Graphic showing four circles representing the four resources. The second circle is highlighted indicating this is the second resource.

Introduction

Assistive Technology devices and equipment increase the ability of an individual living with disabilities to perform the tasks they want. Over 80% of people will use assistive technology at some point in their life and cost is often cited as the main barrier to not receiving the devices they need; gaming is no exception to this. There are many assistive technology options in gaming that will be discussed in this resource. Modifying a gamer’s current controller or providing alternative access to the game through adaptive switch access, voice, or changing the settings can allow many more people to join the gaming community. The following topics are covered in this resource:

  1. Open Source Technology in Gaming
  2. Switch and Joystick Access in Gaming
  3. Accessible Controller Modifications
  4. Accessible Software Options

This page is a part of a series on adaptive gaming. Please visit the other resources in the series if you are looking to learn more:

  1. Introduction to Adaptive Gaming 
  2. Assistive Technology in Gaming (you are here)
  3. Accessibility in Video Games and Gaming Goals
  4. Adaptive Gaming Demos and Recommendations

Open Source Technology in Gaming

Makers Making Change specializes in open-source assistive technology. This means that all of the devices are licensed under an open-source license which allows anyone to access the original design files to customize or create themselves. This results in low-cost devices as the user only has to reimburse the volunteer maker for the material cost. At MMC, we host a library of open source assistive technology where devices can be requested by users or volunteer makers can access the files and documentation necessary to build the device for the requester.

Cost comparison of market and open source versions of a mouth operated joystick and adaptive switch. Market joystick is $1000+ while open source is $250. Market switch is $100+ and open source is under $10.

[1] – See Attribution

Open-source technology is a game changer in making video games more accessible. The reason for this is some individuals may not be able to game with a standard controller or mouse and keyboard, custom setups can be created to allow them to game in a way that works for them. There are fantastic devices that have been created for adaptive gaming that are not open source, like the Xbox Adaptive Controller (XAC). However, open-source assistive technology allows for the customization of devices like the XAC by allowing users to work with the designers of open-source devices to create a device that fits their specific needs.

Video games can be made more accessible in many ways, such as introducing switch access, controller modifications, software modifications, and using built-in accessibility settings if the system or game provides them. This resource will detail these options through a gaming lens.

Helpful AT Resources

The two resources below are great options if you are looking for more information regarding assistive technology.

Intro to assistive tech – https://www.ocali.org/up_doc/AT_Resource_Guide_1.pdf

What is AT? From ATIA – https://www.atia.org/home/at-resources/what-is-at/

Types of Gaming AT

This section will detail specific types of access for video games, but it is important to remember that there are many ways to make video games more accessible and that these methods can “stack.”. For example, someone who is unable to play games with a standard controller may use one or more options for access to control the game. An example of this is, using switch access to give inputs to the game but also using software modifications to make the game more visually accessible.

Two photos of a gaming set up of adaptive swtiches and one of a group of gamers playing. One gamer is using an xbox adaptive controller.

[1] – See Attribution

Switch and Joystick Access

Adaptive switches are used to create access for users living with mobility differences. Instead of controlling the device with the standard setup that may not be accessible, switches and joysticks can be added. This covers a wide range of use cases such as access to devices such as toys, environmental control units, computers/tablets, and communication devices. Although, many of these devices do not have the correct ports (3.5 mm cable jacks) to allow for switch access. So devices like switch interfaces or devices specific for gaming like the Xbox Adaptive Controller can be used.

Adaptive Switches and Joysticks

Adaptive switch access can be the solution to be able to create an effective gaming setup for someone that is not able to use a standard controller or keyboard and mouse. Instead of using those traditional inputs, switches that are mounted near the user can instead be used to control the video game. Think of the switches replacing the buttons and triggers of a controller or the keys on a keyboard (seen in the image below). Switches are either wireless or use a 3.5 mm cable to connect to a host device. But many host devices like tablets, phones, computers, or gaming consoles do not have the 3.5 mm jacks to directly connect adaptive switches. Therefore, for gaming, switch access must be done through either a switch interface or an Xbox Adaptive Controller. Adapted switches also come in many different shapes, sizes, and activation forces. MMC has created a switch selection guide as a separate resource to help guide a user in choosing a switch that is right for them.

Image describing the keyboard inputs or buttons on a controller can be replaced by an adaptive switch.

