Includification: Video Games for All

Bobby Miller

About 15 percent of the world’s population has some sort of physical or mental disability, according to a report issued by the World Health Organization and World Bank. In a number of ways, we try to accommodate for the special needs of these 785 million people. Buildings have elevators or ramps to help wheelchair-bound individuals reach higher floors. TV programs have closed captions to let deaf people enjoy the show. And the list goes on.

However, the relatively young video game industry hasn’t been so quick to design its products in such a way that they can be enjoyed by all people regardless of their needs. This oversight leaves many people out of the fun. PopCap Games, the maker of “Bejeweled,” “Feeding Frenzy,” “Plants vs. Zombies,” and other well-known video games conducted a study. This study found that roughly one in five casual gamers has some sort of physical, mental or developmental disability. Another study led by researchers Bei Yuan, Eelke Folmer and Frederick Harris Jr. found that roughly 2 percent of the U.S. population cannot play video games at all due to their impairments. That’s over 6 million people.

Nvate Includification includification video games Special Controllers video games

Credit: SpecialEffect’s YouTube channel

As the video game industry continues to mature, though, it’s becoming more conscious of the various needs that people have. Disabled gamers can find help through special controllers, through organizations giving them a voice and through game design that accommodates for their needs. This movement has been dubbed “includification.”

Special Controllers for Special Needs

Some disabled individuals are entering or returning to the fun world of gaming thanks to the U.K.-based charity SpecialEffect. As its official website,, states, it was founded by Mick Donegan, an assistive technology specialist who teaches at a number of universities. The charity designs special controllers to fit the needs of disabled individuals on a case-by-case basis—free of charge. The people SpecialEffect helps include stroke patients, individuals with cerebral palsy, injured athletes or soldiers, and more.

The magazine Game Informer detailed the charity’s work by noting that its team sometimes maps buttons to different areas, allows buttons to be activated by voice commands or makes larger analog sticks for easier control. If the individual’s needs change over time as their condition develops, then SpecialEffect will alter the controller as necessary. These controllers are surprisingly effective. For instance, one of their clients can only use one finger and his thumb on his right hand due to spinal muscular atrophy, but he can even complete “complicated action games like ‘Grand Theft Auto V’” thanks to his SpecialEffect controller.

As Game Informer went on to note, the charity is of modest size with 11 workers and two occupational therapists, but they’ve touched the lives of thousands of individuals in profound ways. “We’re not just doing it for the sake of fun,” the organization’s website stated. “By giving people the means to participate, we’re kick-starting rehabilitation, self-esteem and, most importantly, inclusion.” One case study on their website explains that a young man named Callum became paralyzed from the shoulders down due to a BMX accident. However, thanks to a SpecialEffect controller that lets him manipulate a PlayStation 3’s control sticks with his chin, he can now play his favorite racing games with his friends and family again.

The website’s case studies include younger individuals as well. Six-year-old Elliott loved watching his friends and family play Xbox 360 games, but he could only watch due to his cerebral palsy. SpecialEffect designed a large controller to accommodate for his difficulty in making small, subtle movements. It allowed him to compete with others in a variety of games, even ones requiring quick reflexes. “He’s naturally competitive, and this puts him on an equal footing,” his mother said.

Nvate Includification includification video games Special Controllers video games

Elliott can now enjoy playing video games with his sister, Ella.
Credit: SpecialEffect’s YouTube channel

You can follow SpecialEffect on Facebook, YouTube and Twitter. The charity is always happy to accept donations.

If you would like to purchase a video game controller designed with disabled individuals in mind, though, your options are surprisingly slim. Websites like,, and sell some video game controllers internationally for the disabled community. However, few organizations have tapped this market. Controllers for the latest generation of consoles—Wii U, PlayStation 4, and Xbox One—are particularly elusive.

Mark Saville of SpecialEffect commented in an email that the difficulty of finding mass-produced controllers for disabled gamers might stem from just how diverse people’s needs are. “Some people have problems using trigger buttons, some find controllers too heavy, some find the analog sticks too stiff, some can only use a couple of fingers on each hand and some can’t use their hands at all,” he said. “The list goes on, and the issues are further complicated by progressive conditions such as muscular dystrophy, where finger or hand movement might be reduced to millimeters over time.”

Therefore, purchasing custom-made controllers tends to be the more viable option, even if they are usually more expensive. The ironically named company Evil Controllers works with disabled gamers who need custom-made controllers. Visit their website for more information.

PC gamers have different ways they can get in on the action. David O’Connor of noted that many programs can help disabled individuals play PC games. “I am a high-level quadriplegic, and I have been successfully gaming for the last 30 years and so can you,” he wrote. Helpful programs he lists include SmartNav, HeadMouse Extreme, Shoot, VAC, Say2Play, Killers Voice Command, and Voice Buddy. Many of these allow for easy mouse movement or for voice commands to replace button presses.

