Specific circumstances include intractable symptoms, feeding intolerance, intestinal failure, and use of technology. Communication is a cornerstone of this book, with strategies offered throughout and for each specific problem. This book will reinforce and expand skills, while promoting resiliency for individuals and teams. It provides innovative tools from a combination of evidence and the author's 27 years of experience. The content will inform research and quality improvement projects, advancing the quality of our care for children with severe neurological impairment and their families.