This article describes future needs in provision and research in the field of augmentative and alternative communication (AAC) aids for children with significant communication difficulties. The authors highlight the needs of users and the opportunities that technology could provide in enabling this group to engage in communication using AAC. They emphasise that users need a more flexible approach to AAC provision with earlier delivery to ensure appropriate acquisition of communication. Devices should be utilised that suit the individual rather than those which are conveniently available (and perhaps not 100% suitable) and ongoing support to develop vocabulary and broader social conversation skills. This may include devices that are able to engage with the environment using perhaps GPS or are able to recognise different settings to consequently make available different sets of vocabulary (with for example a louder voice in the playground and a quieter voice in the classroom). The authors describe how research and intervention for this client group has been limited in the past and that measuring effectiveness of these interventions may require more sensitive means than ‘the number of times it is used’ but rather measuring the quality and effectiveness of a conversation. To date progress has been driven by researchers, AAC users themselves need to be involved in the development of AAC evolution in the future to ensure its continued relevance. This article projects exciting ideas about how real technology could be harnessed to enable AAC devices to provide more for their users. Linking patient and public involvement (PPI) to future research relevance is a current and important consideration in light of the way research is being funded.