Augmentative and alternative communication devices (AAC) can help support communication for millions of people who have differences in speech and language abilities. Existing commercial devices do not meet all the diverse needs of some individuals. Interviews and surveys were conducted with individuals who have speech or language challenges (n=4 interviews; n=15 survey respondents), or their loved ones (n=9 interviews, n=49 survey respondents). Summaries of communication practices, usage preferences, and ratings of hypothetical devices are shown. We consolidate and present qualitative feedback on user difficulties and likes for types of available commercial devices. The collected quantitative data has been de-identified and published and may be useful for others working with AAC devices and users. Building on our results, we discuss how three directions for impactful AAC development - customizable input, context-aware output, and personalized devices - could help meet the needs expressed by survey respondents in the context of technological advancements and research in the field.