The ability to transcribe disordered speech is a vital tool for speech-language pathologists, as accurate description of a client's speech output is needed for both diagnosis and effective intervention. Clients in the speech clinic often use sounds that are not part of the target sound system and which may, in some cases, be sounds not found in natural language at all. While the IPA provides a wide range of symbols that can be used in clinical transcription, the extended IPA (extIPA) may also be needed to transcribe atypical sounds never or rarely encountered in natural language. When using the IPA and extIPA transcribers aim to show the client's productions, irrespective of the intended target. An alternative tradition of clinical transcription has grown up in the US: the symbols suggested by Shriberg and Kent (SK). In many cases, these symbols are designed to show the intended target with a diacritic illustrating in which way the realization differs from the target. In this article possible confusions that may occur if the SK system is used are discussed, together with problems that may occur when SK and IPA are used together.