The first section of this report focuses on those factors that influence augmentative and alternative communication (AAC) use by adults with acquired disability, including the natural course of the acquired neurogenic condition, use of multiple modes of communication, changing capabilities, communication patterns of adults, changing social roles, transitioning among environments, attitudes of AAC users and others, and instructional constraints. The second section provides recommendations about future technical and intervention innovations involving message management, alternative access strategies, and learning demands.