Given the frequent use of graphic symbols in augmentative and alternative communication (AAC) systems, some individuals who use AAC may have greater familiarity with constructing graphic-symbol sequences than do speaking individuals without disabilities. Whether this increased familiarity has an impact on the interpretation of such sequences or on the relationship between construction and interpretation is fundamental to our understanding of the mechanisms underlying communication using graphic symbols. In this study, individuals who use graphic-symbol AAC systems were asked to construct and interpret graphic-symbol sequences representing the same target content (simple and complex propositions). The majority of participants used stable response patterns on both tasks; a minority were inconsistent on both tasks. Asymmetrical patterns (stable on one task but not the other) were rare, suggesting that neither channel (construction or interpretation) preceded the other, in contrast to earlier findings with participants without disabilities (i.e., novice users of graphic symbols). Furthermore, there were differences between stable and less stable responders on measures of syntactic comprehension and cognitive level but not on chronological age, receptive vocabulary, or AAC system characteristics and length of use.