We synthesized studies that assessed preference for using different augmentative and alternative communication (AAC) options. Studies were identified via systematic searches of electronic databases, journals, and reference lists. Studies were evaluated in terms of: (a) participants, (b) setting, (c) communication options assessed, (d) design, (e) communication skill(s) taught to the participant, (f) intervention procedures, (g) outcomes of the intervention and outcome of the preference assessment, (h) follow-up and generalization, and (i) reliability of data collection and treatment integrity. Seven studies, involving 12 participants, met the inclusion criteria. In these studies, individuals were taught to use either speech-generating devices (SGD), (b) picture exchange (PE) systems, and/or (c) manual signs. Assessments to identify preferences for using each AAC option were conducted in each study. Sixty-seven percent (n = 8) of participants demonstrated some degree (greater than or equal to 55%) of preference for using SGD compared to 33% (n = 4) of participants who demonstrated some degree (greater than or equal to 55%) of preference for PE. The results indicate that individuals with developmental disabilities often show a preference for different AAC options. Incorporating an assessment of such preferences might therefore enable individuals to exert some degree of self-determination with respect to AAC intervention. (Contains 1 table.)