Article

Games and Culture

2021, Vol. 16(6) 702–718
© The Author(s) 2020
Designing for Disability: Article reuse guidelines:
[Link]/journals-permissions
Evaluating the State of DOI: 10.1177/1555412020971500
[Link]/home/gac

Accessibility Design in
Video Games

Mark Brown1 and

Sky LaRell Anderson2

Abstract
This project evaluates the current state accessibility of video games, specifically in
terms of designing for disability. We evaluate 50 games chosen for their sales data,
critical reception, awards won, and other criteria to examine the widest possible
sample of the most prominent games released in 2019. This approach to selecting
games allows for identifying design trends as they emerge from the most widely played
or influential games. The results highlight design pitfalls and innovations regarding
accessibility in four key areas: auditory, visual, motor, and difficulty. As a feed-forward
project, the aim is not simply to catalog what games include which accessibility
features, a nearly impossible feat considering how varied the design features are,
depending on the game. This report also attempts to point to future directions for
how games can continue to innovate in accessibility.

Keywords
disability, accessibility, design, video games, options

1
GMTK Productions Ltd., UK
2
Department of Emerging Media, University of St. Thomas, Saint Paul, MN, USA

Corresponding Author:
Sky LaRell Anderson, Emerging Media, University of St. Thomas, 2115 Summit Avenue, Saint Paul,
MN 55105-1048, USA.
Email: SkyLaRell@[Link]
Brown and Anderson 703

Video game accessibility continues to be a salient issue in game culture. Disability

intersects with video game play in often unintended ways, especially given how
physically demanding video games are (Grammenos, Savidi, & Stephanidis, 2009).
Additionally, online discourse about disability and games has increased in the last
decade, especially regarding accessibility. Online games journalism about accessi-
bility, disability, and games abound, with article topics ranging from showcases of
players with disabilities to informative articles about innovations in accessibility
hardware (Grant, 2016; Wilde, 2013). Improved accessibility for players with dis-
abilities is a worthy goal, but advocates, journalists, and scholars are without an
accurate understanding of the current state of accessibility in video game design
practice. Given the ever-evolving nature of game design standards, it is important to
catalog—as well as evaluate and provide recommendations for—game design trends.
By targeting in-game options and other design features, this project evaluates the
state of video game accessibility. We evaluate 50 games chosen for their sales data,
critical reception, awards won, and other criteria to examine the widest possible
sample of the most prominent games released in 2019. This approach to selecting
games allows for identifying design trends as they emerge from the most influential
games actually being played, be they the highest selling games or simply games that
attracted attention through critical reception or awards. The results highlight design
pitfalls and innovations regarding accessibility in four key areas: auditory, visual,
motor, and difficulty. This project aims to be feed forward: instead of simply
evaluating the results of the study—giving feedback to designers and researchers—
a feed-forward analysis provides suggestions, recommendations, and best practices
for designing the future of games. The aim is not simply to catalog what games
include which accessibility features, a nearly impossible feat considering how varied
the design features are, depending on the game. This report and evaluation attempts to
point to future directions for how games can continue to innovate in accessibility
while also providing researchers a foundational understanding of the current state of
video games. We first address scholarly discourse on disability, accessibility, and
video games, before describing methodological considerations. We then describe our
findings through a discussion and analysis of those findings, organized around four
areas of in-game accessibility features.

Disability, Accessibility, and Video Games

Popular media have a poor record when it comes to portraying disability. Media
representations of disability more often than not showcase harmful clichés that
position disability “as an absolute state of otherness that is opposed to a standard,
normative body” (Snyder, Brueggemann, & Garland-Thompson, 2002, p. 2). En-
tertainment media offer ways for people with disabilities to negotiate their identities,
and thus “there are significant stakes in the humanities-based analysis of disability”
(Snyder & Mitchell, 2006, p. 168). Socially constructed notions of disability, to which
media contribute, position bodies with disabilities in opposition to ability and
704 Games and Culture 16(6)

