For individuals with severe disabilities, home-based access to communication, computer and environmental controls can prove to be a non-trivial challenge. In this chapter, we introduce a family of home-based access technologies that exploit computer vision via one or more cameras, operating in the visible or infrared light spectrum. These technologies are non-contact, requiring no devices to be attached to the user. We present two major categories of access: corporeal access whereby the user interacts with his or her environment using gross movements of the limbs, trunk or head; and orofacial access where the user connects to the environment via gestures of the mouth. After introducing the fundamentals of each type of access technology, we provide clinical illustrations of how these technologies have been applied in the home or community setting. The chapter concludes with a discussion of the merits and limitations of computer vision-based access technologies.