Purpose: Speech sound production intervention in early childhood is relatively rare despite empirical and theoretical support for providing this type of targeted therapy for toddlers. Challenges perpetuate the present clinical condition including those related to treatment decision making (e.g., intervention approach). Method: Although there are numerous speech sound production treatment approaches appropriate for the pediatric population, a much smaller proportion are proposed to be appropriate for children under the age of 3 years. Of these, five approaches (i.e., core vocabulary, cycles, naturalist recast, stimulability, and psycholinguistic intervention) were selected for review because they can be used to treat functional speech sound disorders produced by toddlers and none required additional clinician training for implementation. Results: We found the empirical evidence supporting the use of these approaches with children under the age of 3 years scant to nonexistent. Conclusions: Due to the lack of empirical evidence, early intervention speech-language pathologists must primarily rely on internal factors (e.g., clinician experience and client/caregiver perspectives) to support evidence-based intervention decisions in the absence of external empirical support. Clinical action steps such as careful documentation of approaches used/discontinued and associated individual client outcomes are necessary for evidence-based decision making until more robust empirical evidence is established.