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its what http://pvoice.org/ does

Whereas she is on a ventilator, I imagine she is lying in a bed on her back. As such, writing/drawing is probably impractical as either the writing surface would have to be suspended above her so she could see it, or she'd have to write without seeing the paper/surface.

Pointing at a picture or word board is a good idea, but may prove difficult for her if she is tired, weak, heavily medicated (probable for intubated persons), or her arms have IVs. Also keep in mind whether she needs to use glasses for reading - she may not be able to read the board. It is possible to use an "eye-gaze" board, where you use a small number of words/pictures on a large board and there's a hold in the center of the board. As she stares at her 'response' on the board, you look through the hold in the center of the board and determine which direction her eyes are looking to select her response.

Assistive communication device can be hard for persons lying flat on their backIt would need to be suspended above her, and she may still have problems reaching up to hit the buttons. There's also the issue of what do you do when you're not there - hosptital staf won't want this device suspended above her and there's a good chance of it getting lost or broken. If you have an old laptop with mouse, you can download free voice-output communication software called PVoice at http://www.pvoice.org/

My advice is to use a few sign language words. If she can move one hand, the sign YES is to make a fist and 'nod' your fist up and down at the wrist, like someone nodding their head. The word NO is like a two-fingered "spock nerve pinch". The best online resource for sign language is Michigan State Univ "American Sign Language Browser" at http://commtechlab.msu.edu/sites/aslweb/browser.ht m They provide a small video snippet for each word which makes it really easy to learn. If course, you'd have to learn a couple signs then teach them to your grandmother. Best of all is that it required no additional gizmos or equipment and you can teach your other family members too so they are able to communicate with her as well. Good luck!

If you think the Insurance companies pay full rate, you need to look closer at some itemized statements. They frequently get a cheaper rate, and it's not a sliding scale for them, it's a "buy in bulk" logic.

To keep this on topic, I think schools and kids with a specific need should get the $100 rate - I'm looking at one for my speech aparaxic 7 year old, who would break a normal laptop, but this may just be perfect to go with pVoice http://www.pvoice.org/ and survive in her hands. I'm not interested in receiving charity for it, but this could provide a revolution in assistive technology or kids.

And have you ever thought about who pays for this kind of software in countries where no school, rehab center or other government-funded organization pays for it? Indeed, these people depend on charity. And that's one more reason to create open source alternatives for it.

My own software is being used in (for example) Russia, India and African countries simply because they can't afford the commercial, proprietary counterparts.

Jouke Visser

You didn't mention specific features, and VOCAs come in a wide variety of special features. With this in mind, there is one thing to consider that dedicated VOCAs have over notebooks. The ones I have seen (for my daughter, now 6) are built for abuse. Not abuse in the laptop sense, but abuse as in get dropped from a few feet, have stuff spilled on them sense. This is one reason for their pricetag

With that in mind, if a notebook is fair game, you should look at pVoice. It is open in design (and open source) as well as being free in cost. It was created by a father for his daugher who is a spastic quadraplegic, and the labor of love shows.