Treatment of preschool children with moderate to severe speech sound disorders is typically a long-term endeavor with many sounds and sound patterns requiring intervention. The purpose of this study was to determine if a communication-centered intervention would be effective in improving speech production with this population. The intervention consisted of the combined application of focused stimulation of key words during joint storybook reading and interactive practice of key words using communicative feedback. Participants displayed unique response patterns to the intervention. Two of the three participants demonstrated improvement in the use of the target speech pattern during intervention sessions, with one of the participants demonstrating generalization of the target pattern to conversational speech. Although the third participant did not demonstrate improvement during the intervention period, follow-up testing revealed some systemwide changes in his phonological system. This study provides preliminary support that communication-centered approaches are effective in facilitating phonological change.