Designing Video Games with Everyone in Mind

Game developers are also becoming more sensitive to the needs of disabled gamers, finding ways in which they can adjust their games so that more people can enjoy them. One important organization that has been driving the includification movement forward is the AbleGamers Foundation.

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According to the charity’s official website, it provides consultation to development companies of all sizes to help them make “each game as accessible as possible.” It believes its mission is important because video games allow disabled individuals to have fun and connect with others, which can help maintain emotional health. Plus, as the organization told NBC News, video games provide a temporary escape from disabilities. Paralyzed individuals can run, jump and fight in fantastic worlds, for example.

The website provides many detailed guidelines from the AbleGamers Foundation explaining how game developers can make their experiences accessible to individuals with different handicaps. The methodology varies based on what kind of impairment the game has to tackle, whether it’s mobile, visual, auditory, or cognitive. The website has numerous suggestions grouped by tiers based on how easy the modifications are to implement.

Mobility impairments that limit muscle movement tend to be the most difficult hurdles for disabled gamers, according to the website. Game designers can ease this situation by making their controls entirely customizable. The gamer can map the controls in such a way that requires the least amount of movement on their part or in such a way that they can play one-handed.

Being able to adjust the sensitivity of various movements can help as well. For example, it’s a given that in first-person shooters you aim by moving a control stick or mouse, and the more you move your device, the more the aiming cursor moves. Being able to make this movement highly sensitive is useful for individuals who have trouble moving their muscles because they can then move the crosshair around the screen without straining themselves. tells developers to ask themselves whether or not their game could be played by someone who can move the mouse only an inch in every direction. On the flipside, people with disorders such as cerebral palsy have trouble making small motions, so allowing the player to make movements that are highly insensitive helps prevent the aiming cursor from flying around the screen haphazardly.

There are other ways to accommodate for mobility issues as well. For instance, people with muscular disorders might suddenly find themselves in pain and need to stop playing. So, allowing the gamer to save at any moment allows them to stop without losing valuable progress.

Developers should take auditory disabilities into account as well. While many games offer subtitles so that individuals who are hard of hearing can understand what characters are saying, there’s more to video game audio than dialogue. Games should offer full closed captioning akin to that seen on TV. Such captioning should make note of ambient noise, which is sometimes valuable to the player. For example, if you hear a monster moaning in the distance, then you know a baddie is just around the corner. Deaf people shouldn’t be surprised by what the rest of us knew was coming. So, “[Monster moaning]” should appear on the screen.

Closed captioning, like many of the other accessibility options suggested on, could even help people without disabilities. For example, closed captions would allow a person to play a video game on mute so they didn’t disturb a sleeping baby or hungover roommate.

There are also visual impairments that video game developers should take into account. According to the AbleGamers Foundation, one out of every seven men has some form of “color deficiency.” Although complete color blindness is relatively rare, it’s surprisingly common—especially for men—to be unable to distinguish between red and green. To help such individuals, developers should allow the player to customize the color of on-screen text and menus to create a contrast that is easy for them to see. Developers should also distinguish teams through means other than just color. For example, “Battlefield 3” has the option of making small blue Doritos float over the heads of the player’s allies.

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Puzzle games should distinguish their pieces in ways other than just color in order to allow color-deficient individuals to play them.

According to the official Centers for Disease Control and Prevention website, over 16 million Americans have a cognitive impairment. also has suggestions for making video games accessible to them. Tutorials, for instance, should actually show the player what to do and be interactive in order to make them more memorable. Most gamers prefer learning a game’s mechanics through active means rather than passively reading lots of text, anyway.

The game’s instructions should also refrain from making assumptions about the player’s previous knowledge of the genre. For example, while it might be obvious to role-playing game lovers that dropping an enemy’s health points down to zero knocks it out and gives us experience points so that we can level up our stats, other people might find themselves confused by all this—especially if they’re cognitively impaired.

Nvate Includification includification video games Special Controllers video games

These instructions seem stupidly obvious to some members of the Game Informer community, but they actually make the game more inclusive to cognitively-impaired individuals and to role-playing game newcomers.

Some cognitive disorders hinder a person’s memory, in which case it helps if a video game’s instructions can be accessed at any time. It also helps if the game provides reminders as to what the player is supposed to do next. This can help any type of gamer. I sometimes set a game aside for months or even years, only to come back without a clue as to where I’m supposed to go next.

