Gaming while disabled — the future of adaptive tech is here

Adaptive tech in video gaming has exploded in the last few years, but costs and programming know-how can still keep games out of reach of many physically disabled gamers.

As a teen in the early 2000s, I played a very silly first-person shooter on GameCube called TimeSplitters that had a wide array of characters to choose from (I don’t know why; I never played the story mode).

Out of all of them, I always chose to play as the T-rex, who I equipped with two handguns. The guns would magically float in front of the T-rex’s stubby claws, never actually touching the triggers. I identified with this dinosaur because I, too, was somehow physically getting by — playing this game with a too-short appendage. The joystick was, in fact, controlled by my left arm’s stump, which stops immediately past my elbow. It took a little while, but I eventually figured out how to play video games with my disability.

Like this!

Long before I was a fifteen-year-old pretending to be a pistol-wielding T-rex, my first video game experience was with Nintendo's SNES. The controller’s D-pad was small and hard to press precisely with my limb, leaving little gaming calluses on my arm. Later, my parents were convinced I wouldn’t be able to play Mario Kart 64 and taped the A button down, putting Yoshi in permanent acceleration.

They later bought me a strange miniaturized driver's seat controller with a wheel and pedals you’d press with your hands—perhaps a very early example of an adaptive controller. Eventually, I realized I didn’t need that, and pressed my stump into the joystick — much easier to use than the D-pad, even if it left an impression of concentric circles. Since then, I have used my knees and legs in creative ways to press L buttons as needed, and simply avoided games I couldn’t get to work for me.

Over time, I’ve stubbornly figured out how to play most things, though not always comfortably. Xbox in particular has long been the console that I never saw myself playing; from the time of Halo: Combat Evolved, Xbox games have been particularly two-handy. Nowadays, the Xbox brand is the only mainstream console maker with its own adaptive controller.

Released in 2018, the Xbox Adaptive Controller (XAC) is a large, flat gaming pad with two large buttons and nineteen 3.5mm ports to plug in external devices such as joysticks, buttons, switches, pedals, and other specially-designed devices. The XAC is fully customizable and allows gamers to save three controller profiles based on their needs and the specific games they’re playing.

Third-party input devices can be purchased separately and plugged into the XAC to create the ideal device. Logitech sells an Adaptive Gaming Kit that includes light-touch buttons, large and small buttons, and pressure-sensitive variable trigger controls that can help you get started with designing an XAC arrangement that suits your needs and your body.

In a way, the XAC has formalized homemade adaptive designs disabled gamers have concocted at home for decades. For example, some gamers have used pieces of foam or towels to better manipulate thumb-sticks that are too small or too far away from the gamer’s body.

“The gaming and disability community has been forced to come up with creative solutions to obstacles for a long time,” says Brannon Zahand, Senior Gaming Accessibility Program Manager at Microsoft. “So we wanted to make something that took some of the guesswork out, while still allowing gamers to use the controller in a way that fit each person’s unique needs in gameplay.”

The push for an adaptive controller emerged around the time Microsoft launched the motion-sensing Kinect accessory in 2010, when gamers started to ask Microsoft if they could use it while in a wheelchair or with one arm. “That really drove home the profound impact that unintentional exclusion could have on gamers with disabilities if we weren’t intentionally including them in our design and development processes," Zahand says.

“The gaming and disability community has been forced to come up with creative solutions to obstacles for a long time.”

Xbox received a great deal of guidance from the AbleGamers Foundation, a nonprofit out of West Virginia that designs custom gaming tables for profoundly disabled gamers. “How our organization works is all about exploiting movement,” founder Mark Barlet told Input. “I always say that I don’t care (of course, I do care) about the nature of your disability — the diagnosis you carry tells me nothing about how I can enable you. I need to know what you can move.”

From there, AbleGamers can design a gaming table, sometimes using the XAC, that features switches, knobs, buttons, and other devices that permit manipulation for each gamer. In general, AbleGamers tries to encourage their gamers to move into PC gaming, which allows for far more customization. “The USB is an open-source environment,” says Barlet. “There are so many more things that we can plug into the computer.”

This has been the case for at least over 10 years. Third-party controllers have been on the market for quite a while; it’s mainstream gaming consoles that are now catching up. With the array of adaptive gaming options out there, “There’s almost nothing you cannot play now,” Barlet told me. Well, holy shit.

Creating accessible gaming tables and controllers is all about mapping or assigning certain standard controls to a different input, often in a more convenient location for the gamer. For example, as Robbie MacGillivray points out on his blog OneArmedGraphics, you could map the shift key onto a foot pedal to hold shift with a foot and click with one hand simultaneously.

