It is well documented in the literature that children with intellectual and developmental disabilities are at risk across many developmental areas. These risks increase exponentially for children who also have significant physical disabilities and communication impairments. For those with significant physical disabilities, who use communication technology, and who have functional vision, eye gaze technology is, and can be, transformative. Case studies will be used to provide concrete examples of how children are using eye gaze to not only develop language and communicate as they independently access communication applications and speech generating devices, but also to play and interact with applications on tablets. All of these have profound positive impacts on individuals’ independence, relationships with others, participation in daily life, and quality of life.