Adult scaffolding during repeated storybook reading was developed for children who use speech as their primary expressive modality, but through the use of augmentative and alternative communication, it has been extended to children who do not have functional, intelligible speech. Scaffolding strategies during repeated storybook reading and during repeated storybook reading plus augmentative and alternative communication were compared for a child with severe speech and language impairments. Although the overall number of utterances was greater during the augmentative and alternative communication condition, increases in phonological complexity occurred in both contexts because of adult scaffolding. Mean length of utterance, child initiations, correct responses to wh-questions, off-topic utterances, and repetition of adult models did not differ between the two conditions. Clinical implications are discussed.