Another option for cognitively-impaired gamers that anyone can appreciate is the ability to adjust the game’s difficulty level. As noted, some games automatically lower their difficulty, give hints or allow certain sections to be skipped if the player fails a certain task many times. You cannot, however, adjust the difficulty of playing online against real people, in which case it helps if the player can at least practice against computer-controlled opponents before entering the fray with other humans. A game’s online interface should also group people of similar skill levels to ensure the competition is fair.

Certain modifications, though, are more controversial amongst the gaming community. In particular, individuals with mobility issues find games much more accessible if they can create macros. A macro allows the player to press one button—or with a computer one key—and then the game automatically registers that one button press as a sequence of button presses, or as pressing multiple buttons at the same time. If someone is having trouble accomplishing a move that requires the player to press the jump button and attack button while holding down on the run button, for example, then all these commands could be assigned to one quick button press. While this function helps disabled gamers, it could also enable cheaters to input a huge number of commands at once to gain an edge over the competition.

Some companies who are paranoid about cheating also make it so that their games only respond to certain controllers, programs, or devices. This tactic might stop cheaters from using programs to provide them unfair assistance, but it also prevents disabled individuals from using special controllers or programs that suit their needs.

As the AbleGamers Foundation noted, game developers should find more effective ways to root out cheaters. If a disabled player wants to use certain modifications that could possibly make the game “too easy” for able-bodied gamers, then the developer could make it so that achievements aren’t handed out while using these modifications. For instance, if a disabled player does need to use macros or a special assist controller to make it through a game, then do not award them with points on their online profile. That way, cheaters won’t use such modifications to scoop up easy trophies and achievements, but disabled players can still enjoy the game. After all, most disabled individuals aren’t playing for the fame of being up high on online leaderboards; they just want to play the game and have fun.

The website contains many more suggestions for developers who want to make their games accessible to everyone.

Resources for Disabled Gamers

Even with special controllers out there and even with game developers who are concerned about the accessibility of their experiences, it can still be difficult for disabled gamers to figure out which games they can play and which ones they cannot. interviewed Robert Kingett, a 24-four-year-old gamer with tunnel vision and cerebral palsy. As he told the website, video game reviews rarely address the kinds of questions he has before purchasing a game. While most of us just need to know whether or not the game’s fun, he and other disabled gamers have much more on their minds. “Would the game have an easy-to-see minimap?” he asked. “Would the game have closed captions so my deaf friend could help me? Would the game have control customization options where I could toggle stuff instead of holding down buttons?”

After all, even seemingly tiny design choices can hold back a disabled gamer. Kingett mentioned that “Grand Theft Auto V” has tutorial instructions in small font at the top-left corner of the screen, which is not at all conducive to his visual impairments. Such inconveniences are especially annoying if they appear late in the game, right when the ending seems just out of reach. For instance, in the final hours of the Nintendo 64 classic “Banjo-Kazooie,” the game quizzes the player on where certain pieces of music were used in the adventure. While most of us could identify a tropical tune as coming from a tropical level, deaf gamers would definitely need the help of a hearing individual who is familiar with the game.

Thankfully, some websites want to help disabled gamers with the selection process. Josh Straub, on his blog—Disabled Accessibility for Gaming Entertainment Rating, or DAGER, System—looks at how much help, if any, gamers with various impairments will need when playing a certain title.

There are some larger resources for the disabled gamer community as well. AbleGamers, for example, provides “expert reviews and information on video games and assistive technology aimed at helping individuals with disabilities make educated purchases,” as stated on its website. “This includes keeping an up-to-date database of video game titles reviewed specifically to assess the accessibility of each title.” Plus, its large online community allows gamers with disabilities to not only socialize but also discuss which games are accessible to people with their needs.

The video game community as a whole is growing fast, whether we’re looking at hardcore gamers who spend hours a day with a controller in their hands or casual gamers who enjoy some quick diversions on their smartphones. It’s only natural, then, that video game developers would want to make their games more accessible to their growing audience. As technology evolves, video games are not only becoming prettier but also more open to customization options. According to Robert Kingett, these options are the key to reaching out to disabled gamers. “There are three words I’d say that make a video game completely accessible: customization, choices and alternatives,” he told

In the meantime, what can you do to help out the includification movement? Well, if you notice that a video game seems inaccessible to impaired individuals, then why not email the developer and voice your concern? Companies need to realize that many people care about these issues if they’re going to take them seriously. Also remember that charities such as AbleGamers and SpecialEffect are always happy to accept donations.

On a final note, when you play video games with other people, be polite to those with special needs or other difficulties. Speak out if the online community is being cruel or unfair. Robert Kingett told that he stutters, and many gamers online claim he sounds “retarded.” Everyone deserves to enjoy the game, and everyone deserves respect. That’s true whether you’re interacting with someone in the real world or in “World of Warcraft.”

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