normalcy (Garland-Thompson, 1997). The field of disability studies argues that

disability itself is social, at least in part, inasmuch as all bodies have impairments—for
example, the wide and necessary use of eye glasses and contacts for people with less
than perfect eyesight—but impairments only transform into disabilities within certain
social parameters (Ellcessor & Kirkpatrick, 2017). Using poor eyesight as an ex-
ample, most people would only treat it as a disability when proper eye care and
resources—surgery, glasses, and contacts—were not available. These resources,
along with the discourses surrounding particular medical diagnoses and impairments,
position disability as a social reaction to bodies (Ellcessor, Hagood, & Kirkpatrick,
2017; Shakespeare, 2014). And this social positioning of disability often takes places
in media portrayals, sometimes through hurtful stereotypes and tropes (Barnes, 1992;
Garland-Thompson, 2001).
Video games stand out as a noteworthy part of media’s relationship to disability,
given how they are physically “quite demanding” and “often require mastering
inflexible, quite complicated, input devices and techniques” (Grammenos et al., 2009,
p. 2). And it is games’ physicality that attracts research on games as medical in-
terventions (Balan, Moldoveanu, & Moldoveanu, 2015; Chang, Chen, & Huang,
2011; Stendal, 2012). In a similar vein, some work has explored how games can aid
students with learning disabilities (Marino & Beecher, 2010; Wästerfors, 2011).
While helpful, this type of research exists within, and reinforces, the paradigm that
disability is medical: while medical diagnoses and impairments inform disability, it is
not the be-all and end-all, given the social elements that transform impairments into
disabilities. Under a social paradigm, some studies explore what games mean to the
identities of people with disabilities (Anderson & Johnson, in submission; Cairns
et al., 2019). And other work investigates how games portray disability (Carr, 2014,
2019; Derby, 2016) since these portrayals provide options for persons with disabilities
to imagine their identities (Snyder & Mitchell, 2006). Disability continues to emerge
as salient in game studies’ research, but as a subject of investigation, it is still in its
infancy.
Given video games’ physically demanding nature, disability advocates and re-
searchers have worked toward improved accessibility standards for games
(Grammenos et al., 2009; Powers, Nguyen, & Frieden, 2015). Bierre et al. (2005)
identify primary areas of disability that affect video game play, namely, cognitive
disabilities, auditory disabilities, mobility disabilities, and visual disabilities. Yuan,
Folmer, and Harris (2011) outline both common issues of accessibility in games as
well as provide some potential strategies to address them, but the results are far from
conclusive and not up-to-date, given the advancements in accessible design. Bierre
et al. (2005) ask the question that motivates both researchers and advocates of ac-
cessibility in video games: “How could we define a minimum accessibility standard
that is easy enough to implement for all game developers?” (p. 9). While a conclusive
answer seems elusive, the pursuit of the answer merits consideration here.
Three paradigms provide approaches to establishing accessibility standards for
video games. First, Powers et al. (2015) present a legally focused paradigm that would
Brown and Anderson 705

address issues of accessibility standardization through legal precedent. In the United

States, for example, the Americans with Disabilities Act and the 21st Century
Communications and Video Accessibility Act provide groundwork for what Powers
et al. (2015) suggest is a method for providing “a legally binding accessibility
standard for video games” (para. 1). Second, Grammenos et al. (2009) offer a design-
focused paradigm through a design principle that they call “universally accessible
games.” Games designed through this set of best practices would allow for players
with varying abilities/disabilities, especially in the form of allowing in-game ad-
aptation and accessibility options. They conclude that “universally accessible games
may be a demanding but still manageable and achievable task” (p. 25), and they list
what they consider best practices to accomplish that goal.
Third, a discourse-focused paradigm describes the state of accessibility in video
games as a method to map future directions for improved accessibility (Anderson &
Schrier, in submission). Discourse includes not only how individuals talk and write
about something—informative for its own sake as it delineates expectations for how
any cultural phenomenon should work—but also how phenomena exist in cultural
production, such as popular media (Fairclough, 1992). The current state of video
game design trends is therefore evidence of such discourse: they establish expect-
ations for design and reflect expectations of game producers and players. And it is not
possible to adequately express best practices, as suggested through a design-focused
paradigm, without properly understanding the current state of accessibility in game
design. Put simply, contemporary design informs what accessibility standards will be
carried forward in the future.

Methodological Considerations
The following research question guided the data collection and analysis:

RQ: What is the current state of accessibility in video game design?

The study operationalized “current state” by examining games only released in

2019. The goal was to compile a list of a diverse range of games across a variety of
genres, production scales, platforms, and regions in order to best represent the current
state of video game design trends. Our approach to game selection was a circular
process that began with aggregated review scores while also returning to sales figures
and awards to round out the process. We used the website [Link] to find the
most favorably reviewed games of 2019 with an eye toward avoiding games that were
simple graphically remastered versions of older releases or older games that had
additional content released in 2019. Graphically remastered games were not included
because they had the least potential to exhibit recent design trends, while full remakes
such as Link’s Awakening and Resident Evil 2 were included because they were
designed as new games that simply followed the stories and basic gameplay me-
chanics of the older, original releases. We also used the websites [Link] and
706 Games and Culture 16(6)

