Disability, Neuroatypia, Phobia, …: Video games beyond entertainment.

Disclaimer: this article deals with an area that belongs, in part, to medicine. Although I originally trained as a paramedic, I’m here as a columnist. I have tried to source as much of my article as
possible. I strongly advise you to contact professionals before modifying or initiating any treatment.

Content

I – Video games, a tool for neurological disorders

II – Access to games for all

III – The last word and sources

The 5 senses of the disabled are affected, but it is a 6th that delivers them; far beyond the will, stronger than anything, without restriction, this 6th sense that appears is simply the desire to live.
Grand corps malade

You can’t choose the body you live in. This sentence is true for every human being on this earth, but it resonates even more for people with disabilities, whether visible or invisible, motor or cognitive. I wanted to share this article with you after reading a paper on a clinical case from an addictology department. It concerns an adolescent whose parents are worried about his video game (VG) use. The patient was isolated and unsociable, and his passion was destroying his life. After follow-up, the medical team realised that the young man was suffering from an Autism Spectrum Disorder (ASD). It turns out that the JV (in this case an MMORPG) has actually helped him to compensate for his difficulties with social relationships. It occurred to me that our favourite medium might have a place in the treatment of certain patients, and not just those with ASD.

Digging a little deeper into the subject of JV and the medical world, I came across another problem that needs to be addressed if this therapeutic bonus is to reach as many people as possible: accessibility. As I said at the outset, you can’t choose your body. As well as being fun, JV is an opportunity to escape, to embody someone else, to live another life. For me, it’s important that the game-player interface allows access regardless of the abilities of the person in front of the screen. That’s when I realised that there’s a whole world of ideas out there. That’s why I’d like to take you with me on a journey of discovery into JV beyond entertainment.

I don’t have the pretension or the capacity to deal with all disabilities, especially as they are specific to each individual. I’ve concentrated on just two areas that have given me plenty to write about. However, there is still a lot to share. So I’m going to divide this article into two separate parts: “Video games as a tool for neurological disorders” and “Access to games for everyone”. To do this, I’ve looked at a number of different articles and gone to meet those who are best placed to talk to us about it. This paper is long and as comprehensive as I can make it, so I invite you to read through it, not in one go, but more by the profiles that most tempt you first. Each meeting can be read independently of the others, and the introductions provide a context that you can discover afterwards. The main aim is to make you realise the power of the JV beyond the entertainment aspect. It’s time to put an end to this preamble and embark on what I hope will be a discovery for many of you.

Video games, a tool for neurological disorders

Good mental health enables people to fulfil their potential, to cope with the normal stresses of life, to work productively and to contribute to their communities
WHO

To tackle this point in the best possible way, I spoke to two neuropsychologists who place video games at the heart of their practice. Each of them gave me a different approach, giving me an overall view of the value of video games in therapy. Mathieu Cerbai works to raise awareness among professionals, patients and their families. Thanks to one of his presentations, he gave me an overview of the current state of JV studies. Sébastien Serlet really uses JV in his practice, to the point where he wants to develop his own games to help patients. So these psychologists, who are above all gamers, will be talking about theory and practice.

Mathieu

Mathieu Cerbai has been a great player since childhood, even if, like many others, he is short of time. In his own personal experience, he has already experienced episodes of depression. He is convinced that video games can have a significant impact on the treatment of certain disorders. Now a neuropsychologist, he has been working for seven years in a psychiatric hospital treating patients with mental and neurodevelopmental disorders. Along with other health professionals, he set up the Raptor Neuropsy association, which aims to break down taboos and preconceived ideas about mental health.

Popularising the science behind this speciality is at the heart of their activities, which are aimed at both healthcare professionals and the general public. In the same vein, since 2019 it has been interested in the various studies on the subject of mental health and video games, leading to the publication of a book on the subject in 2023. Research is becoming increasingly active around this medium, and I’ll give you a summary below.

To put video games in context, there are around thirty-three million players in our society, with almost perfect parity and an average age of thirty-nine. From a therapeutic point of view, video games can be of interest at several levels, ranging from adherence to therapy to a genuine lever for treatment, via a simple learning support. Another thing to know is that no study has shown any direct relationship between gaming and violence.

The aim of therapy is to achieve a state of recovery, not cure, in other words to be able to live with the disorder and overcome the difficulties of daily life in order to achieve personal goals, and this is where JV comes in. I’m going to give you a brief summary of Mathieu’s work, punctuated by a number of testimonials he has collected. If you’d like to find out more, I invite you to read his book (the links are at the bottom of the article).

Firstly, on the social aspect, there are favourable results for reducing difficulties in school or work environments (Kovess-Masfety et al., 2016) as well as prosocial behaviour (Dorman, 1997; Gentile et al., 2009). Family/friend ties are strengthened.

I’ve been able to meet friends with whom I’m still in contact, or whom I’ve even met IRL. I’ve been talking to them for almost 8 years now. It was also a time to relax, to socialise, but also to compete in certain types of game. What’s more, it means being part of a community. We have a laugh and have a good chat.
Young woman aged 20 with depression

There are also benefits for the concept of the relationship with existence, particularly in terms of autonomy and the feeling of belonging (Bauer et al., 2019), which is sometimes facilitated by the use of an avatar, which can go as far as setting a long-term personal goal (Fraser et al., 2023).

