There is a rapidly increasing range of augmentative and alternative communication (AAC) systems available for children who cannot communicate orally. Finding the best system for any one user is a challenge for the professionals and carers involved. As yet the use of portable, tablet forms of communication aid has been little researched, despite the rapid growth in their popularity. This article seeks to establish how a tablet form of AAC is exploited in day-to-day domestic interactions between a parent and a child where the child has a severe physical disability and complex communication needs. The study utilises conversation analysis (CA) as the methodology and looks in detail at sequential components of the interaction and the salience of certain interactional moves to both adult and child participants. The mother chose when and where the iPad or other forms of AAC were utilised within the day. Extracts were selected from the available data to exemplify the types of typical exchange that occurred and some key features of the iPad enhanced interaction. The analysis describes how turns are designed incorporating the iPad and discusses what is added to the communication toolkit. Asymmetries in this mother–child interaction are observed and discussed. The child typically remains a respondent to initiations by the caregiver, who in this scenario necessarily remains in control of the iPad symbol display. However, the child uses eye-gaze strategies to indicate interests that lie both within and external to those on offer on the iPad. The article reflects on the child’s agency in initiating a possible novel topic in this way.