People with speech-impairing conditions like A.L.S., autism, Down syndrome and strokes have started to discover that general-purpose devices, such as iPhones and netbooks equipped with downloadable text-to-speech software, can in many cases help them communicate better and more cheaply than the expensive proprietary speech devices covered by Medicare and private health insurance.

In addition, disease experts say that children with Down syndrome often prefer to have a standard computer or something with some cachet like an iPhone rather than a stigmatizing, specialized device.