It’s an opportunity to take on challenges, to try and improve myself. This can be in the face of a difficult boss in adventure games, or a difficult level in a platformer, or even in racing games, when you’re trying to beat a time record.
Young man aged 25

In clinical terms, the Nantes University Hospital uses videogames to treat phobias such as acrophobia (fear of heights). Other teams, for example, have worked on claustrophobia (Rahani et al., 2018). Also, contrary to popular belief, JVs do not appear to have any harmful effects on well-being (Vuorre et al., 2022) and can be useful for raising awareness of disorders.

Video games have helped me to channel my stress and anxiety. They give me that feeling of control over my life that helps me to calm down.
Young man aged 29 with mental health problems

However, it is important to qualify this. Excessive gambling can lead to a sedentary lifestyle and therefore have an impact on physical health (Pelletier et al., 2020). Moderation is the key word. Posture, diet and sleep must be and remain priorities in order to avoid harmful effects.

I’ve noticed that it’s had a negative impact on me, mainly interms of my sleep patterns, which tend to shift.
Young man aged 21

The impact on the functional sphere, which refers to our cognitive abilities, is undoubtedly one of the most telling elements. There is a reduction in distractions (Torner et al., 2019), improved alertness (Mayas et al., 2014), decision-making and problem-solving (Reynaldo et al., 2021). The elderly are not left out when it comes to memory training, with significant improvements (Toril et al., 2016).

To talk about more practical ways of dealing with the problem, Mathieu looks at Attention Deficit Disorder with or without Hyperactivity (ADHD). For those who don’t know, ADHD is mainly characterised by attention difficulties, combined with emotions that are difficult to manage, stress and irritability. The disorder has a wide-ranging impact at school, in society and at work. JV can be used to improve attention (Sonne et al., 2016; Chen et al., 2017), emotion regulation (Rodrigo-Yanguas et al., 2023; Strahler Rivero et al., 2016) and motivation (Granic et al., 2014). However, it should be borne in mind that ADHD makes it easier to become addicted (Rodrigo-Yanguas et al., 2022). Designing games adapted to this type of patient and their habits would therefore be a real plus (Sújar et al., 2022).

Personally, video games helped me deal with stress when I was a student. I used to take a little break from gaming while I was studying, which gave me a chance to breathe and get back on the right
foot. It’s also a great way to meet new people, to talk to people from all walks of life, and that can do you a world of good.

I have some difficulty concentrating, I go from one thing to another, it’s hard for me to do just one thing at a time… But it’s different with games. [Little by little, I’ve managed to concentrate, organise myself and coordinate with my team-mates. In the end, it’s good to see that you’re able to stay focused on a single thing, to be able to meet an objective (especially in cooperation mode).
Young woman with ADHD

A second neuroatypical condition that benefits greatly from video games is Autism Spectrum Disorder (ASD). To give you an idea of what can be found in the literature, I’m going to go into a little more detail here.

According to the French National Authority for Health: “Autism spectrum disorder is a neurodevelopmental disorder. The diagnostic criteria updated by the DSM-5 are defined in two symptomatic dimensions which are :

● persistent deficits in communication and social interactionobserved in a variety of contexts ;

● the restricted and repetitive nature of behaviours, interests or activities.

This dimensional definition is supplemented by a level of severity according to the level of help required”. This definition includes two important concepts taken from the DSM-5 (the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and Psychiatric Disorders of the American Psychiatric Association), the reference in the field.

The permanent communication deficit manifests itself in gaps in the learning of the social codes that are essential for living in a community. To be clearer, we can take the example of innuendo. It is difficult for a person with an ASD to function with implicit means of communication such as sarcasm or irony. Things are taken literally. All the methods of making someone understand that they are in the way without actually saying so do not work, are not understood and this is just one example. Communication must be frank and direct.

The restricted and repetitive nature of these activities corresponds to deeply rooted habits and sometimes disturbing movements for neurotypicals, but a real outlet for autistic people. There is a kind of security in what is pleasurable, what is controlled, which can sometimes spill over into addiction.

Professionals working with autistic patients believe that the use of video games, combined with physical activity, known as “exergaming”, results in a much higher level of adherence to treatment. It is estimated that 92% of patients enjoy this exercise.

There is growing evidence that exercise would be beneficial not only to improve physical activity and promote exercise, but also to promote social and cognitive skills in children.
Anjana Bhat, physiotherapist.

Fiche de mathieu Cerbai concernat le jeu vidéo et la schizophrénie — Example of a sheet proposed by mathieu

As we all know, gaming is a pleasant way to get away from the feeling of constraint. This, combined with the immersion of video games, makes it easy to combine the useful with the pleasurable in a number of areas. An Australian study looked at the impact of video games on the socialisation of autistic teenagers. A small group of children were invited to play Minecraft, both online and face-to-face, and the results were significant. Bonds were quickly forged between the players, as well as between their parents. Questionnaires even showed the development of a desire to make friends, something that is not necessarily innate in people with ASD. The appeal of online gaming lies in the distance it creates. The absence of physical involvement and the possibility of stopping at any time are important safeguards that allow the experience of this art that seems so natural to neurotypical people.

