For those unfamiliar with video games, physical ability might not be the first thing that comes to mind — but button mashing, wiggling the joystick and reaching for keys all take a degree of strength and dexterity. Accessible gaming lowers these barriers, making it easier for those with Duchenne muscular dystrophy (DMD) to keep playing even as the disease progresses.
What is accessible gaming?
Accessible gaming changes how video games are played to accommodate mobility challenges, like limited strength and decreased fine motor skills. It uses adapted controllers, adjusted gameplay, remapped buttons and more to make actions easier and reduce fatigue.
Not all video game systems can be modified to suit DMD gamers, but Xbox, PlayStation and Nintendo Switch can generally be customized to meet a player’s needs. Some people with DMD prefer PC gaming (which uses a computer, not a console), because it more easily integrates with assistive technologies they already use with a computer, and can offer more options for modifying games.
What are the benefits of accessible gaming?
From exploring the galaxy in Mass Effect to roaming the old West in Red Dead Redemption, a gamer doesn’t need to have Duchenne to fall in love with the sense of adventure video games provide. But for many with DMD, the chance to dip into a different reality carries extra appeal. As people with Duchenne grow older, movement becomes more and more limited — but these restrictions disappear in the world of a video game. In addition to escapism, video games offer:
- Social interaction: Many video games provide a chance to connect with others online, or play side-by-side with a friend or family member.
- Independence: Accessible controllers and consoles creates ways for the player to experience autonomy.
- Mental health: Gaming offers a way to relax and have fun that is not limited by physical ability.
- Problem-solving: Following a storyline and reaching objectives is good mental stimulation and provides a sense of accomplishment.
Learn more about DMD treatment and care
How is gaming made more accessible to those with DMD?
There are many adaptations that can be made to gaming materials so people with DMD to keep playing as Duchenne progresses.
The main areas that require adjustment are:
- The gameplay: Settings and configurations can be adjusted to make gameplay easier. For example, the length of time a player has to aim a shot can be extended, or inputs can be changed so that a single button tap replaces repeated mashing.
- The controllers: Specialty controllers help accommodate reduced muscle strength and dexterity. These might be lighter, have buttons that require less pressure or replace the controller entirely with larger buttons that don’t require finger dexterity. Games can even be played with a hands-free device that relies on head and mouth movements and breath controls, instead of a joystick or controller. Games can also be controlled through voice activation or with a webcam and a program that recognizes facial expressions.
- Storylines: For those with cognitive or learning difficulties, simplified storytelling, adjusted objectives and longer play times can help make video games more accessible.
Every accessible gaming setup is unique to the user’s needs, and will change over time as their needs change and technology develops. To keep playing comfortably a teenager with Duchenne might need an adjustment as small as propping a controller up on a pillow, while an adult with very limited movement might need a device with a sip/puff sensor to control a game.
Where to find accessible gaming devices and help
Finding accessible gaming resources all depends on what games a player wants to explore, and what their physical needs are. Talk to your local DMD community and healthcare team: They may have recommendations to give for local technical advice and support.
More broadly, online resources like AbleGamers are valuable sources of information on accessible gaming. Organizations like The Controller Project can help create customized controllers for gamers with disabilities. Some console makers now offer equipment specifically designed for accessibility, as well.
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