There are many individuals with moderate to severe cognitive impairments who have real problems using communication aids to interact spontaneously. The development of technologies that use touch screens seemed to promise help to these people. However, this has not been realized to any significant extent. In the proposed project, the applicant will develop a voice output communication aid that will integrate hardware, software and a language representation system, in a new and exciting way. The system will be beta-tested with a number of non-speaking individuals who have moderate to severe cognitive disability.