Play provides a natural platform for peer interaction and collaboration through shared rules and talking points. Although current research on the use of ready-made games for therapeutic purposes is limited, we hope that further studies will provide a strengths-based approach to helping pre-adolescents with autism
develop lifelong friendships and social skills
Abi Thirumanickam, PhD

Video games are therefore an effective tool for helping children with ASD to cope with reality, both physically and intellectually. But underneath this beautiful panorama, there is a nuance to be made. One of the hallmarks of autism is stubbornness. A child who takes a liking to video games, in this case, could easily lapse into excessive consumption of the medium. That’s why it’s important that use of the medium should be supervised, but also that the skills developed should be applied in the real world. To be as effective as possible, parents, carers and carers also need to be involved in this therapy.

Video game-based technology is a powerful tool for teaching language and communication skills, cognitive flexibility and social skills to children with autism. Numerous studies demonstrate how video games and technology engage children – especially children with autism – by improving sustained attention and perseverance during the learning process.
Randy Kulman, PhD

Other studies highlight other impacts of JV on ASD, such as the reduction in repetitive behaviour (Anderson-Hanley et al., 2011), executive capacity training (Anderson-Hanley et al., 2011) and stress reduction (Carlier et al., 2019; Jaramillo-Alcázar et al., 2022).

To conclude this section, here are three commercial games that have been proven to help atypical people develop certain skills (especially children).

Portal 2 is a simple but imaginative game in which a player uses the game’s singular tool, a portal gun, to navigate otherwise impassable levels by placing portals with varying properties. With very few rules and few instructions, Portal 2‘s open-ended gameplay requires a high level of cognitive flexibility.
Minecraft is, of course, incredibly popular with typically developing children and children with autism. This sandbox game (open-ended with no real rules or end goals) gives children a great deal of control over their environment. In creative mode, Minecraft offers the chance to explore an unknown world and face fears without giving up on safety.
New Super Mario Bros. U emphasises the need for cooperative play, taking on a task with teammates and developing a shared interest in achieving a goal. It requires players to understand how their actions affect other players and helps children practise skills such as communication, flexibility and empathy.

One of the advantages of doing this virtually is that you don’t need any additional equipment, and you can repeat as many times as necessary to practise or evaluate the therapy, with the aim of transferring it to real life. If we add online, the video game has the advantage of being able to be used remotely, which makes it possible to treat patients from far away or even from medical deserts.

However, children’s use of video games must be carefully monitored. It is recommended that children under the age of two should not be exposed to screens, and children under the age of six should not be exposed for more than one hour a day (Tamana et al., 2019; HCSP, 2020; McArthur et al., 2022). Although the actual addiction to video games is still debated, excessive use does exist (Griffiths & Pontes, 2020).

Another disadvantage is linked precisely to this passion (‘hyperfixation’) and my ADHD; I sometimes forget to eat or look after myself because I’m too absorbed in the game, but any passion has this effect on me, not just video games.
Young man with mental and neurodevelopmental disorders.

To sum up what we know today, the feedback is really on the positive side. Even if we try to qualify these statements, it’s hard to find negative results when it comes to health and video games. Obviously, there are still a lot of studies to be carried out, but preconceived ideas are not going to have an easy time of it with the advances in science in this field. In Mathieu’s view, it’s becoming increasingly essential to introduce video games into therapy, provided, of course, that we master what we’re doing. It remains a great hope to have an additional tool in cases that are still a little complicated to understand. I’d like to thank Mathieu Cerbai for taking the time to provide me with all these resources, which I’d like to share with you. It’s a colossal piece of work that has given me an overview of the current literature. He was also the one who advised me to get in touch with another psychologist, Sébastien.

Sébastien

Sébastien Serlet is a psychologist specialising in neuropsychology, working mainly with children and adolescents. The patients he sees have cognitive and/or psychological problems that need to be dealt with. To avoid consultations being an extension of school days, which are not always easy, Sébastien uses games to take a more playful approach. Usually, for this kind of therapy, board games are often proposed, but here we develop an approach through video games. This medium allows him to work on a whole range of cognitive functions without it really being seen as an exercise.

As well as wearing his “health professional” hat, Sébastien has also set up a start-up to design virtual reality games to meet his own needs, and those of his colleagues. This other function, a combination of software development and psychological knowledge, leads to proposals adapted to motor, sensory or cognitive disabilities. The aim of this initiative is to create a link between digital technology and reality, so that patients can transfer what they do in the game into their everyday lives.

For him, in order to understand the tool, you have to be “a bit of a geek at heart”. He remembers the LANs (local area network games) he organised with his friends when he was a child. This passion gave rise to a community of discussions and magazine exchanges at school. Today’s shrink sees the social side of JV and its positive aspects for the profession. Further proof that gaming doesn’t just create Otaku (the Japanese term for people who devote their lives to hobbies such as video games or manga). At the start of his career, he was directed towards the use of digital tools in the rehabilitation of patients with cognitive disorders. The aim is to place people in simulations (reconstitutions of rooms in the home, for example), and the virtual enables them to go beyond the limits imposed by the real thing. So Sébastien naturally set out to find game mechanics that could be used to help people.

