Augmentative and alternative communication (AAC) system development has often made early use of innovative technology. Touch screens have been a part of this technology for some time. In fact, touch screens were invented in 1965 but it wasn’t until the 2000s when they became really popular and significant advances in the technology were made. These types of mainstream devices make use of applications (apps) that enhance accessibility for people with communication difficulties. They have successfully replaced some of the more expensive bespoke AAC systems. This article provides an overview of selection and accessibility in mainstream technologies for the purpose of AAC. Selection methods are categorised as either direct selection (techniques that allow a person to indicate the desired item directly from a selection) or scanning (a system or partner that cycles through available choices in some kind of repeated pattern and some other signal is needed to indicate the desired response when offered). Recent advances in mobile technology have been harnessed by each of the mainstream companies to offer new ways for individuals who use AAC to access their products. The authors explain how speech recognition, visual and augmented reality work and suggest that these may provide new opportunities for people with communication difficulties to access technology. They propose speech recognition devices could be accessed using synthesised or digitised voices, and visual and augmented reality could enhance severely disabled people’s ability to interact with the environment. The possibilities are exciting but there are also difficulties. The authors emphasise a need for developers, service users and rehabilitation professionals to create partnerships to further this innovative and fast moving field. By providing an overview of current advances in technology, the authors provide a useful clinical overview to ensure practising clinicians are up to date with a rapidly expanding area of practice. The area of AAC and technology is an area that all speech and language therapists need to be aware of. All of our patients are becoming more tech-savvy and consequently there are many more opportunities that can be harnessed to enhance communication for both adults and children living with communication difficulties.