["Journal of Applied Research in Intellectual Disabilities, Volume 39, Issue 3, May 2026. ", "\nABSTRACT\n\nBackground\nEffective communication is essential for health, quality of life and social participation. Adults with communication disabilities—particularly those with intellectual disabilities—often face systemic barriers to accessing appropriate support.\n\n\nMethod\nA retrospective audit of 497 consultations from 276 adults with intellectual disabilities living in Australian group homes (2017–2022) was conducted at a private speech pathology clinic. The audit examined the proportion of patients recommended for and receiving a full communication assessment.\n\n\nResults\nA mixed method analysis was conducted and identified that of the 234 patients recommended for assessment, only 93 (39.7%) received one. Thematic analysis found that facilitators included dedicated funding, carer advocacy and multiple clinical contacts. Barriers were primarily related to funding limitations, competing clinical priorities and poor service access.\n\n\nConclusion\nThere is a clear gap between recommended and delivered communication assessment. Systemic reform is needed to prioritise communication through improved funding pathways, carer training and access to speech pathology services.\n\n"]