I take a whole-child approach and work on specific areas of break-down or inefficiency for that child, considering first sensory regulation and trust. Regulation and trust are foundational for communication growth to occur. I start therapy by building trust through play and ensuring the child has a mode of communication to get their needs met. I use total communication and find the best mode for that child whether it be AAC, ASL, speech, or a combination. I utilize and combine many approaches depending on severity level, emotional response, and individual needs of the child. I meet the child where they are, and we build together both small and big steps, celebrating that small victories along the way. For CAS, depending on the severity of the child, I use DTTC and PROMPT approaches, using a small amount (10 or less) of functional and powerful words with high intensity repetition using mulitsensory cues. When moving past DTTC, I focus on high practice movement of phonemes connected to each other in syllable shapes rather than sounds in isolation continuing with the best multisensory cueing approach for that child. I utilize ReST, Speech Motor Chaining, DTTC, PROMPT and combine my own clinical experience and knowledge of executive functioning. I also keep in mind the language and reading risk of children with CAS and use dynamic assessment to determine appropriate language and phonological awareness goals to keep the child on track academically.