[Link] to choose the best-selling games of 2019 in the United States and
the United Kingdom to ensure to include games that were popular, if not critically
acclaimed, such as FIFA 2020. Last, we added games that were Game Awards’
nominees for 2019, in case they were not already included. Fifty games were selected,
a complete list of which can be found here: [Link] While
there were a number of multiplayer games on the list, and multiplayer games present
their own unique accessibility challenges, the scope of the project aimed to look at
broad trends across games and therefore no distinction was made between single-
player and multiplayer games. All games on our list were available to identify both
innovations and failures in accessible design.
To establish criteria to judge which design features acted to increase accessibility,
we picked four accessibility categories in video games with the assistance of the game
accessibility specialist [redacted for anonymous review] based out of Bristol,
England. We did not limit our findings to the four categories, given the broad scope of
accessible design, but instead, the categories acted as a starting point to guide the
process of data collection. The four categories were as follows:

1. Subtitles. Does the game provide them, and if so, are they present for all
dialogues? Are they of an appropriate size? Are they visible against the
background? Does the subtitle indicate the speaker? What options does the
player have to change these things?
2. Visual acuity. Is the text legible from an acceptable distance? Are user interface
(UI) elements contrasted against the background? Does the game provide
options to change these things?
3. Color vision deficiency. Are key elements distinguishable from one another for
those with the three major forms of color vision deficiency? Does the game
provide a color-blind mode or options to change the palette?
4. Controller remapping. Does the game let players change which buttons
perform which actions? Does it provide some controller layout presets to
choose from? Does it allow players to alter other controller aspects like
sensitivity and analog stick dead zones?

The following process dictated how data were collected. First, each game would be
played on its default settings for about an hour to discover if the game was difficult to
control, difficult to see particular elements, and so on. For instance, to assess the text
size in some games, a screenshot was captured at 1080p resolution and imported into
image editing software to take note of the actual size of the text. To evaluate color
vision deficiency issues, screenshots were taken of games at a moment when color
was suspected to be an issue—such as when color was used to convey critical
gameplay information—before using color evaluation software to create a simulated
color-blind view. To assess other common accessibility issues, such as in audio
design, we looked for when audio cues were used to convey critical gameplay in-
formation as well as if all dialogues and sound effects were subtitled. Second, the
Brown and Anderson 707

games’ options menus were opened to take note of which games provided acces-
sibility options for the four categories listed as well as to evaluate to what extent
accessibility was afforded by these options. Third, any other accessibility design
features found during play would be included, such as the dyslexic font option in
Overland or the assist mode in Super Mario Maker 2. Fourth, reviews were collected
for as many games as possible from websites dedicated to reviewing games from an
accessibility point of view, often by critics with disabilities. The websites include
[Link], [Link], and [Link]. Fifth, a re-
quest was published from a [Link] account that currently has over 62,000
followers to ask video game players with disabilities to highlight any accessibility
success and failures experienced in 2019. The tweet was a simple question asking
players with disabilities about any accessibility successes or failures in video games in
2019. The external research was valuable inasmuch as both authors are normative, or
commonly called “able-bodied” [sic], and hence, some accessibility issues would not
appear obvious. Additionally, several accessibility problems and solutions do not take
place until much further in the games than the first hours of play, and thus, external
reviews and input from other players were necessary, given the scope of the project.

Findings and Discussion

This section provides a description of the study’s findings through the analysis and
discussion of those findings: as a feed-forward project, the goal is to showcase
missteps and innovations in accessibility design, not just to catalog what design
features appeared in which games. The findings are organized into four primary areas
of accessibility design: auditory, visual, motor, and difficulty. The results highlight
examples of what we consider poor accessibility as well as excellent or innovative
accessibility design.

Auditory Accessibility
2019’s Resident Evil 2 serves as a reminder why accessible auditory design remains
a salient issue. A primary villain in the game is a mutant named Mr. X, and players
spend the majority of the game running away from this invincible enemy. Players can
only predict his position by listening out for his footsteps, except for players who are
deaf or hard of hearing: Resident Evil 2 offers no visual reinforcement of Mr. X’s
footsteps, making him near impossible to track for those living with some auditory
disabilities. [Link] dubbed the game “virtually unplayable very early on
for deaf/hoh players” and a “complete failure in accessibility” (Craven, 2019).
Several games include some design features to help convey sound effects to those
who are unable to hear them. Far Cry: New Dawn offers sound subtitles for things like
gunfire and explosions, with little arrows that point to the sound’s source, and in
Gears 5, the musical sting that symbolizes that all enemies are dead is subtitled as
“music settles.” Additionally, in that game, enemy bullet trails are—by default—
708 Games and Culture 16(6)

