George is a man who has lived with Multiple Sclerosis for many years since its onset in adulthood. He no longer has the strength or coordination to speak clearly or to walk, but he can still move his right arm from his lap to his stomach. George can also nod "yes" or "no" to questions, and he sometimes points to objects in the room to indicate his needs. George spends most of his time in his bed.

After an AAC assessment a few months ago, George decided that he wanted a computerized device that could speak recorded messages. He knew his speech was getting harder and harder to understand. So, with the help of a Speech-Language Pathologist trained in AAC, he started "voice banking." After making up a list of the many things he would need to communicate, they began to record his own voice speaking the messages. These messages were then stored under buttons in a communication device. George knew that the messages would be there, in his own words, when he needed them later.

To help him access the stored messages in the device, a large round plastic button was attached by a safety pin to the stomach area of his hospital gown so that he could reach up to push it with his right hand. In fact, it was placed right next to the nursing call bell button, so he always knew right where to find it. The button acts as a switch to turn the device on. To select which message he wanted, George learned to push the button to make the device scan through each message until it reached the one he wanted. He could listen to the messages using headphones. He would then push the button again to have it speak the message out loud to the listener.

In order for him to reach the button, George needs to be in a semi-sitting position. Most of the time, he keeps the reclining hospital bed propped in an upright position, and he has pillows stuffed behind his head. An occupational therapist has also customized his wheelchair with extra padding and straps to help him sit comfortably when he visits with family outside of his room. When in other positions, George relies on nodding his head as trained partners scan through the alphabet or ask him simple questions.