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We currently have one client using a Sicare Pilot (we previously had two). They were both installed and managed by a previous colleague of mine and I have only had experience of managing the device in recent months, since I have had to change its configuration. It is used by an MS patient (middle-aged woman, not technically-minded), whose speech is now quite slurred and changes through the day. She uses it without a microphone. She uses it for community alarm, telephone, door entry and TV/video. It seems to work well, although turning the TV down, when loud, does seem to take 2-3 attempts. The main noise barrier currently is the new washing machine in the ajoining kitchen, and this may require some new speech learning, with it on in the background. I have been pleasantly surprised by just how effective the system has been and I am now considering supplying it for another MS patient, whome I have previously discounted it for. The use of multiple patterns, to account for different intonation/noise etc., seems to work well, although having to access the client at different times through the day can have practical problems. Obviously any such system should also have the backup of having a switch input, to at least raise an alarm. I have recently been in contact with the Product Manager of Sicare and he informs me that there is a new version of the software soon to be released, although I do not know the details of the approach they will be using for speech recognition this time round. Jeremy Linskell CEng,MIPEM,SRCS Clinical Engineer Co-ordinator, Electronic Assistive Technology Service Tayside Orthopaedic and Rehabilitation Technology Centre Ninewells Hospital, Dundee, DD1 9SY, Scotland tel +1382-496286, fax +1382-496322 email: [log in to unmask] (backup email: [log in to unmask])