Sébastien discusses his therapeutic methods in videos

Today, he finds that it’s an underrated tool, perhaps still too little known by people who don’t play (enough). So Sébastien decided to take the plunge into VR, even though he realises that it can take time to create the right situation. He didn’t want to go back to the ‘paper and pencil’ method, and he is well aware that with the parents of his patients, screens are an irritating subject. So his mission was obvious: to show – and this is where the link with Mathieu comes in – that video games can make a big difference. As we saw earlier, people who play video games develop skills. And that’s exactly what we’re looking for in rehabilitation, to develop or train skills. Medical advances are a real Level-up. We also find this notion of gradual difficulty inherent in regular progression.

Tell me what you’re playing and I’ll tell you who you are
Sébastien Serlet

Take a patient who loves football. Through video games, he can work on adaptation and reflexes with Fifa, but also planning and organisation with Football Manager. Sébastien even gets to the stage where he couldn’t do without JVs, because depending on the games his patient plays, he can start to paint a picture. Battle Royale games like Fortnite, with their fast-paced gameplay, are more suited to people with attention deficit disorder (playing them doesn’t mean you have, or will develop, ADHD, but this type of game is often found in children with ADHD), whereas children with ASD will shy away from multiplayer games. For parents, it’s important to have a professional who’s familiar with their children’s codes and who can play down this relationship with games that’s been decried by the misinformed media. As Sébastien says, you don’t get ‘addicted’ to video games by chance, you don’t just sniff the cover – there’s bound to be something underlying it. A child who has been bullied will quickly take a liking to playing a super-powered character capable of defeating those they might see as their harassers.

Before taking the plunge, Sébastien always asks parents for permission. A joystick lying around the practice or a game, so that a natural relationship can develop around this medium. He presents the gaming session as a stage in the therapy, with the child showing that he or she wants to make progress and commit to the treatment. Then comes the type of game used, from cooperation to work on social skills like It Takes Two, platform games like Crash Bandicoot to focus attention, or versus fighting to work on self-fulfilment or frustration, depending on whether the therapist is looking for the patient to win or lose. Debriefing is important, as it enables the child to become aware of how to manage his or her emotions following the outcome of the game.

Digital technology is booming in therapies for disorders such as phobias and addictions, enabling immersion and above all personalisation of the experience. The University of Paris-Descartes even has a degree in psychology that teaches the rudiments of Unity. The major obstacle to the proliferation of tools is, of course, the cost of producing these scenarios. As we all know, designing a game requires money, and so one game per patient requires a huge amount of resources. Ideally, it would even be possible to erase the joysticks, using an electroencephalogram for example, to maximise patient motivation.

Seniors, e-sport champions

Another important aspect is to combat the feeling of being left behind by changes in our society. These days, everything is done on screen, and older people who haven’t kept up with this rapid development feel out of their depth. It’s easy to find examples of old people’s homes organising video game discovery workshops for residents who quickly get hooked. This activity can be a source of reinforcement for the intergenerational bond, which can reduce a loss of socialisation. Video games are not just a solution to boredom, they should also be a time for social interaction.

If we return to the subject of disorders, the FDA (Food and Drug Administration), which manages the authorisation of health products in the United States, has given its approval for a video game to be considered as a genuine therapeutic tool for ADHD. EndeavorRx, the game in question, is available on prescription with a specific dosage for a specific indication and “treats” patients. Similar projects are in the pipeline in France.

Sébastien is delighted to see, through his professional experience, that the video games he loves so much have the potential to help patients make progress. Many healthcare professionals are aiming to help people, while at the same time achieving a high level of adherence to the therapy, thanks to the fun aspect. He goes even further, trying to include parents to help them prepare their children for the discovery of video games and screens.

The work of psychology with video games has only just begun, and Sébastien is determined to make his contribution. He trains future practitioners and is happy to share his passion. I’d like to thank him for taking part in this paper. With Mathieu, we have two major players in the democratisation of video games in certain care pathways.

Society is constantly evolving, and so is the JV. Twenty years ago, the playground geek didn’t talk openly about his video games because they weren’t popular. Today, it’s a 180° turn, and students who don’t play may find it difficult to fit into certain groups. In order to be as effective as possible, it is important that the medical world follows suit, especially when we see the benefits that this medium can bring with few harmful effects. For those who are interested, the website therapieetjeuvideo.fr offers a directory of psychologists who use video games. Now it’s time to get down to the nitty-gritty of the subject.

Access to games for all

Setup informatique de Tony — Example of adapted setup (Tony’s)

In this second part, we’re going to move away from the world of medicine to that of accessibility. We can divide it into two parts: games and peripherals. By this I mean that accessibility is more than just an extra menu, although the progress made by the studios is welcome. We’ll be talking to Valentin Squirelo and David Combarieux, two able-bodied people who are trying to offer accessory solutions to those who need them. But the heart of this part is the meeting with Alex, Gyzmo, Rayann, Tony, Amelitha and Fred, all disabled people, to understand that the JV can help and be helped these people that we do not imagine to be major players in this adaptation, oh so, indispensable, although they are the first concerned. Let’s get on with this second chapter!

Valentin

Valentin Squirelo is developing a software programme called Playability. In fact, there are two of them working on the project. The basic idea was to offer a solution for people with reduced mobility, or even just facial mobility. As the project progressed, the scope was broadened with the idea of offering alternative controls to the general public, along the lines of Nintendo’s innovations. He was rather sceptical about the investment proposals because he was afraid that the accessibility aspect for disabled people would be abandoned in favour of the family aspect. However, this vision has made him want to reach out to as wide an audience as possible, and put motion-based JVs back at the heart of usage. Some studios are making efforts, like Sony with God of War (contextual action settings) or Nintendo with Mario Kart. Even more simply, with adapted fonts or filters for colour blindness. These are small changes that offer accessibility that is easy to implement, but insufficient in most cases.

