Abstract. We discuss our experiences employing a video-based mousereplacement interface system, called the Camera Mouse, at various care facilities for individuals with severe motion impairments and propose adaptations of the system. People with severe motor disabilities face many challenges with assistive technology. Traditional approaches to assistive technology are often inflexible, requiring users to adapt their limited motions to the requirements of the system. Such systems may have static or difficult-tochange configurations that make it challenging for multiple users at a care facility to share the same system or for users whose motion abilities slowly degenerate. Current technology also does not address short-term changes in motion abilities that can occur in the same computer session. As users fatigue while using a system, they may experience more limited motion ability or additional unintended motions. To address these challenges, we propose adaptive mouse-control functions to be used in our mouse-replacement system. These functions can be changed to adapt the technology to the needs of the user, rather than making the user adapt to the technology. We present observations of an individual with severe cerebral palsy using our system.