Clinicians providing intervention for pediatric speech sound disorders (SSDs) have many treatment approach options from which to select. Because treatment needs vary across children based on many factors including the error type(s) present and patterns of deficit noted, these factors need to be considered early in the therapeutic process to find the best-suited approach. In this article, the authors describe and contrast a traditional motor articulatory-based approach with phonologically-based approaches including cycles, contrast therapies (e.g., minimal pairs, maximal oppositions, and multiple oppositions), and complexity through presentation of hypothetical case studies, updated summaries of the evidence base for each, and a summary of current research limitations for informing clinical practice. Although children with SSDs are ubiquitous in pediatric clinical caseloads, familiarity or lack thereof with the evidence base supporting different approaches potentially limits speech production outcomes for children receiving speech services. Even so, limitations in the evidence base constrain practical application of a given approach to daily therapeutic interactions.