Let’s start at the beginning. Valentin is the kind of person who wears many hats. He’s done all sorts of jobs: entrepreneur, developer, engineer, but he’s always been involved with the JV. He was even a sales representative for Nintendo. He has been an inventor for 10 years. In his studio, projects have flourished, and he presents them on Youtube and Twitch. His job is to invent new ways to play. He has a strong affinity with emerging technologies, lots of electronics and recognition algorithms. At the same time, he does odd jobs for friends, particularly one of them who is disabled. It’s important to remember that 95% of adaptation needs are not met by the market; there’s always a need to modify the accessory with 3D printing, Velcro or other customisation. So Valentin’s expertise is a real added value in the world of accessibility.

[…]between someone who was able to prototype anything to sell Red Bull or video games, in fact, it’s the same skills when you have someone coming by and you tell yourself that if you make this thing in half an hour, it changes the way they interact.

Valentin quickly began to make a name for himself with the people who needed his services. One of the projects that really put him in the spotlight was a Nerf prosthesis that enabled one of his friends, who was missing his right hand, to simply play (a bit like Megaman). The prosthesis ended up being exhibited for a year and a half in a museum in Chicago.

Valentin is dedicated to entertainment, as this project shows. He has a very human side, and his inventions are open-source. He even helped a woman in Arkansas (USA) to find someone who could make the famous prosthesis for her grandson.

From then on, he stopped being an entrepreneur and started creating content focusing on accessibility and video games. One of the first issues he tackled was how to transform a wheelchair joystick into a JV controller. It was obviously a successful challenge, but it was also the moment of epiphany that gave birth to Playability, his software that lets you control a game using facial recognition. But the challenge wasn’t enough, so 5 weeks before the event he decided to win the Lépine competition and make a video about it, giving him plenty of time to develop his prototype from start to finish. You can follow the process in the video below.

Five weeks to win the Lépine competition

It was a real revelation for Valentin, the realisation that this is what he wants to do with his skills. The small open-source project became a tool that he wanted to push to the limit to make it usable by as many people as possible, and so to devote time to it, no miracle, you need money. So the content creator puts on his entrepreneur’s hat to find investors capable of supporting the project, and he makes no secret of the fact that this is an arduous task.

Currently running on Windows and soon on all operating systems, PlayAbility is software that simulates a keyboard, mouse and/or joystick. The idea is to assign each key to an action. This data can come from another accessory, a chair joystick or a facial movement captured by a webcam (50 facial points are taken into account). Sensitivity is completely configurable. It’s compatible with 100% of games and can be combined with other software. The next step is to add voice command management, but not like with Alexa or Google home. The aim is really to have a fine analysis of sounds, not words, to gain in speed, but also to enable people who can’t speak to use it. The idea is also to be able to capture hand movements so that it can be used like a joystick: I move my hand forwards, the character moves forwards or any other action.

He realised that what he was proposing was not just a solution for people with reduced mobility, but could also be used by people unfamiliar with the usual controllers, or even just for fun with friends. Anyone who’s been around will remember the impact the Nintendo Wii had on bringing JV games into the home, with over 100 million units sold. This console reached people of all ages, whether or not they were used to playing games. The aim is to deliver a turnkey tool that can be used even by people who are not used to JVs (a mum who wants to allow her child to play). Ideally, the studios should get on board and create profiles for their titles on which users can choose their inputs. All of which is to say that Valentin has no intention of stopping there and offering more solutions to reach as many people as possible. And it’s working so well that he’s had feedback from disabled people whose relatives want to borrow PlayAbility to play. It’s one of the rare occasions when an accessibility tool makes able-bodied people want to use it.

However, there is a big problem with tools like Playability. Software or peripherals designed to enable people to play are used by others to cheat on competitive games. This use encourages developers/publishers to ban anti-cheat aids, or even consoles themselves, which reduces the scope for action. Valentin’s concern is to offer software that offers as many options as possible, but not to cheat, and that’s no easy task.

Matthe en roue libre test PlayAbility

There are two things to remember about the story of Valentin and Playability. The first is that it’s often when you least expect it that you find the project that makes you want to give it your all. The second is that an idea that germinates to help a minority can quickly grow and benefit the majority. You’d be surprised how many things in your daily life come from this kind of project. For my part, I’d like to thank Valentin, who really was my entry point into the world of accessibility, which I didn’t think was so vast or so interesting. It’s only a short step from enabling people with disabilities, who are advised to go for retrogaming (the controls are simpler), to play modern games. The software option is not the only one; it is possible to do a great deal of work on the hardware, and we’ll come straight to that.

David

Video games still have this negative connotation, particularly in the medical world. As we saw above, there’s a balance to be struck, but JVs can still provide significant added value for people who find themselves isolated. David Combarieu has seen it for himself: his stepson, Théo, lost a large part of his mobility in an accident, with paralysis in his fingers. This meant that he had to rethink a large part of his daily life, including his leisure activities. How do you use a games console when you’ve lost the finesse of movement in your hands? The first solution was an arcade stick, big joystick, big buttons, it works! Then came the desire to discover other games that required two sticks (one for movement, the other for the camera). Suffice to say, if you can juggle with two arcade sticks, nobody can boast about it. Another problem is that arcade joysticks only pick up four directions, whereas games are designed with eight, which makes them more rigid.

