My therapy protocol for a child with moderate to severe CAS includes not only addressing speech-motor planning but all communication needs. It is important for children to have the ability to demonstrate their understanding, knowledge, and skills, which is why using alternative means of communication via communication books and/or communication apps is included in the therapy plan. Speech-motor planning is targeted using carefully selected words/phrases based on the child's mastered and emerging sounds/syllable shapes with motivating activities and games paired with high energy and positive reinforcement. Dynamic Temporal and Tactile Cueing is used to improve speech-motor planning, generalization, and intelligibility. Receptive phonemic awareness (understanding that words are made of individual sounds), answering/asking questions, sentence structure, and increasing vocabulary is targeted each session using alternative communication methods. Early implementation of alternative communication methods decreases the occurrence of failed communication attempts and and provides the child with means to demonstrate what they know but cannot verbally express. While speech-motor planning will take time and effort, simultaneously building language and preliteracy skills using alternative communication systems will provide a foundation for social and academic success.