This paper describes the development and evaluation of a low-cost head-operated joystick for computer users with disabilities that prevent them from using a conventional hand-operated computer mouse and/or keyboard. The paper focuses on three issues: first, the style of head movement required by the device; second, whether a head-operated device should work as an absolute positioning device or as a joystick; and, third, the accuracy required by the device. It finds that the device's "nose following" style of head movement is more accepted by users than alternatives; that users also preferred the joystick relative pointing device over absolute positioning devices; and that users did not notice inaccuracies inherent in the device's design, thus allowing production at a lower cost. (DB)