[1] – See Attribution

Joysticks work in conjunction with the adaptive switches as many games require joystick input. On a standard controller, there are two joysticks, commonly referred to as thumbsticks or toggles and a mouse is used in PC gaming. External joysticks would replace that input from a standard controller or mouse. Joysticks come in many different shapes and sizes with different heights and toppers. Accessing joysticks is a common issue in creating accessible gaming setups as they can be tough to find. Makers Making Change has created an analog joystick selection guide to help users choose a joystick that works for them. SpecialEffect’s has a fantastic resource on the joysticks available for adaptive gaming currently.

Image describing the mouse or thumbstick controller can be replaced by a joystick

[1] – See Attribution

Joysticks can be either digital or analog. Analog joysticks can be thought of as the thumbsticks on the controller, whereas the digital can be thought of as the D-Pad. This means analog joysticks can have proportional activation, where there is a gradual input depending on how far you move the joystick in one direction. Digital joysticks only have four inputs (left, right, up, and down). Analog joysticks are the preferable option for most gaming scenarios.

There is a secondary type of joysticks that can be mouth operated. These joysticks use sip and puff technology, and the user controls the joystick with one’s mouth to move and interact with the game. Makers Making Change has an open source low-cost option for this called the LipSync Gaming. There are market solutions as well, such as the Quadstick.

Photo of the LipSync mouth joystick device

[1] – See Attribution

Switch Interfaces

Think of a switch interface as an adapter, allowing the user to connect the switches to a computer, tablet, or smartphone using USB or Bluetooth. A switch interface provides a way to connect the adaptive switch to the computing device and allows for multiple switches to be used at once. MMC has created a Switch Interface Selection Guide to assist in users selecting a switch interface that works best for them. Switch interfaces on the MMC library currently do not allow for direct connection to consoles. Therefore, they can only be used for mobile and PC gaming. This allows the interface to communicate to the computer that the switches are acting as a gamepad. Switch interfaces also can include many other features such as button mapping (described below) and advanced techniques like creating macros. Macros are like shortcuts that can eliminate the need for multiple switches.

Switch interface diagram showing the connection of a mobile device or PC to a switch interface. From the switch interface, the joysticks or switches can plugged in.

[1] – See Attribution

Xbox Adaptive Controller

The Xbox Adaptive Controller (XAC) is a controller that was developed by Microsoft to allow for alternative access in gaming. Think of this device as an on-the-market version of a switch interface that is specifically for gaming.

Photo of user playing pinball with an xbox adaptive controller

[1] – See Attribution

The big difference between the switch interfaces and the XAC is the ability for the XAC to be able to connect to consoles. However, the XAC is only intended to be used with PC gaming and the Xbox consoles, but adapters can be used to connect it to other gaming platforms. The compatibility between consoles and other gaming platforms can be seen below:

Gaming Platforms Natively Compatible With XAC (Y/N) Adapter Needed? How-To Resource/Video Links
Xbox One Y No Adapter Needed
Xbox One S Y No Adapter Needed
Xbox One X Y No Adapter Needed
Xbox Series X and Series S Y No Adapter Needed
PC (Windows 7,8.1, and 10/11)
Limited functionality on 7 & 8.1
Y No Adapter Needed
Mac N Software needed to recognize controller
PlayStation 4 N Titan 2 or Brook Wingman or Cronus Zen Link to titan 2

Link to Brook wingman

Cronus Zen Tutorial Page

PlayStation 5 N Titan 2

Cronus Zen

Video Tutorial

Cronus Zen Tutorial Page

Nintendo Switch N Mayflash Magic NS Video Tutorial
Android (5.0) Y None SpecialEffect Tutorial

 

Link to Android games

IOS (14+) Y None SpecialEffect Tutorial

PC/Xbox One and newer consoles also feature an application called Xbox Accessories that allows for button mapping and co-pilot mode. Co-pilot mode is exclusive to Xbox and PC, but button mapping may be a feature of some switch interfaces.

Co-pilot mode

Xbox’s Co-pilot mode allows two controllers to control the same game. This is accessed through the Xbox Accessories application. This is a great tool for two gamers that want to play together and may not be able to use control options given to them in a game. This can also be a powerful tool to add more options for input to an individual’s setup to include switch access alongside standard controller access.

two photos showing two types of copilot mode. One where the users is using both the controller and adaptive switches. The other where one person is using the controller and the other is using the xbox adaptive controller.

[1] – See Attribution

Co-pilot can be used on either PC or Xbox consoles. This allows for the cases of either using two XAC connections or an XAC and a standard Xbox controller to control the same game. This is different from co-op mode in games where people often play two different characters in the same game, rather the same characters are controlled by both.

