Keith Irvin was just a toddler when 4-year-old Mark Steidl moved into the house across the street in Pittsburgh, PA. After a decade of happy memories together with their families, Keith remains "K" to Mark. Their friendship transcends Mark's communication challenges.

Emily Birkett was filled with curiosity when Madi Leal became her kindergarten classmate at Jean Little Elementary School in Guelph, Ontario, Canada. They became inseparable, and today, at age 13, they perform together on the school drum team, go rock climbing, and hang out by the pool. Madi holds her own in social situations, despite her speech limitations, and Emily continues to be a vigilant friend.

McKenna Pugh, 12, thinks it's wonderful that her younger sister has learned to speak up. Though it doesn't mean that 10-year-old Erika will always get her way, it ensures her a say in everyday matters, like whether to have dessert and what to do when friends visit. Growing up in Madison, WI, the sisters mastered sign language and gestures because Erika is nonverbal due to Rubinstein-Taybi syndrome and autism.

Mark and Madi, who have cerebral palsy, have developed comprehensive augmentative and alternative communication (AAC) systems. Speech communication devices boost their use of unaided AAC techniques. The unwavering support of close peers like Keith, Emily and McKenna helps to bring out their unique voices.

Siblings, classmates and neighborhood friends are often the best advocates and interpreters for young AAC users. These relationships flourish when championed by adults.

Peers are unmatched resources when it comes to expanding or editing vocabulary on a child's device, said Jaina Hulbert-Billings, MA, CCC-SLP, director of a summer program for children using AAC and their typical peers. "My big push this year was social language," she said. Children are quick to adopt informal communication like "How's it going?" and "That's awesome!"

Games and other structured activities are catalysts for friendships where typical children talk with, not for, friends who use AAC. It's about talking naturally, said Linda Bonnar, MA, CCC-SLP, ATP, director of the Communication Pathways Program in Bath, ME. "It helps to have a predictable context."

Spending time with peers is a welcome diversion for children with disabilities whose complex care needs often mean more frequent interaction with adults. Peers often become key AAC troubleshooters. "Siblings like to learn the ins and outs of devices," Bonnar said. "Many learn to program them."

Keeping typical peers in the loop with parents and school staff during the device implementation process can be challenging, noted Lucinda Diggs, MS, CCC-SLP, of Cape Speech Therapy in Cape Coral, FL. Helpful strategies include inviting siblings to therapy and offering presentations on AAC use for classmates.

When McKenna and Erika held a tea party, McKenna programmed vocabulary pages on her sister's AAC device for the occasion. She is updating vocabulary selections to reflect the family's recent move.

Choice is the foundation of best AAC practices for Emily and Madi. Emily verbally presents Madi with two choices, such as books, and Madi indicates her choice by raising her right or left hand. This allows Madi, who uses a wheelchair, to select adaptive gym equipment when Emily and other friends stay inside with her at lunchtime.

Body language can reveal more than words, said Keith, who can tell how his friend is feeling by the way he looks. Years of homework sessions, trick-or-treating and summer fun have provided plenty of practice. After Keith spurred Mark's interest in astronomy, their families enjoyed star-gazing weekends together. "When I am with him," Mark wrote in his online journal, "I am never in the darkness."

Patti Murphy writes for DynaVox Mayer-Johnson.