The Rehabilitation Engineering Clinic (REC) has been a pioneer in developing custom AT for over 50 years in WA. The clinic has prescribed complex mobility solutions for powered chairs such as such as chin operated joystick and head controls and has done several custom modifications on chairs when there are no commercially available solutions for clients with a range of disabilities such as SCI, ABI and MND. This session outlines clinical factors that need to be considered when setting up this complex technology and demonstrates some of the alternative controls and custom modifications REC has been instrumental in developing.