How do deaf quadriplegics or deaf people with no hands communicate?

i wonder if one of those speech apps could be made to accept input on one screen (visualizing a tapper in the mouth tapping on the input screen) and show text or ASL on another. as long as they can see they could (learn to) read ASL. there is an app intended for the elderly to transcribe speech into text. maybe that can be used with the speech app to communicate with the speaking/hearing.
 
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