When starting therapy, we are often supporting a child who is very frustrated and has experienced a high amount of communication failure. In the beginning, our first goal is give the child the most functional and powerful words we can, as quickly as possible… starting with what he/she "can" do. This includes building early functional targets from their existing phonemic repertoire so they can experience early communication success. Next we continue to expand on building their ability to motor plan to produce words with mass practice of targets and distributed practice of these targets in naturalistic activities. This supports generalization and carry-over of the new targets. Multimodality cues, high repetition and practice of therapy targets and use simultaneous speaking are used to increase the words the child is able to say. Home program and parent involvement are critical components so that parents feel empowered to carryover words from the therapy setting and can help their child successfully communicate across settings. As part of the home program, parents typically go home with materials from the therapy session to practice the skill taught in the speech therapy session at home as well.