A video showing the possibilities of the co-pilot mode and how to set it up on PC and console are shown below:

Co-pilot mode video: https://www.youtube.com/watch?v=ol6VbnnTGRQ

Set up Copilot Mode with Xbox One and Windows 10: https://gameaccess.info/how-to-set-up-copilot-on-xbox-one-windows-10/

Button Mapping

The technique called “button mapping” allows for the user to choose which inputs (switches, joysticks, etc.) relate to an action in the video game. This also works on standard controllers to choose which buttons on the controller relate to the actions in the game. This can be very useful in customizing a gaming setup to be more effective for the gamer. Button mapping can be available on the switch interfaces themselves, in-game, or on PC launching platforms like Steam.

XAC or Switch Interface

Button Mapping is available on the XAC through the Xbox Accessories application and available on most switch interfaces. Most recently developed games also feature in-game button mapping options. This is an important concept to understand when discussing switch access for video games as it allows the customization of the gamer’s switch setup.

Here is a resource for how to go through the process of button mapping on the XAC: https://gameaccess.info/how-to-create-a-profile-for-the-xbox-adaptive-controller/

In-Game

As mentioned before, button mapping is sometimes an in-game option for games with accessibility options. To check this, go to the settings in the game and try to find either a “controls” section or an “accessibility section.”. You are looking for an option that will allow you to change the input relating to a certain movement. For example, in Brawlhalla this setting is found under the “controls” option in the settings.

keyboard settings for the game brawlhalla Keyboard mapping for brawlhalla
Steam

Steam, a platform to purchase and launch games on PC and Mac, also has its own unique set of button mapping. Steam is a powerful tool when playing games on a PC while using an XAC for switch access. Some games that an individual may want to play on the computer will not be available on Steam. For example, Rocket League and magic the gathering are bought on the Epic Games store and browser, respectively. But once the game is installed on the system. Using the “add non Steam game” feature built within Steam, these games can be launched through Steam. What this allows is to connect the XAC to steam and be able to remap the controls to suit the game.

Steam should be the primary launcher of any game that is being used with the XAC. Using Steams “big screen mode” and with a controller connected, the user can independently access, remap, and launch games using the XAC. Although this tutorial is for how to connect an Xbox One controller to steam using the “big screen mode,” the process is the same for the XAC.

Controller Modifications

Controller adaptations or modifications can be a great inexpensive option to allow for alternative access to a standard controller.  Controller modifications can be broken down into DIY controller modifications and ones that are on the market solutions.

Two photos of controller modifications. One using 3D printed parts and one using electronically modified parts.

[1], [2] – See Attribution

DIY Controller Mods

DIY open-source controller modifications can be found in many online libraries online. Of course, on the Makers Making Change library under gaming we continue to add controller modifications. Another great resource is The Controller Project, where controller modifications are hosted. Controller modifications can be done by adding physical components such as 3D printed components to a standard controller to make pressing the buttons, triggers, and joysticks easier. Controller modifications also can allow for easier mounting for individuals that are unable to hold a standard controller but can access all the buttons.

DIY controller modifications that are featured on MMC and The Controller Project can sometimes run into the case where the modification is for a controller that is different from the system the user wants to play on. For example, if the modification that works for the user was created for a PlayStation controller, but the user wants to play on an Xbox, an adapter can be used to make this happen. Common adapters are the These adapters have different compatibilities but can make the connection between controllers easily. It is also important to note that the Bluetooth Xbox and PlayStation controllers can be connected to Windows PC’s for controller-compatible PC games.

Market Controller Mods

There are a few companies creating accessible controllers by modifying them for switch access, alternative joystick access, and changing the layouts. This can mean adding additional switches built into the device or adding ports for switch access to the controller. These options can be explored as possible components of an accessible gaming setup. Links to some commercial controller modifications can be found in the “Market AT Solutions for Gaming” section below.

Software

Image showing a screenshot of The Last Of Us 2 gameplay using high contrast mode. The enemy's are shown in red and the protagonists are shown in blue.

