There is a developing research base to support the rationale underpinning augmentative and alternative communication (AAC) for people with learning disabilities. However, there is a paucity of research examining the process involved in implementing AAC support for people who have profound disabilities. This paper seeks to explore the processes involved in planning and implementing AAC systems to support the communication of two 6 year olds with profound and multiple learning disabilities. Following assessment, a plan of intervention involving specific implementation of objects of reference, gestures and signs was implemented to enhance communication opportunities for both children. Both children improved their communication skills through use of specific AAC supports. Results suggest that important aspects to include when planning intervention are understanding the level of each child's cognition in relation to their receptive abilities and a consistent, collaborative approach where strategies are agreed between team members. Specific challenges are discussed.