Persons with multiple disabilities use forehead and smile responses to access or choose among technology-aided stimulation events.

Three adults with profound multiple disabilities had almost no useful hand, head, or eye movement.

The team taped tiny optic sensors to each person’s forehead and cheek. A small forehead wrinkle or a smile closed the switch and turned on music, lights, or a fan.

Sessions ran like a mini-experiment: hit the switch, get 5 s of the liked stimulus. The goal was to see if these tiny, non-hand responses could work as a remote control.

All three clients learned to trigger the switch on purpose. Forehead or smile became a reliable “yes” button.

They quickly used the button to keep their favorite songs or vibration pads going, showing the setup is doable in real homes or day programs.

Robertson et al. (2013) ran a twin study the same year. They dropped the forehead option and added a tongue switch. Both papers got the same good result, so the forehead trick is not a one-off fluke.

Anonymous (2025) took the idea further. They swapped microswitches for a tweaked tablet and asked adults to match colors or do arm lifts after choosing leisure clips. Scores jumped from 0% to near 100%. The tablet study shows that once a tiny response opens the door, you can pile real work on top of play.

Ivancic et al. (1996) warned that “preferred” items often fail for people who barely move. The present study answers that warning: give the person any micro-movement that works, then the same item becomes a strong reinforcer.

If a client can’t hit a switch, don’t give up—look at brow lifts, cheek raises, or tongue twitches. One successful microswitch can replace hours of hand-over-hand setup and gives the person an instant vote in music, fans, or calls. Start with an optic sensor, test two body parts, and let the data pick the winner.