[1], [3] – See Attribution

Software is another powerful tool for accessibility in gaming. Many recent games feature in-game accessibility options. These settings can be very helpful for players to be able to adjust their game to meet their visual or auditory needs. Some games even have in-game button mapping. Unfortunately, game developers do not have a current standard around including accessibility in their game, so it can vary. More recent games made in the last 3 years will have some form of accessibility built in. Games that have larger budgets (commonly referred to as AAA games) often feature more accessibility options. Although, there is no promise. The Can I Play That? website features accessibility reviews of video games and discusses the accessibility features, so before purchasing a game, the gamer is able to check what is featured. Below is a list of common accessibility features that could be included in-game:

  • Brightness
  • Contrast
  • Color Blind Mode
  • Subtitles
  • Difficulty options
  • Button Remapping
  • Narration and Descriptive Audio
  • “Slow Motion” or Reduced Reaction Time
  • Aim Assist (automatically aims the weapon at the target)
  • Reduced Screen Effects (i.e. motion blur, depth of field, screen shake, etc.)
  • Heads Up Display (gives direction or waypoint to the gamer)
  • Simplified Controls (reducing the number of inputs to play)
  • Setting Controller Vibration
  • Customizing Audio Levels

In-Game software changes can make a game playable for many. The two main options where software is used frequently in gaming are for people living with visual differences and voice control in gaming.

Visual Differences

People who are blind or low vision often use software to make video games more accessible. This often results in magnifying the screen or using screen readers to play video games. AbleGamers has a fantastic resource on gaming with visual differences. They note that frequently, side scroller fighting games are a good first choice for gaming if this is an individual’s accessibility needs. This is due to each character in the game having unique sounds for each input in the game.

Can I Play That? has compiled a list of games for blind and visually impaired players that may be a good option for some: https://caniplaythat.com/2021/10/21/5-games-for-blind-and-visually-impaired-players/

Voice Control

Adding voice control in gaming can eliminate the number of physical inputs a gamer needs or be the sole input for the game. This is often done with additional software that has been added to the system. Voice control is mainly used on PC gaming using free or paid-for software but can also be used on consoles with the addition of an adapter. SpecialEffect’s has a full video series and guides on how to use the free voice control software GavPI and the paid software VoiceAttack. They have also made a tutorial on how to use the Titan 2 adapter with voice control software for console gaming.

There is also a market device called the Enabled Play Controller that allows for multiple inputs such as voice control, facial expressions, head positioning, hand gestures, tilt controls, and shake detection. This is a fantastic option for some gamers that want to use voice control as the lag when using voice is significantly limited.

Market AT Solutions for Gaming

The following tables give links to where commercial options for adaptive gaming can be found. In this section, switches, joysticks, controllers, keypads, adapters and mounting will be discussed.

Switches

We have also created separate resources to help users select adaptive switches and switch interfaces.

Name Price Link
Logitech Adaptive Gaming Kit $99.99 Logitech G Adaptive Gaming Kit for the Xbox Adaptive Controller
Buddy Button Switch $75.00 Buddy Button Switch | Hand & Finger Switches | eSpecial Needs
Pal Pad Assisitve Switches $48.95+ Pal Pad Assistive Switches | Assistive Techology | eSpecial Needs
Jellybean Switch $75.00 Adaptive Communication Switches | Assistive Technology | eSpecial Needs
Blue2 Bluetooth Switch $260.00 Blue2 Bluetooth Switch | Adaptive Switches | eSpecial Needs
Micro Light Switch $95.00 Micro Light Switch | Tilt Switches | eSpecial Needs
PowerLink4 Control Unit $330.00 PowerLink 4 Control Unit | Assistive Technology | eSpecial Needs
Adjustable Angle Switch $109.95 Adjustable Angle Switch | Enabling Devices

Joysticks

We have also created a separate analog joystick selection guide to help users select the joysticks for them.

Name Price Link
Mini XAC Thumbstick $59.95 Mini XAC Thumbstick (evilcontrollers.com)
MINISTIX-TU $75 MINISTIX-TU (USB Version) — Warfighter Engaged
JOYSTIX-FPS $75 JOYSTIX-FPS — Warfighter Engaged
USB Joystick (PC) $34.99 Usb Joystick: PC;6306200: Video Games – Amazon.ca
Thrustmaster T.Flight Hotas 4 Flight Stick (PS5, PS4, PC) $99.99 Thrustmaster T.Flight Hotas 4 Flight Stick (PS5,PS4,PC) : Amazon.ca: Video Games
Thrustmaster T-Flight HOTAS One for Xbox One $119.99 Thrustmaster T-Flight HOTAS One for Xbox One : Amazon.ca: Video Games
Thrustmaster T Flight Stick X (PS3 and PC) $54.99 Thrustmaster T-Flight Stick X (PS3 and PC): Desktop: Video Games – Amazon.ca
Logitech Extreme 3D Pro Joystick (PC) $52.42 Logitech Extreme 3D Pro Joystick (Silver/Black) : Artist Not Provided: Amazon.ca: Electronics

