Hi

• Mouth writing: we had one young person who became very proficient at writing neatly and quickly using a pen in her mouth. It required an almost vertically positioned easel/board but ultimately led to issues with her neck/back requiring surgery
• Voice to text: many versions of this software work successfully these days but not easy to manage in a classroom environment (loud classroom it's difficult to pick up / quiet classroom it disturbs others)
• Eye gaze technology: amazing software (some of it free) but needs a lot of practice and patience to be able to record quickly; for instance, the young lady who writes with her mouth, preferred to carry on doing so despite the pain/damage caused due to the relatively slow speed she could manage using eye-gaze software. She ultimately compromised using a mouth held stylus and an on-screen keyboard - less pressure on neck than writing, quicker than eye-gaze. Presumably if practice starts early, efficiency could develop over time so your 4 year old may find this successful
• Scribe: may well be needed at least for a while to help the child 'keep up' in lessons, in combination with one or more of the methods above. As skills develop, the scribe should be needed less and less

Thanks for this Rob - much appreciated.

I have a student on caseload that uses her feet although posture is not ideal.

Also switches for scanning and selecting on screen keyboard can be positioned next to different parts of the body i.e. Head or foot.

SMARTBox are usually very helpful at thinking of ideas.

If the student is bright, has good verbal skills and wants to be I dependent she could try the Notability app for the iPad. It has a voice record function, so she could record all her ideas in one go. Then she could use a stylus in her mouth to press play and pause and an adult could type up her work with the student offering changes as she goes along. The predictive typing function links to the voice recording, so is more accurate than usual, which is helpful.

The fact that the voice record, typing and prediction are all on the same screen makes this app really helpful for all sorts of students who have ideas, but write or type slowly. Documents cane be converted to rich text and then to Word. I have used it with students and for my own work. The reviews on the App Store tend to be from Uni students, which is a boost for PhysMed and other students!