Background: Reaching mutual understanding can sometimes be challenging in interactions involving communicators using aided communication. This explorative qualitative study offers insights into some of the features of utterance interpretation and meaning negotiation in interactions using graphic communication systems. Method: Relevance theory was applied as a framework for analysis of conversations between a non-speaking child using a communication aid and her communication partners using natural speech. Results: Through analysis of a series of videotaped conversations, several assumptions and contextual implications affecting the interpretation processes were identified. A tendency to organize interpretations according to contextual expectations and scripts emerged as a central explanatory factor in co-constructing meanings from available graphic utterances. Conclusion: This study highlights the importance of understanding factors that may affect the interpretation processes of all participants in interactions involving aided communication.