Automatic reinforcement by response-produced auditory stimuli has long been hypothesized to play a role in the vocal development of infants. Clinicians and researchers have translated this idea into stimulus pairing interventions intended to increase novel vocalizations of nonverbal children with autism and other developmental disabilities by conditioning speech sounds as reinforcers. A number of studies have demonstrated positive effects of stimulus pairing procedures, but negative results have also been reported in the literature. This article provides a brief review of the existing literature on stimulus pairing procedures and a discussion of alternative procedures that may serve to establish speech sounds as reinforcers. Directions for future research are discussed and recommendations provided to clinicians.