shown clearly as visible yellow lines to aid players in seeing where shots are
originating from. Another game worth mentioning is Apex Legends and its ping
system which allows players to highlight areas, enemies, and objects to teammates
through both a subtitled voice line and a visual indicator, allowing players to
communicate important info in a multiplayer game but without audio.
A primary feature for deaf and hard of hearing players is subtitles for spoken
dialogue. And several games provide excellent examples with large fonts, speaker
names, and high contrast backgrounds. The game development company Ubisoft is
notable for releasing games with huge, clear, and labeled subtitles, such as in Far Cry
New Dawn and Ghost Recon Breakpoint. Several games from other companies, such
as Control, have eminently readable subtitles. Star Wars Jedi: Fallen Order offers
massive, high-quality subtitles if players choose them, and Metro Exodus also
employs black backgrounds and speaker names. Most of these let players customize
the subtitles, through a menu of different options. It is worth noting that in 2019,
Ubisoft experimented with having subtitles on by default, and with this feature
enabled in Far Cry New Dawn, 97% of players kept them on. Other games, such as
Borderlands 3, offer subtitles as an option before the game even begins. It is also
worth noting that every game included in this study includes subtitles.
There were many examples of less than ideal subtitles in the games selected for this
project. Many games, such as Death Stranding, fail to include the speaker’s name
through labels or color coding. Games like Borderlands 3 and Rage 2 put too much
text on one line, forcing players to scan across the entire screen to read the subtitles.
Several games mismatch the text and audio, like in Planet Zoo where the vocal audio
says “Trade Center,” but the subtitle says “Animal Storage.” Many games fail to
include subtitles for every part of the game. In FIFA 20, the sports commentators are
not subtitled, an opening cut scene in Rage 2 has no subtitles, and Breakpoint does
not transcribe certain enemy audio cues that give players information about enemy
behaviors. Some games use on-brand and overly intricate fonts instead of plain, sans
serif text: while the stylized subtitles in games like Devil May Cry 5 and Sekiro are not
unreadable, the subtitles in Blasphemous pixelated gothic font is, in fact, blasphe-
mous, and typical for games that choose art style over readability.
Last, some games exhibited too small subtitles. Examples include Crackdown 3
and The Surge 2, both of which have tiny text to read during gameplay. The smallest
subtitles, out of the games studied, were in The Outer Worlds, which has ridiculously
small text written in a 16-point sized font. For comparison, typical Netflix subtitles are
in a 50-point font.

Visual Accessibility
Text size is the area where games most frequently fail in terms of accessibility, not
only in subtitles but also across UI, in collectible documents, and on players’ heads-up
display. For instance, The Outer Worlds utilizes minute words all across of its UI,
greatly reducing legibility, especially for players with vision disabilities. The text in
Brown and Anderson 709

Fire Emblem: Three Houses is already small when played on a TV and becomes
minuscule when played in the handheld mode of the Nintendo Switch console. And
Death Stranding sacrifices legibility for a sleek visual design, but at any reasonable
distance from the screen, the text’s size would certainly exclude players with vision
disabilities. The worst example of visual accessibility out of the games studied is John
Wick Hex, which writes some critical information in a 12-point font.
Other games use a far more readable font size. In Outer Wilds, the text appearing on
the in-game computer terminals are legible from most distances. The same is true of
the UI in Kingdom Hearts III and the translation screens in Heaven’s Vault. Other
games offer the option to choose your own text size, such as the existential detective
drama Disco Elysium or the gothic horror adventure Sunless Skies. Planet Zoo, Ghost
Recon Breakpoint, and Borderlands 3 let you scale the entire UI, making both text and
icons easier to see. Another area where some games have innovated is in offering
players the option to switch out special fonts for plain, easy-to-read text: Untitled
Goose Game allows players to change its cursive to-do list to a more basic font. And
Overland is one of the only major games in 2019 to offer a font choice that is designed
to aid those with dyslexia.
Several games in 2019 also use built-in screen reader technology to have the game
speak its text to players. With this option enabled, a voice will read what the player has
selected when navigating the in-game menus in Eagle Island. And Apex Legends can
turn text chat messages from other players into voice—and voice chat messages into
text—so players with various auditory or visual disabilities will not miss out on the
singular experience of having other players critique their low-level characters. As
a final note on text and visual accessibility, a number of games give players the
opportunity to read text at their own speed. Bloodstained will not advance its
characters’ text conversations to the next line until players press a button, and Tangle
Tower allows players to pause the dialogue at any moment. While time is always
progressing in the clockwork space simulator Outer Wilds, players can have the game
pause while reading text. And Kingdom Hearts III lets players slow down time when
clicking through menus to allow for more time to read the menus’ contents.
Another key area for visual accessibility is color blindness, and several games
demonstrate innovative approaches to the challenge of designing with color blindness
in mind. The Color Dungeon level in The Legend of Zelda: Link’s Awakening DX—
released in 1993—was not much fun for those with deuteranopia, but the Nintendo
Switch remake adds features such as distinct shapes on the enemies and unique cracks
in the floor tiles to help distinguish between the different colors. Far Cry New Dawn
has simple color-blind mode which makes key on-screen elements become pink and
yellow, Total War: Three Kingdoms allows players to switch the color scheme of the
game’s different factions, and Resident Evil 2 lets players pick the laser dot color of
their weapons to help it stand out from the background. Apex Legends has one of the
better features, with three distinct palettes to choose from in the accessibility menu
including a preview of what those new colors will look like right there on the menu.
710 Games and Culture 16(6)