The second solution was DIY. David and Théo soon realised that there was nothing on the market for this type of need. By looking around the community, they quickly realised that they weren’t the only ones in this situation. The networks are full of people looking for solutions. They began to create very home-made alternatives. At the same time, they got in touch with other players in the same situation.

In the space of just a few years, this accessibility-minded group is beginning to make a name for itself. In 2018, Xbox is releasing the adaptive controller, a controller designed differently and much more. It’s a hub to which, via USB or jack ports, you can connect a whole host of peripherals to create the perfect controller, well almost. For his part, David got in touch with Hugues Ouvrard, head of Xbox France, who gave them controllers to tinker with. Through his contact with gamers, David realised that there was another problem: players’ accessibility to e-sport competition venues. We’ll see later the case of Rayann, who had to sleep in his wheelchair between two days of competition. David decided to set up the Handigamer association to help his players with transport and accommodation adapted to their needs. Playing is all very well, but some people want to compete. In digital sport, there’s no need for categories like in physical sport, all competitors are on an equal footing. Where there’s work to be done, it’s mainly in terms of logistics, and the association does that well. It’s pretty amateurish at the moment, but you get the feeling that in the pro world there’s an attempt to include everyone. The rules need to be adapted to include the necessary equipment without people crying cheating (once again). There’s still work to be done in this area, but the desire is there and that’s the main thing.

Today, disabled players are gaining in confidence and visibility. Some are taking to Twitch or Youtube to show how they play (and how they mock the able-bodied).

David talk about Handigamer

David also founded Hitclic, this time a company. It’s a multi-faceted company, always with the idea of designing peripherals that don’t exist. The main activities are importing peripherals available in the United States, Japan or elsewhere, but also offering tailor-made solutions.

[…] the video game industry, when they propose a controller, in inverted commas, for disabled gamers, that controller is only going to cater for a certain percentage of people anyway.

Companies like this are rare, as evidenced by the fact that Hitclic has a European reach. David receives requests from Spain, Germany, Denmark, Italy… That’s not to say we’re a big company that produces a lot. We only have one order from time to time, but the number of requests is growing all the time. The aim is not to reproduce what already exists. If the product is already available elsewhere, the idea will be to make it available at a lower cost via the Hitclic site. David even offers translated documentation where necessary, as well as after-sales service.

Extrait du site hitclic — Extrait du site de Hitclic

To give a specific example, the Flex controller is a Nintendo-licensed peripheral manufactured in Japan by Hori. David has managed to get a distribution contract for France, which means the controller is available at a reasonable price without having to speak Japanese.

The site’s extensive catalogue is sorted by type of device, game platform or body part.

Handigamer/Hitclic also works with professionals supporting players who need equipment. If the need is clearly identified by an occupational therapist, for example, it is possible to have a product on trial. It’s complicated to do this for everyone, whether from a logistical point of view or even in terms of availability.

David’s main focus is on motor disabilities because of the hardware he offers, but he has also seen video games have a positive effect on cognitive pathologies. He remembers once, when he was running a workshop in a specialised centre, a patient who was only there to watch because his uncontrolled movements could damage the hardware. David decided to give it a go anyway, and what a surprise! The patient showed strong concentration, finer movements and, above all, a smile – the proof of success that was being sought. The outcome of all this is, above all, enjoyment, regardless of the game, the performance or the setup. If the player is having fun, the effort is well worth it.

David also provides support for carers, such as parents. If one of the siblings can’t play like the others, for whatever reason, it’s possible to ask for advice on both materials and games to help introduce the future player in the best possible way, without going through the frustration of failure.

In recent years, developers have made a few efforts to improve accessibility directly in games. It’s uneven, but it has the merit of being there and opening doors. Manufacturers are also making progress in this area. The arrival on the market of Sony’s Access controller, for example, is a different approach to Microsoft’s, while retaining a standardised way of using the accessories that already work on the Adaptive controller.

Flex Controller Overview

The negative point is the same as the one we saw with Valentin. Manufacturers are increasingly locking up their machines so that you can’t connect just anything to them to prevent cheating. But this also has an impact on a lot of accessories used by people with reduced mobility.

David does an enormous amount of work, but he always finds time to help out, as he did for this article. It’s thanks to him that I’ve met the following players.

Alexandre

Alexandre was disabled from birth and uses a wheelchair, which makes it difficult for him to get around as he likes. This was especially true during his childhood, when it was impossible for him to go and play football with his mates. While staying with friends, he discovered GameGear, the portable console released in 1991. His parents soon realised that video games stimulated and amused him, and that he enjoyed them. They ended up buying him a Playstation (the first of its kind), as well as subsequent ones. His friends from school used to come and play with him on Saturdays, and that’s how JV became a real passion. Alexandre admits that it served as an escape, but above all as a way of bonding despite his situation.

Eventually, this passion spread beyond the afternoons spent with friends. Today, Alex makes videos about it on Youtube, previewing games supplied to him by publishers. The aim of these videos is to democratise disabled gamers, but also to assess the accessibility of games.

