JoyBox is a switch interface that can control a keyboard, mouse, or joystick. Up to 12 switches can be used simultaneously via the joybox. The user has connected the joystick (6 switches) and the extra sip/puff control (2 switches) to the joybox. The accompanying software makes it possible to program the keys/key combinations controlled by each switch and the programming can easily be modified as needed.
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Joyboxen is not available anymore, but there are similar switch interfaces, for example at enablemart.com (last checked March 2020).
This tip is from 2007