And the designers of The Outer Worlds chose against conferring information solely
through color because one of the company’s directors is, in fact, color-blind.
Some games, though, are still using severely outdated full-screen filters which
often do not work as intended and only really have the effect of making the game look
ugly or unintelligible. The full screen protanopia filter in Call of Duty: Modern
Warfare, for example, does not stop red enemy names from blending into the
background at key moments. But thankfully, the Call of Duty series has long since
switched from red and green teams to red and blue ones. Some games still use color as
the exclusive way to convey information, such as in Death Stranding wherein the
labels on players’ packages go from yellow to red to indicate how damaged they are.
Those labels look practically identical to those with certain types of color blindness.
Providing more visual clarity is a good way to alleviate challenges presented to
players with color blindness and help with other visual disabilities. As examples, in
Eagle Island, players can dim the background to make the foreground layer easier to
see as well as put outlines around enemies and objects to help them pop out. In FIFA
20, players can boost the size of the character indicators, and in Ghost Recon
Breakpoint, players can not only boost the size of the UI but they can also put shadows
behind indicators and markers to ensure they stand out from the background.

Motor Accessibility
One of the most commonly requested features in online discussions of video game
accessibility is the option to remap a game’s controls, meaning an in-game menu
where players can change what actions each input performs. This feature allows
players with motor disabilities to put all the key functions in easy-to-reach places or
to avoid using difficult inputs like touch pads or the buttons under the analog sticks.
Unfortunately, some games still do not offer any controller options whatsoever,
including the Zelda remake, the avant-garde Death Stranding, and the zombie biker
game Days Gone. Other games do with presets, which are preformulated options
to change controller inputs, but are usually limited to a handful of arrangements. For
instance, Crackdown 3, The Outer Worlds, Resident Evil 2, and Wolfenstein
Youngblood simply allow players to pick between a few developer-made layouts.
While not terrible, it is not good enough considering no two disabilities are the same
and how easy it is, from a programming perspective, to build this functionality into the
core of the game.
However, a meaningful number of games in 2019 let players pick their own button
placement. For example, The Surge 2, Team Sonic Racing, and Sekiro: Shadows Die
Twice have full remapping capabilities. And Devil May Cry 5 demonstrates the value
of providing this accessibility option on the game level instead of relying on system-
level remapping. System-level remapping is when a game console can directly switch
all inputs from one button and translate them into inputs from another buttons, such as
swapping the X and Y buttons on a controller. But Devil May Cry 5 not only allows for
button remapping in the game but also allows for customizable controller remapping
Brown and Anderson 711

