But in 2019 the vast majority of blockbuster games such as FIFA or Fortnite require either a controller or a mouse and keyboard.
This is where SpecialEffect comes in. Founded in 2007, the unique UK charity brings together a 25-strong team of accessibility experts, gamers and therapists to provide accessibility solutions for people with physical disabilities completely free.
That involves developing free software like EyeMine to let gamers play Minecraft with their eyes, for example, or making the set-up to help Ajay, an IT support analyst with spinal muscular atrophy, play Call of Duty with his chin.
Mick Donegan, CEO of SpecialEffect, told The Big Issue: “Playing online is much more commonplace than it was, so playing video games has become an increasingly sociable way to engage with other people.
“And, therefore, if people are unable to access that technology then you can argue they are even more excluded than they otherwise would have been.
“Playing games is a great opportunity to be included socially and an opportunity to make friends and to compete – it’s almost like there is a pressure valve bursting to open up for many of the people we work with. The great thing is it gives people an opportunity – for those who can – to get to the level where they can compete online with other people and often beat them.”
Gaming accessibility expert Ian Hamilton agrees. “Quite simply having access to games is important because games are important,” he said.
“Popular games are huge cultural phenomena. They’re all over the media, they’re what your friends are talking about, what your friends are doing. So it’s a big deal to be excluded from that and an equally big deal to be included.”
Disabled gamers have attracted plenty of attention online for competing against able-bodied opponents. Dutchman Sven Van de Wege – aka BlindWarriorSven – plays Street Fighter to a high level while American Clint “halfcoordinated” Lexa, who has hemiparesis – a weakness of one side of the body – speedruns games with one hand. But Donegan insists that, for many, the chance to move without restriction is one of the real attractions.
He said: “For many of the people we work with, they have to be in their home, rehab, hospital or intensive care. Movement is difficult for many of them and certainly the ability to get right out of that environment and to take control in a virtual world – many of them tell us it is very liberating and enjoyable.”
Representation remains a problem with relatable video game protagonists with disabilities in short supply – Deus Ex’s Adam Jensen using prosthetics which have been turned into real-world solutions by Open Bionic is one of the most notable exceptions.
And, bizarrely, Wolfenstein II: The New Colossus’s portrayal of a wheelchair-bound protagonist – in an alternative history game about fighting Nazis, no less – has been praised.
But be under no illusions – gaming can do better. And not just with physical disabilities. Subtitling is still not guaranteed – last year’s Spyro the Dragon remake being the latest offender to omit them.
“Just 10 years ago we would never have imagined something like Microsoft’s Super Bowl advert,” said Bill Donegan, SpecialEffect project manager.
“It’s a difficult thing but more and more ideas are being shared and hopefully it will become part of the game development process to consider accessibility from the outset, making it easier to implement it well.”
Video games have the unique power to offer the chance to go anywhere and do anything.
To talk to friends, to find like-minded people and communities you could never reach in person, and to escape reality and have fun when it may be in short supply in everyday life.
It’s up to the game industry to give even more gamers with disabilities that essential opportunity.