Today, a game costs 80 euros. When you realise that the game isn’t accessible, let alone the hardware, that’s a lot of money lost. And so you’re reluctant to buy new games.

For example, Playstation France sent him their access controller so that he could test it.

Alex gives his opinion on Playstation Access

The CapGame association, which gave him his foot in the door, put him in touch with the first publishers. Now Alex follows his own path, depending on the games he wants to try out. The first time he got a game in advance, it was difficult not to talk about it with other people before the embargo ended. It was an experience he has fond memories of. He’s pleased with what he’s been able to build on the networks. The recognition of his work by industry professionals is a real achievement. The image of the disabled geek locked away in his room is beginning to change, thanks in particular to online gaming. He has made new friends who have gone on to watch his videos. He feels that his work is useful.

He’s an avid fan of motor sport games, to the point of competing in them. The hours of driving were so many that he finally got fed up of playing with the controller and looked for a steering wheel that would suit him. So he found a suitable accessory in the United States, which he brought over. To put the figures into perspective, the steering wheel cost €300, plus €400 for adaptation work, not forgetting €100 for customs. All this only to realise once in his hands that it wasn’t adapted to his disability. That’s how he got to know David, with the idea of sharing his experience. Alexandre even became a Handigamer ambassador. He’s also tried Playability, and he’s blown away by the software’s responsiveness.

Here’s a simple example: to play, Alexandre has to put the controller down on a shelf built into his armchair because he can’t hold it. On Playstation controllers, the rear triggers are not recessed, so he has to press the L2 and R2 buttons, which causes undesired actions. So he had to find suitable controllers. The Switch, for example, is very difficult to access.

Alexandre is also thinking about the use of video games in rehabilitation protocols for people who have suffered physical trauma. He feels that not enough is said about this. He also thinks that the specialist press is not sufficiently involved in accessibility. Tests indicate that accessibility is good, even though it has not been thoroughly tested, which can mislead some consumers. Fortunately, there are people like him who can really enlighten gamers.

Another important point is that now that he’s really delving into all the accessibility parameters, it can sometimes take him several hours to try everything out, until he exceeds the playing time allowed by the distribution platforms’ refund policies. This means he can’t claim a refund for a game he can’t play.

Menu d'accessibilité de The Last of us 2 — The last of us part 2 is a masterpiece of accessibility

To sum up, he feels that video games are becoming more and more accessible, but to play at their best you need to make a substantial investment, particularly in the setup (the desktop, for example). The MDPH can help finance a gaming installation to a certain extent, which is proof that the benefits are recognised. Even if progress has been made, it’s far from perfect and there’s still work to be done. But the satisfaction of being able to play like everyone else, having sessions with your mates, is a great feeling. Alexandre is a very altruistic person. The difficulties he encounters are just an extra motivation to help others. He really enjoys sharing his experiences to open the eyes of as many people as possible.

Thank you Alex for sharing all this with me.

Jeremy

Gyzmo, aka jeremy, suffers from non-progressive congenital myopathy (a lack of muscle). His passion is football, which he would have loved to have been able to play, but the disease made that impossible. So he had to find another hobby, like any other child. That was video games. The medium has enabled him to develop socially and professionally. His aim today is to de-demonise video games, because it’s all a question of moderation. Being a geek can be compared to being a sportsman: it’s a beneficial activity, but it can also be harmful to yourself and those around you when you fall into addiction with the same cravings.

Gyzmo started out playing solo, because at the time there was no such thing as online. The difficulty of these games – some will remember the Ninja Turtles on Nes – sharpened his determination and his desire to excel. The advent of multiplayer really opened him up to the world. Very quickly, he made friends from the four corners of the globe. As time went by, he became a very high-level FIFA competitor – he’d had his football! He learnt the basics: follow the rules, train and compete against the best. These were the beginnings of e-sport. Jeremy has found his place both socially and competitively. It was also a demonstration that his disability does not prevent him from being like everyone else and aiming for the e-sporting elite.

Online gaming is inclusive, with no race barriers and no judgement on physical condition. It’s a great way to get in touch and talk to other people. People who, perhaps, wouldn’t have been part of his life if he’d simply bumped into them in the street because of prejudice or fear.

[…]I’d like to stress that, socially, it really helped me gain self-confidence because I was able to see that I had my place in society, that I made a lot of friends, including the best man at my wedding.

On the professional side, e-sport has enabled him to develop his skills. Self-taught, he learnt communication skills, then management and finally programme production. He has managed to turn it into a profession specialising in inclusion through gaming. Jeremy runs workshops and masterclasses without restricting himself to disability. He fights for inclusion in the broadest sense of the word, and there’s no question of categorising people. The label of “disabled person who plays video games” is not for him. His approach is to propose inclusion, not impose it. The aim is to offer a new gaming experience and to have a good time so that people are encouraged to ask questions and seek out information. In his experience, the message gets across much better this way and the educational aspect is drowned out by the fun. In his view, it’s a pity to set up ‘disability’ stands, because inclusion has to be real and we have to mix everything up, especially at conventions.

His personal goal is to get off the disabled adult allowance and make his wife and two children proud. To achieve this, he has a second job in technical support, which enables him to supplement his income and feel like a man. With his knowledge of communication, Jeremy wanted to help David, whom he saw trying to do a lot on his own. By working together for Handigamer, they have become true acolytes.