for each of the main characters that players control. System-level remapping would
force players to use the same inputs for all three characters. It is important to note that
controller remapping is a relatively simple feature to include in a game’s development,
as long as it is implemented early in the game design process: if all game actions are
assigned an input variable that can be adjusted through an in-game menu, then the
most extensive part of the process is building the menu, not adjusting the entire
game’s controller input code.
Apex Legends and Borderlands 3 take remapping a step further: they not only let
players pick their own buttons but they also give in-depth control over functions such
as camera sensitivity and analog stick’s dead zone options. Additionally, they include
aim assist and aim snap options for shooting in the game to make playing more
accessible to people with motor disabilities that affect the ability to move analog sticks
and computer mice. Also worthy of note is Overland: the entire game can be played
with just a mouse, just a controller, or just a keyboard. Those are strong options that
should open the game up to a wider range of players.
The year’s most impressive game regarding motor accessibility is Gears 5. Be-
tween controller remapping, the ability to make the camera follow behind your
character and the option to use the left stick for aiming when the gun is raised, players
are able to basically play the game with one hand. Pokémon Sword and Shield is
notable, too, for its casual control scheme that maps all important buttons onto one
Nintendo Switch Joy-Con controller, making it possible to play the game with one
hand.
Toggles are key feature as well: toggling a game function on or off is more ac-
cessible to players with motor disabilities than requiring players to hold a button down
continuously. For instance, we see this feature in Crackdown 3’s lock-on mode as well
as in Borderlands 3’s aim, sprint, and crouch options. Toggling also appears in Yoshi’s
Crafted World, where hasty or patient egg throwing is basically just about toggling or
holding the aim button. These options remove the requirement for players to hold
a button down for great periods of time, which can be impossible with some motor
disabilities. Unfortunately, not every game follows suit: players still need to hold
down the lock-on button in Devil May Cry 5, and Team Sonic Racing should have
borrowed Mario Kart 8’s generous auto-drive option. And while most games also
allow players to turn off button-bashing quick-time events, there is no such option in
Jedi: Fallen Order.

Game Difficulty: Accessibility

Finally, video game options that alter game difficulty can be a valuable resource for
players with many types of disabilities, including cognitive, motor, visual, and au-
ditory disabilities. Offering more lenient challenge levels can give players with
disabilities more time to deal with threats while also allowing players with all types of
game literacy to enjoy games. Many games offer plenty of difficulty options to pick
from, and the language used on these options is anecdotally improved: instead of
712 Games and Culture 16(6)

patronizing players who choose to play on easier difficulty settings through insulting
setting names—see Wolfenstein: The New Order’s settings labeled “Can I Play,
Daddy?” accompanied by a picture of the protagonist with a baby’s pacifier and
a bonnet—many games in this study described these settings like wanting to feel like
a “badass” or just wanting to focus on the story.
The exact nature of these difficulty modes is often described to the player.
As examples, Astral Chain’s unchained mode performs the more difficult button
combinations for players but denies players’ letter rankings, and Resident Evil 2’s
assisted difficulty mode replenishes the character’s health. Some developers note
which difficulty level is intended by the designers, which is a fair compromise to
afford accessibility without denying game designers their creative freedom. Super
Mario Maker 2 continues Nintendo’s campaign for what they call assist modes, with
the option to bring up a palette of blocks and items that players can place inside levels
to aid players in finishing challenging levels. Additionally, Yoshi’s Crafted World
offers a mellow mode which gives players infinite flight to easily finish levels. The
rhythm action rogue like Cadence of Hyrule is generous with its approach to a
lowered difficulty mode inasmuch as the game typically expects players to move their
character to the beat of the music. The authors doubt that having no sense of rhythm
counts as a disability, but we personally appreciated the game’s fixed beat mode which
allowed us to move without conforming to the beat of the song.
As a final note on difficulty options, or the lack thereof, we turn to Sekiro: Shadows
Die Twice. The sheer magnitude of online commentary on the game’s difficulty and
the lack of options to adjust difficulty is surprising, both from news organizations and
from anonymous online commenters. While we do not wish to repeat the internet’s
conversation when the game was first launched, it is worth noting that Sekiro,
FromSoftware’s latest game, is actually less accessible than the company’s notori-
ously tough Dark Souls and Bloodborne games. The game removes key features
found in those earlier titles, such as the ability to level up your character or invite
a friend into the game to help with difficult enemies. Sekiro does offer some ac-
cessibility options, like full controller remapping and toggles, but there is nothing to
make the game less difficult.

Conclusions and Feed-Forward Future Directions

A categorical summary of all accessibility features in video games would not be
feasible, given how industry-standard practices are not in place to compare them
against. Each game approaches accessibility differently considering how different
each game is, and while certain features like subtitles should follow best practice
guidelines published from several advocacy organizations (Grammenos et al., 2009),
other accessibility design features simply need to adapt to the varied gameplay re-
quirements of each game. Certain features fall flat, regardless of the game, such as
color-blind filters that wash out most colors in games, instead of building colors in
games around the idea that people with color blindness might find certain elements in
Brown and Anderson 713

