Background: Four elementary (primary) school students with severe speech and physical impairments (SSPI) who used augmentative and alternative communication (AAC) aids were selected to take part in an intensive, 4-week summer intervention program. The program was designed to explore effective approaches, content and contexts for supporting communication (including oral language, literacy, and technology skills) among young people who require AAC. Method: Features of the intervention included (i) using an integrated approach to provide language and literacy opportunities intended to elicit the students' active involvement in meaningful, productive and expressive tasks in everyday contexts; (ii) constant modelling of AAC usage; (iii) requiring family involvement as a criterion for participation in the program; and (iv) follow-up visits to schools during which effective instructional strategies were shared with staff. Results: Formative and summative assessment measures revealed that all four participants made progress during intervention. However two of the students maintained these gains into the follow-up period, whereas the other two did not. Each pair seemed to share certain characteristics, which are illustrated in this paper by two case study synopses. One relates the story of a child whose successes continued into the follow-up period, and the other chronicles the experiences of the child whose successes quickly waned. Conclusions: This study provides a range of instructional approaches, curricula and contexts to promote communication for children with complex communication needs. These instructional supports are more likely to improve access to inclusion in schools that seek to work in partnership with parents, plan educational transitions, and implement adequate training and awareness-raising among their staff. (Contains 3 tables.)