Adolescence is a unique developmental period, spanning the gulf between childhood and adulthood. For adolescents who use augmentative and alternative communication (AAC), the major physical, cognitive, linguistic, social, and emotional changes associated with adolescence may have significant implications for their use of AAC. These challenges are reviewed here, and it is suggested that effective interventions targeting the needs of adolescents who use AAC address four main areas: social networks; peer relationships; language needs, particularly vocabulary; and curriculum access, including literacy development. It is proposed that interventions that harness the group connectedness of adolescents and that focus on preparing adolescents for the next life stage are most likely to be successful.