Dear J., I am the mom of 6 boys. Three of them have had need of speech therapy, so far. At first, with my now 12 year old, I thought it was a waste of time. However, we stuck with it and he's so much the better for it. My 6 year old has a stutter, and had unintelligible speech, and now after 3 years of speech, he's still stuttering a bit, but he's completely understandable. My not quite four year old is still in speech therapy. He has made great strides since he began at 1-and-a half. Most of the "treatment" involved getting the boys to say sounds properly(or as close as they could), and then rewarding them with play. Singing songs also helped the younger guys, as did reading the books we had about their favorite things(trucks, animals, ball games,superheroes), and having them make the sounds of the things in the books. My four-year-old made really fast strides this way. You will have to try out what the speech pathologist gives you, but tell her/him about what motivates your little one. If he loves to watch Diego, then maybe a Diego book will help a session along. If he loves trucks, make sure they are handy so that they can be used to communicate. I am a believer in speech therapy, but you really do have to create a fluid plan for your little guy, and when he has a session that is fun, and productive, make notes of what he did, and replicate it, as often as he will tolerate it. It's not supposed to be a "working" session, so if he decides you're done after 10 minutes, you are. The other thing I want to suggest is that you make sure he has some time with other little folks who are a bit older than he is, say 4, and ask the other kids if they will help him push trucks around or play a block game with him. You will have to help maybe, for a little while, but if he has even a little success communicating what he wants or needs, to another child, it will pave the road for more initiation. God bless you.