Persons with severe and profound intellectual disability (ID) have a wide range of difficulties. A number of difficulties, along with a delay in speech and language development, can greatly interfere with successful communication with others. For these individuals, the presence of potential communication partners does not always guarantee successful initiation and maintenance of communication. Therefore, factors that limit or enhance successful communication with others probably lie in characteristics of individuals with ID, but also in their environment. The goal of this article is to provide an insight into specific characteristics of communication in individuals with severe and profound ID. In relation to specific features of communication, we can notice that persons with severe and profound ID represent a heterogeneous population. While some reach the stage of symbolic communication, others remain at intentional (preverbal and non symbolic) or pre-intentional stage of communication, even in adulthood. It is necessary to provide natural interactive context with respect to different modalities of communication exchange so that they can functionally use their communication skills in everyday situations.