Building a one-button PC setup: how a gamer with SMA layers assistive tools

Andrei Cebotar, a 37-year-old in Moldova living with spinal muscular atrophy, can reliably press a single mouse button, yet plays games, writes, and chats online by stacking several assistive tools rather than relying on any one. The centerpiece is PlayAbility, a free Windows app that turns webcam-tracked facial expressions and head movements into a virtual Xbox controller—raised eyebrows trigger a jump, a cheek raise drinks a potion—so games accept the input with no mods. For text, he uses Handy, a free open-source speech-to-text tool that transcribes locally and never sends audio off the machine, which he found more accurate and reliable than Windows Voice Access.

Hardware fills the remaining gaps. He moved from a Razer Tartarus keypad to the Xbox Adaptive Controller, a hub with 3.5mm ports for low-force external switches, joysticks, and pedals that can be arranged around the user’s body (Sony’s Access Controller and Logitech’s Adaptive Gaming Kit serve similar roles). He tested but abandoned two options: a Tobii eye tracker caused eye strain during long sessions, and Talon Voice’s powerful hands-free control produced too many false triggers from ambient sound to be worth the upkeep.

The practical takeaway is that accessibility comes from layering, not a single device—PlayAbility for in-game actions, Handy for writing, the adaptive controller for movement. Cebotar recommends newcomers with conditions affecting fine motor control start with the two free, webcam-and-mic-only software tools and add hardware later once they know what’s missing. A planned follow-up looks ahead to EMG wristbands.