Background: Many individuals with Huntington's disease experience reduced functioning in cognition, language and communication. Talking Mats is a visually based low technological augmentative communication framework that supports communication in people with different cognitive and communicative disabilities. Aims: To evaluate Talking Mats as a communication tool for people in the later stages of Huntington's disease. Methods & Procedures: Five individuals with Huntington's disease participated in the study. Three conditions were compared: unstructured communication, verbally structured communication, and communication using Talking Mats. The conversations were videotaped and analysed quantitatively and qualitatively. Outcomes & Results: Talking Mats increased communicative effectiveness for all participants. Verbally structured conversation resulted in higher effectiveness than the unstructured counterpart and effectiveness differed depending on the type of conversational topic. Conclusions & Implications: Talking Mats could be a valuable resource for people with Huntington's disease and their conversation partners. It could be used for social purposes, for understanding a person's opinions and for making decisions. Additional research is necessary in order to generalize the results to the population of individuals with Huntington's disease and to understand better the mechanisms behind the positive effects observed. (Contains 7 figures and 6 tables.)