the game difficult to see. But with those easily avoidable pitfalls recognized, game
developers would benefit from hiring an accessibility consultant, an increasingly
common practice in the games industry, or at least turn to players with various
disabilities to playtest games to notice missteps that normative designers would not
notice.
As a rudimentary summary, game developers in 2019 typically attempted to make
their games as approachable and accessible as possible, often through completely
optional features and modes that do not affect the experience for the normative or
hard-core player. There are still issues needing to be addressed: it is clear that games
still have much to improve on regarding accessible design, with annoying oversights
like too small text, features that do not work if players are color-blind, and honestly
embarrassing issues such as in Borderlands 3, where boosting both the UI and the
subtitles makes the text fall off the side of the screen. It is especially aggravating when
a game makes big strides in one area but stumbles in others, such as Control with its
large, easy-to-read subtitles, accompanied by too small UI text. It is also troubling to
see that publishers, who have the power to set in place accessibility standards for their
own games, are not yet consistent across their games. For instance, Nintendo includes
innovative accessibility features in some games which appear conspicuous compared
to a complete lack of options in others. While individual game developer companies
utilize the same publisher, the publisher should still incentivize accessible design
by requiring developers to adhere either to a set of best practices or to look to the
publisher’s other, more accessible, games as guides for how to improve accessibility.
One perplexing trend the authors have noticed is that a number of games are adding
necessary accessibility options several months after a game’s release, in the form of
downloadable software patches. While the adage “better late than never” may apply
here, it is not a good look when players with certain disabilities have to wait ages to
play a prominent Sony game like Days Gone.
There is reason to be hopeful, as many developers and publishers have taken great
strides toward improving accessibility in video games. Ubisoft continues to be an
industry leader in this space with impressive accessibility features across Far Cry New
Dawn, The Division 2, and Ghost Recon Breakpoint. Microsoft is also worthy of note
in this space: Gears 5 has an enormous selection of options, including color-blind
settings, controller remapping, button toggles, and gore and language filters for
certain cognitive disabilities, making it one of the most accessibility feature-packed
games of 2019. Respawn Entertainment demonstrated significant effort toward ac-
cessibility with impressive options in both Apex Legends and Star Wars Jedi: Fallen
Order. Gearbox Software ensured Borderlands 3 included many thoughtful options,
which is a welcome improvement for a series that has struggled with accessibility in
the past. Overland and Eagle Island are packed with accessibility features, despite
being made by relatively small indie teams. And hardcore, ultra-challenging games
like Devil May Cry 5 and Astral Chain demonstrate that challenge does not nec-
essarily preclude accessibility: the games’ options invite everyone to play by offering
714 Games and Culture 16(6)

practice areas, assisted combat combinations, and easy difficulty settings, but players
looking for a challenge will not struggle to find it.
The feed-forward mission of this project dictates that we offer the following 10
suggestions, stemming from our findings in this project and our informed opinion, for
how accessibility in video games may continue to improve. Note that some of the
examples we use, for illustrative purposes, are not from this project’s list of games.
First, remappable controls allow players to move game functions on a controller to
a place where they can more easily access them. Offering controller input presets does
not go far enough: look to games such as Nier Automata as the accessibility standard
regarding button remapping, given how the game allows players to assign any game
function to any button. As part of button remapping options, in-game menus should
offer the ability to adjust the sensitivity for analog sticks, computer mice, and gyro
controls so that fine motor movements can control large movements on screen, and
vice versa.
Second, button bashing, or the video game mechanic of requiring players to
repeatedly press a button in quick succession to perform in-game actions, is an enemy
of players with motor disabilities. Game developers should consider adding the option
to allow players to simply hold down a button to complete these quick time events, or
simply automatically complete them, instead of requiring players to repeatedly
hammer at a controller. Similarly, holding down a button for a great deal of time can be
uncomfortable or painful for some players with disabilities. Game designers should
look to Mario Kart 8 in which players can enable an option for cars to drive forward
automatically or to Battlefield in which players can simply toggle between normal and
zoomed aiming rather than needing to hold down the shoulder button to aim.
Third, games, when possible, should offer multiple different ways to control the
game. Splatoon is a game primarily designed around gyro controllers—a prohibitive
task for some players with disabilities—but players can instead choose to play with
more traditional analog sticks. Likewise, The Witness normally requires two analog
sticks, or both the keyboard and mouse, to move. But the game also provides the
option to simply move with just the computer mouse. Game developers for PC games
can accomplish the most in this area: if possible, they should allow players to control
the entire game with just the keyboard or just the mouse. And allowing for the use of
external hardware, such as Microsoft’s adaptive controller, or external software, such
as an on-screen keyboard, can allow for even more accessibility options for players.
Fourth, color-blind modes should ensure that critical gameplay information, such
as enemy outlines and loot rarity, is visible to those with color vision deficiency. Game
developers can test their games with color-blind filters, and they should avoid red and
green as contrasting colors—such as red and green teams—because those colors
become indistinguishable with the most common forms of color blindness. Blue and
orange tend to be more accessible for contrasting colors. And if color is critical to a game,
like in the puzzle game Hue, developers should apply unique symbols to each color as
a backup accessibility option.
Brown and Anderson 715

