This article focuses on the importance of community nurses’ involvement in the identification and early referral and intervention of children and adults who have very little or no speech. The use of Augmentative and Alternative Communication strategies with nonspeaking children and adults are described in terms of the different kinds of systems that can be used as well as the general principles involved in working with people with severe disabilities. In conclusion, it is emphasized that close collaboration between community nurses and rehabilitation specialists is vital in ensuring that a difference is made in the lives of people with severe disabilities in this country.