Accessible Gaming Controllers

Name Price Link
HORI Nintendo Switch Fighting Stick Mini $79.64 Nintendo Switch Fighting Stick Mini by HORI – Officially Licensed By Nintendo: Nintendo_switch: Video Games – Amazon.ca
Mayflash F300 Arcade Fight Stick Joystick $119.999 Mayflash F300 Arcade Fight Stick Joystick for PS4 PS3 XBOX ONE 360 PC SWITCH & NEOGEO mini : Amazon.ca: Video Games
HORI Fighting Stick Alpha (PS5, PS4, PC) $279.96 HORI Fighting Stick Alpha – Tournament Grade Fightstick for PlayStation 4, PlayStation 5, and PC – Officially Licensed by Sony : Amazon.ca: Video Games
XONE One-Handed Controller $99.95+ XONE One-Handed Controller (evilcontrollers.com)
PS5 One-Handed Controller $99.95+ PS5 One-Handed Controller (evilcontrollers.com)
PS4 One-Handed Controller $99.95+ PS4 One-Handed Controller (evilcontrollers.com)
Xbox Series X One-Handed Controller $99.95+ Xbox Series X One-Handed Controller (evilcontrollers.com)
Nintendo Switch One-Handed Pro Controller $119.95+ Nintendo Switch One-Handed Pro Controller (evilcontrollers.com)

Keypads

Name Price Link
Azeron Gaming Keypad $225 Azeron Store
Razer Tartarus v2 Gaming Keypad $79.99 Amazon.com: Razer Tartarus v2 Gaming Keypad: Mecha-Membrane Key Switches – 32 Programmable Keys – Customizable Chroma RGB Lighting – Programmable Macros – Classic Black : Video Games

Adapters

Adapters can be used to connect different controllers, mouses, keyboards, and other accessories to a given gaming console. These adapters may be beneficial to someone who may want to game using a keyboard, mouse or a different controller than the commercial one for the particular console they are using. The compatibility of these adapters is very important to consider. Please visit the manufacturers website to see if an adapter will work in your use case.

Name Price Link
Mayflash Magic NS $21.98 MAYFLASH Magic NS Wireless Bluetooth Controller USB Adapter for Switch,Switch OLED, Windows, Raspberry Pi, Compatible with Switch Pro, PS4,PS5 Controller and More
Cronus Zen $129.99 Cronus Zen Controller Emulator for Xbox, Playstation, Nintendo and PC (CM00053)
KeyMander 2 $143.44 OGEAR KeyMander 2 3Play Keyboard/Mouse Sharing Switch for PC and Game Consoles – GES1337
Titan 2 $312.49 ConsoleTuner Titan Two Device [Programmable Scripts Macros Mods Remapping Keyboard Mouse] Advanced Crossover Gaming Adapter and Converter for Playstation 4 PS3 Xbox One 360 Nintendo Switch and More

Mounting

Mounting can be used in order to position devices in any place the user wants. The mounting is most commonly used for assistive switches but could also be used for other devices. The following is a list of different mounting systems commercially available.

Name Price Link
Gooseneck Mounting System for Assistive Technology Switches $227.15 Gooseneck Mounting System for Assistive Technology Switches (rehabmart.com)
Assistive Technology Magic Arm Mounting System $439.78 Assistive Technology Magic Arm Mounting System (rehabmart.com)
Flex Arm Mounting System with 6-inch flex arm $137.95 The Flex Arm Mounting Systems are used for mounting Adaptive Switches or other user-provided devices to wheelchairs, tables, bed rails or other fixed objects with appropriate surfaces. (mealtimepartners.com)
Flex Arm Mounting System with 24-Inch Flex Arm $146.95 The Flex Arm Mounting Systems are used for mounting Adaptive Switches or other user-provided devices to wheelchairs, tables, bed rails or other fixed objects with appropriate surfaces. (mealtimepartners.com)
Flex for Assistive Technology $415.00 Flex for Assistive Technology| BoundlessAT.com
One for Assistive Technology $565.00 One for Assistive Technology| BoundlessAT.com

Attribution

[1] – These graphics were created using the help of icons from Canva

[2] – Image of Evil Controller from: https://www.evilcontrollers.com/store/accessible-controllers

[3] – Image of The Last of Us 2 with high contrast mode from: https://www.theverge.com/21274923/the-last-of-us-part-2-accessibility-features-naughty-dog-interview-ps4