12 years ago my wife had 4 strokes, barely lived, was in a coma, etc.
After lots of rehab she came home, but was paralyzed on left side, couldn't speak, couldn't hold a pen to write. Our communication technique was having her point to letters or phrases on a piece of paper.
I wrote a typing program back then that would accept as input any USB joystick for selecting letters/phrases and then text to speech on button press. Not terribly complicated, but also better than anything I could find at the time.
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