Purpose: In this article, the author presents a conceptual framework for intervention at school-age levels reflecting upon a number of aspects raised by Kamhi (2014) in the lead article of this forum. The focus is on the persistence of traditional practices, components of language intervention, and prioritizing goals for students with language learning difficulties. Weaving together learning and generalization challenges, the author considers advanced levels of language that move beyond preschool and early elementary grade goals and objectives with a focus on comprehension and meta-abilities. Method: Using a 3-tiered macrostructure, the author demonstrates how integrating students' background knowledge into intervention, helping them develop an awareness of structure and content interactions, and addressing the increasing demands of the curriculum provide a roadmap for improving clinical practices at school-age levels. Conclusion: Reiterating some of Kamhi's notions, the author addresses gaps that exist between available and, often, exciting research in language, literacy, and current practices in schools. Professionals are challenged by the persistence of approaches and techniques that defy what they know about children and adolescents with language learning disabilities. Nonetheless, there are reasons to remain optimistic about the future.