to determine what these words are. The words may be altered to produce age-appropriate approximations if needed based on their phonemic inventory and oral motor capabilities. Based on the assessment, treatment will start where the child is successful and work to build confidence while also allowing the child to be challenged. Additional supports for verbal productions are provided as necessary, often visual or tactile in nature. In conjunction with the verbal productions, alternative and augmentative communication systems are explored with the family to determine the best options for improving basic communication of wants and needs by the child in the home and/or school environments.