This keynote address begins with a discussion of the difference between words and action, directed specifically to the practitioner's task of meeting the communication needs of children and youth with severe disabilities. Brief overviews of current perspectives and practices are provided, considering such areas as how communicative acts are defined and understood and the need for inclusionary environments that are rich in communication opportunities for individuals with severe disabilities. Specific problem areas are identified, including: the need for disseminating and implementing the extensive knowledge base on communication practices, the need for improved preservice and inservice training, and the need to match words with action. (Author)