Augmentative and alternative communication (AAC) service providers are increasingly serving a significant number of clients from culturally and linguistically diverse backgrounds. In this paper, we discuss general considerations and future research needs relevant to the use of AAC strategies and techniques with bilingual children, specifically, issues related to the scaffolding of communication and language development in more than one language, and the selection and customization of AAC systems for bilingual children. We do so by first reviewing key research on bilingualism with children with communication disabilities and its implications for research and practice in the AAC field. We propose the use of a sociocultural approach to AAC service delivery and argue for the support of both languages needed by the child to fully participate in his or her communicative environments. Implications of the sociocultural perspective and future research needs are also presented.