Purpose To identify what facilitates retail communication access for people with complex communication needs, and the impact of communication in this context on social inclusion. Materials and method Seven adults with lifelong or acquired complex communication needs who used augmentative and alternative communication devices (AAC) and nine retailers participated in interviews to determine factors that contributed to communication access and inclusion. Interview data were analysed using the grounded theory method within an ecological model of social inclusion. Results Retail participants did not differentiate between disabilities and their lack of understanding of complex communication needs was a barrier to inclusion. Participants with complex communication needs had received little preparation from speech-language pathologists on how to use AAC effectively when shopping. Communication access was achieved predominantly through participants’ individual self-advocacy. Conclusions Organisational and systemic measures are needed to better inform retailers about their responsibilities toward people who use AAC. Business prioritisation of communication access, government programs that differentiate and support people with lesser-known disabilities such as complex communication needs, and speech-language pathology support to use AAC in the retail environment is likely to improve communication access and social inclusion. Implications for rehabilitation There is an urgent need to consider. Social policy that differentiates people with complex communication needs and contributes to public awareness of their communication needs. Directly-delivered training for retailers on adjustments for communication access for people with CCN. Support from local disability advocates, speech-language pathologists and disability services for self-advocacy with retailers by people with CCN. Early training aimed at all stakeholders by speech-language therapists in the use of speech generating devices when retail shopping.