Five adults with profound physical and intellectual disabilities were taught to respond to photographs of preferences embedded in Microsoft PowerPoint (Microsoft, 1997) presentations by operating microswitches that functioned as mouse clicks. Rate of responding was generally correlated with changes in types of presentation, although variability in rate was often high, and session durations were quite short. Two participants showed substantial increases in responding when fitted with switches that were easier to manipulate. This exploratory study demonstrates that people with extremely limited physical and cognitive abilities can be taught to operate switches that produce changes in visual arrays on a computer screen and sometimes differentially so. Implications for responding to photographic representations of preferences, rather than the tangible preferences themselves, are discussed.