With young children and persons with cognitive impairments, a key skill is what is known as "cause and effect" - understanding that when they activate a certain switch, a certain action will follow. This is an important transferable skill to have in order to control one's environment, learn how to make choices, and to effectively use educational software.

Use of a single switch is acquired progressively, from the individual randomly hitting a switch to purposely using it to communicate or operate a device. This can be done therapeutically by incrementally presenting tasks to the child or adult that allow them to first learn basic cause-and-effect, and then move to making intentional choices from a variety of options. A number of software games exist to develop this skill. Explore the Bridges website for software games that are effective to learn switch use: http://www.bridges-canada.com/default.aspx