Many participatory design methods are heavily reliant on the presence of communication skills, with approaches often focusing on verbal or written outputs. For people with communication difficulties it can often be difficult to engage with such approaches. This workshop aims to bring together researchers, designers and practitioners to explore share both positive and challenging experiences of working with users with communication difficulties within participatory design. We will generate a description of a set of design methods which have been adapted and used with people communication difficulties, with a view to enhancing the knowledge and skills of workshop participants for the future.