Evil Controllers, maker of custom Xbox and PlayStation controllers, designs completely custom gaming gear for disabled gamers using the same principles of remapping. Since prosthetic devices such as myoelectric arms are still slow to react and cannot perform the kinds of instantaneous manipulation that we need to play games, it’s especially crucial that custom controllers are designed like typical prosthetic devices — taking into account the specific and unique physical abilities of each user.

“There’s almost nothing you cannot play now.”

AbleGamers’s builds often include the XAC, but it isn’t the only adaptive device — or potentially adaptive device — out there. Some products on the market such as the Quadstick enable quadriplegic gamers to play PlayStation, Xbox, Nintendo, and even PC games with their mouths. There are even specialized gaming eye trackers. Other gamers have figured out that some controllers designed for specific types of games make perfect adaptive controllers for them. Mice made specifically for MMOs (Massive Multiplayer Online games), with their programmable side buttons, are especially useful for gamers who can only use one hand.

On PC, gamers have access to customizable mods and add-ons built by independent developers that can also improve gameplay and increase accessibility. For gamers with visual disabilities, like Ziri Harwyn, a former professional World of Warcraft player based in Santa Rosa, CA, being able to relocate certain in-game features to the center of the screen, rather than in the periphery, enables her to continue to play. “I also have add-ons that will scream at me if something dangerous spawns under my feet so I know to move if that’s not where I happen to be looking at the moment,” says Harwyn. “People who aren’t almost blind also use the same programs. It’s just helpful shit, ya know?”

Reconfiguring game settings and finding the right add-ons to make PC games more accessible requires a little bit of technical know-how that still presents a significant barrier to many disabled gamers. AbleGamers’s Certified APX Practitioner Course for game developers is also helping game companies design accessible games from the ground up so that this kind of solo tinkering will be less necessary. The Foundation has trained 140 developers in the last 14 months across major game studios. The designs of more PC games are incorporating the needs of disabled gaming communities, including those of blind and deaf players.

But the adaptive gaming hardware like XAC and the Logitech Adaptive Gaming kit to get you started are both around $100. After that, additional third-party inputs can each cost upwards of $70. For competitive disabled gamer Yhassir Hassan, that was enough. “I brainstormed with different buttons for a week and also asked advice from some friends,” says Hassan, to help figure out the best way to play Rainbow Six Siege with one arm after his amputation.

But other gamers need more devices and more sophisticated setups. Mike Hansen, an industrial designer with spinal muscular atrophy, says trying out loads of different adaptive equipment to find out what works best for your particular body gets very expensive. And although gaming is an expensive hobby for anyone, able-bodied gamers can at least buy used controllers online, or even at thrift stores, fairly easily. Disabled people, who are statistically more likely to have lower incomes and experience poverty, are strapped with these extra costs just to start playing. AbleGamers and other local charities can help with costs — and to a very rare extent in the U.S., so can insurance — but there isn’t enough funding to go around.

Disabled people, who are statistically more likely to have lower incomes and experience poverty, are strapped with these extra costs just to start playing.

Evil Controllers sells an XAC Handle Base Thumbstick Extension — basically an extra thumb-stick that can be placed in any location, including on the bottom of your controller so that your knee can manipulate it — for $74.96. Hansen uses this extension with his mouth to play World of Warcraft. For him, the XAC didn’t work out and the $500 Quadstick, actually designed for mouth use, was prohibitively expensive. “I kind of held off for a while and finally said, ‘You know what? My mouth works, I might as well just go for it,’” says Hansen, who uses the thumbstick extension with his mouth so he can get back to gaming — especially in the pandemic, during which he has had to maintain isolation to protect himself.

He’s able to play with friends on his Twitch stream and takes extra pride in beating people who don’t know he’s disabled: “When I am able to shitcan somebody it reminds me that I put the time and effort into finding a way for me to play the game at the same level [as anyone else] despite the issues. Unless I told them that I was disabled, they otherwise wouldn't have known. That kind of anonymity or ability to blend in is what I seek.”

For Harwyn, however, playing in a guild that knows about her disability and is accommodating is essential to get by. “For me, I need people to know so I can make sure I am in a role that is least likely to affect the group overall. Some fights, if one person is out of place or doesn't know what to do, they can kill the entire 40 player group instantly. When they understand what I'm dealing with on my end, it affords me a little more empathy in the situations where I do mess up. Which I do.”

Accessibility is about getting to the game, but it’s also about the social worlds within them. Sometimes accessibility is the anonymity that online gaming affords, but other times it’s the ability of games to enable friendship and compassion. But, while the latest tech has made accessing games easier than ever before, the next frontier is lowering costs and cultivating greater accessibility in gaming culture.

You can check out AbleGamers’s resources for more information about gaming with different disabilities.