Little empirical research has examined guidelines for neuropsychological assessment of people with severe physical and sensory disabilities. This study focused on people with expressive disabilities--people unable to speak, write, draw, or manipulate test materials. Measures were selected and adapted to be suitable for the assessment of cognitive functioning for such people. Responses were selected from multiple choice answers or were spelled out on an alphabet board. Individuals with expressive disabilities in addition to traumatic brain injuiry (TBI) were compared to individuals with TBI alone and a normative group. The measures were generally found to be reliable and valid assessment instruments. Individuals with expressive disabilities were able to manage the task requirements of the adapted tests. The results provided support for the adaptations trialed.