Fifth, games can offer options that increase contrast between gameplay-critical
items and busy backgrounds. In Street Fighter V, an option allows players to replace
the backgrounds with a black dojo, and in Shoot 1UP, players can change the opacity
of the background layer.
Sixth, while most games offer subtitles, too many of them fail in critical areas.
Instead, video game subtitles should ideally be large, in an unceremonious font, and
should keep within about 40 characters per line with only two lines on screen at a time.
Game developers should also consider using shadows, outlines, or black boxes to
contrast the subtitles against background objects. In order to distinguish which
characters are speaking which lines, games can use portraits, names, or colors. If there
is any in-game or diegetic text that players need to read, players should be able to
choose between diegetic text like handwriting and more easily readable fonts, as best
demonstrated by the Life Is Strange games or Untitled Goose Game. The best practice,
when possible, is to allow players to choose how they want their subtitles displayed.
Seventh, games should offer the ability to change the volumes of different parts of
the sound mix. Games such as Mortal Kombat X allows players to independently
change the volume of effects, dialogue, and music which helps players who are hard
of hearing to drop the background music in order to increase the volume of the more
game-critical sound effects.
Eighth, providing multiple forms of game-critical information is useful to a variety
of players with different disabilities. Games should avoid expressing critical in-
formation with only visuals or with only sound. When games use sound effects to
reinforce visual information, such as when enemies in Half Life 2 will emit a loud
flatline sound when they die, players with low vision can better understand what is
happening. Alternatively, clear visual cues to accompany critical sound effects, such
as the grenade indicator in Call of Duty, can help players who cannot hear the enemy’s
yells to know how to avoid the grenade. When possible, games should translate game-
critical sounds into visual indicators, such as Fortnite which shows players’ sound
effects like footsteps and gunfire. Also, puzzles that can only be completed through
listening to music or sound effects should, at the very least, be made optional in some
way.
Ninth, simulation sickness can be prohibitive to a wide range of players with
disabilities, so games should allow players to choose to turn off camera effects such
as “head bob,” screen shake, and motion blur. When possible, games should allow
players to adjust the camera’s field of view and sensitivity. To avoid sensory overload,
games should avoid, or at least provide the option to turn off, flashing lights and
repeated patterns. For instance, Just Shapes & Beats allows players to turn off flashes,
and Stardew Valley lets players change the falling snow effect.
Tenth, games should allow for a variety of difficulty levels. Lower difficulty levels
give players more time to plan their course of action and provide more chances to
make mistakes before getting a “game over.” Assist modes give players even more
control of game experience. For instance, in Super Mario Odyssey’s assist mode, blue
arrows point players to the next objective. In Celeste’s assist mode, players can
716 Games and Culture 16(6)

change the game’s speed. And in SOMA, players can turn off enemy encounters
altogether. Last, gameplay that contradicts the core mechanics of a game, such as the
shootouts in the otherwise puzzle-based game LA Noire, should be made skippable.
Ultimately, it is impressive to see how almost every major game in 2019 included
some kind of accessibility option or even a full accessibility menu. Studios like
Microsoft, Ubisoft, and EA are publishing information about their accessibility
options online, so players can make better purchasing decisions. Microsoft has even
made hardware and controller accessibility a part of the conversation by not only
developing and releasing their widely acclaimed adaptive controller but also by
dedicating their 2019 Super Bowl commercial to it. The authors believe that games are
for everyone, and the barrier of entry can be easily lowered if developers provide even
a few extra options.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship,
and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of
this article.

ORCID iD
Sky LaRell Anderson  [Link]

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Author Biographies
Mark Brown is a video game journalist and critic. He is the creator of Game Maker’s Toolkit:
a highly regarded YouTube series about game design, with over 80 million views. Mark is also
a professional design consultant, gives guest lectures around the world to universities and game
development studios, and has run four successful game jams. He has contributed to publications
like EDGE Magazine, Wired, and Polygon.
Sky LaRell Anderson, PhD, is an assistant professor of digital media arts in the Department of
Emerging Media at the University of St. Thomas in Minnesota, United States. His award-
winning research investigates the role disability plays in structuring how we talk about and
engage with games. He also examines how games portray mental illness as well as how they can
be critical tools for imagining improved discourses about mental health. His teaching primarily
covers digital culture, game studies, and media literacy. Dr. Anderson is also an independent
game designer with games published for free on his website [Link].