Would it work to push buttons with a pen or similarly shaped thing in his mouth ? Perhaps it ' s a psychological leap to start using one ' s mouth for things , but I know of a lot of quads who use mouth penpointer to do a lot of things , like type , write . Maybe you guys could tape the remotes on a table with a good height , taped down pointing towards the tv so they don ' t slip , and with his penpointer placed next to them where he can grasp it with his mouth . Just an idea ! In my experience , any low tech solution you can come up with will be a thousand times more expedient than seeking any rehab tech unfortunately . Sorry if this is a duplicate comment . I ' m on mobile and it looks like my first reply never made it due to my intermittent wireless , but who knows