Suffering from "locked-in syndrome", Jeff Hall communicates with the world using just one finger.
The former TV engineer from San Antonio, Texas was paralyzed by a stroke when he was 40 years old and left with only limited movement including some control of his head, arms and legs.
With the help of technology he can live independently and has recovered some of the freedom he lost seven years ago.
He talks using a text to speech synthesizer called Ghost Reader and with the aid of an Apple computer and an Android phone he can pay bills, text friends and send emails.
"Thanks to those, the entire world has opened up for me," he says.
Seven years ago this enabling equipment was limited and expensive. The kit that helped Jeff to speak cost $10,000 (£6,000).
But today he is able to use the same common gadgets as other people.
"One of the beauties of mainstream devices is that they have hundreds of peripherals that you can just add on," says Robin Christopherson from AbilityNet, a British organisation that promotes accessibility in technology.
"In a specialist device, adding in say, Bluetooth connectivity will add another $100 (£60) to the price."
She says the main reason people like Jeff now feel comfortable with off-the-shelf technology is the way that operating systems are designed.
Many of the major technology firms now involve the disabled community in development.
Jason Grieves is visually impaired and leads the Windows 7 accessibility team at Microsoft.
"In Windows 7 we were able to provide a Beta out and this allowed customers with disabilities to provide us with feedback.
"They were able to send us emails and send us tools that they wanted to see incorporated into the operating system," he says.
The critical thing, according to Hall, is how well these systems can be adapted for use with applications created by third party developers for disabled users.
It is these pieces of software that allow Jeff Hall to freely interact with the world. He uses them for everything from speaking to controlling the lights in his home. But there is a contradiction here.
While leaving software open to manipulation can benefit disabled users, it also means that software systems evolve outside of the control of the big technology firms.
This could disadvantage disabled users as accessibility may be overlooked when no one firm or group of firms is held responsible for ensuring it.
"There is a certain amount of friction between open source like Android and accessibility," says Robin Christopherson.
"It is one of these strange situations where a closed environment like the IOS (Apple's operating system) actually lends itself far more to make sure that accessibility is catered for.
"It's pretty much a free for all in the Android environment and because it's a disparate community working on open source software, the first thing that goes out the window is accessibility."
But surely technology cannot go backwards?
Jeff Hall worries that as systems develop, they could start to alienate disabled people.
Innovations such as multi-gesture controls - two-finger scrolling on the iPad and iPhone, or the use of a Microsoft Kinect, are impossible for people in his position.
Multi-gesture is in itself a small thing but he fears it could be a harbinger of worse to come.
People like Jeff are relatively few in number and, in his case, are literally voiceless.
He is calling for tech giants to continue to maintain awareness of users like him and of the way in which technological marvels can transform their lives, for better and for worse.