Over, down up functionality

There are three types of 'normal' buttons (and there are also shape buttons, but in 7 they have only two states which you cannot change):

• Text buttons: they have rollover and down states, taken over from the OS you are using
• Transparent buttons: have no rollover/down states in CP7 (they have in CP9 - where they are editable)
• Image buttons: as described by Rick, where you have 3 different images for each state

If you want a custom button with three different states, you need to create an image button, which means creating three different images in a graphical application.

Situation changes in CP8 and CP9 where I definitely would create shape buttons because they are more flexible, have three states, can be used on master slides, question slides, score slides and timed for the rest of the project. All situations that are not possible for normal buttons. And you don't need a graphical application to create the states.

I never slap any hands

Since you talk about left toolbar, are you on version 7?