Communication supports for people with motor speech disorders can include strategies and technologies to supplement natural speech efforts, resolve communication breakdowns, and replace natural speech when necessary to enhance participation in all communicative contexts. This article emphasizes communication supports that can enhance participation, as described in the World Health Organization's International Classification of Functioning, Disability and Health. The article begins with a discussion of partner and patient-reported assessments to evaluate participation levels and barriers to participation. Then, it provides an overview of communication supports for speakers with motor speech disorders, organized by the status of the disorder as stable, improving, or degenerative. The article includes nine case examples to illustrate principles and provide examples of how to address stable and changing needs.