Problem: Jerry is a fourteen-year-old young man with cerebral palsy. He uses a wheelchair but cannot control it himself. He does have control over the mobility of his head and neck muscles. He is placed in a center for children and adults with severe impairments. His parents speak only Spanish and the director of the Center where he attends day school from 9 to 4 spoke only English. His bus driver and several of the paraprofessionals speak Spanish as their first language. Jerry appears to understand English and Spanish to some degree. He reacts to statements made to him and about him by banging his head and using a vocalization that sounds as if he was gagging or laughing. He can smile and frown but is completely non-verbal. He uses head and eye movements to indicate choices. He spends two hours per week in a center learning how to use a head stick for keyboarding and to be fit for braces to control arm, leg, and torso movements.