Progress is being made in terms of accessibility, and we need to encourage the slightest advance. It’s important to motivate those who can make a difference. Representation is another problem, and not just in video games, but in society at large. Jeremy’s project is to “normalise differences”, he prefers to be seen for what he has achieved and not for his condition as a disabled person.

Jeremy’s speech

We take a look at the use of video games in rehabilitation. Occupational therapists have realised that it’s a fantastic tool for getting patients out of the ordeal that can be their therapy. They add a playful side that boosts motivation and restores the desire to move forward.

While taking part in the Handica trade fair in Lyon, Jeremy met a mother whose son was a keen video game player. He had to stop after an accident. In a spirit of kindness, Jeremy showed her some solutions and offered to talk to the young man to help him play again and, in so doing, rediscover the social side of online gaming that he loved so much. This gesture alone, which may seem insignificant, means a lot to some people, and the mother of the family was overwhelmed with emotion at this new option. There’s also the anecdote of a father who took a dim view of video games. When he saw that his son, no longer able to play, had lost his smile, his contacts and his joie de vivre, all he wanted to do was find a way to get his son to play again.

Example of use of video games in rehabilitation

Jeremy is proof that video games are a magical tool that can do great things for you and for others. I’d like to thank him for his heart-warming vision and his desire to make things happen in a caring way.

Rayann

Rayann was introduced to video games as a child by his older brothers. His relationship with this medium has always been a bit special. It was a way of leaving his armchair behind and exploring virtual worlds. This hobby eventually turned into a real passion, which led him to e-sport. During a competition organised by the Salty Arena, an association based in Lille, our ace joystick user finished top 5 on Tekken, which enabled him to be recruited into a team. Rayann’s aim is to show the world that disability does not make a person. And if there’s one quality he possesses, it’s perseverance. He never gives up, and that’s a must for any sportsman.

My life is an Elden Ring session and I want to show that I runt his world! Just like in the game, even if it’s complicated, you have to keep going.

But that doesn’t mean he is abandoning his professional side. At the moment, Rayann is looking for a training course that might enable him to enter working life. As he says himself, seriousness comes first, then e-sport. It’s the world of development that appeals to him. He’s a keen learner, and it all started with HTML/CSS and Python. Then he created a video game with Construct 3. It’s a real Swiss Army knife. But it’s the iOS environment that stimulates him today. After taking an initial training course, he continues to learn on his own. The big difficulty is finding an establishment that agrees to take on a disabled person and that, of course, doesn’t cost an arm and a leg. But he hasn’t given up hope.

Rayann not only has a motor disability, he also has some comprehension problems, nothing serious, but he simply needs a little more time to assimilate things properly. During his childhood, the professionals who helped his parents decided that Rayann could not be educated, either in an institution or even at home. This additional shortcoming, which he tries to compensate for every day, is an additional obstacle to his project, but he keeps going. He owes part of his fighting spirit to the people who put him down and judged him incapable.

rayann et david à roland garros — Rayann et David à Roland Garros

Since then, he has had his revenge thanks to the Lycée Jean Moulin in Roubaix (which he thanks from the bottom of his heart), where he had the opportunity to take his first diploma. The most important thing for him is to have spent a month in a lycée and to feel like any other pupil. That was the trigger for what followed, what made him want to fight every day. That was just the beginning, he also attended the Apple Foundation Program where he learned Swift and UX design. It was there that he decided to continue down this path.

One day, David asked Rayann to take part in a tournament on a mobile tennis game. Rayann had a month to train to try and qualify. As a result, he found himself at Roland Garros to play in the final, where he finished top 7. He liked the venue, which was adapted to his needs, which was not the case at his hotel, where he had to sleep in his wheelchair due to a lack of staff to help him. He has no regrets whatsoever about this event, which he will treasure for the rest of his life. He would like to take this opportunity to thank David, without whom he would not have had the chance to take part in this type of event.

🙂 l'apparence est souvent trompeuse pic.twitter.com/tK8xNCyGFY
— Loup-Solitaire (@N_O_R_A_K_I) July 22, 2024

Rayann’s testimony

Rayann sees himself as a lone wolf, out against the world but very open to others. His perseverance is a real lesson, as is his ability to look on the bright side of things. It’s great to talk to people who are driven by their desire to make a dream come true.

Tony

Like many people, Tony has been playing video games since he was a child. As life progressed, his training as a baker and his football training took the place of games in his daily life. Then an accident turned his life upside down. Three years of rehabilitation, a new diploma and unsuccessful job searches began to spark the idea of getting back into gaming. The first step was to create a setup that met her needs by looking at what was available just about everywhere. It was around this time that the Xbox Adaptive Controller made its appearance, and he used it in conjunction with the Cronus adapter. The addition of other accessories is essential if he is to achieve the precision he needs to play, such as a touchpad to replace a joystick.

One thing led to another and Tony began to take an interest in what was happening in the non-profit world, in particular CapGame, which was founded in 2013 and tries, among other things, to raise awareness of accessibility in the video game industry. Tony has therefore joined the team of accessibility testers for games in terms of motor, hearing and visual impairments, to name but a few, in order to establish a scale to help gamers find their way around. To take things a step further, the game is streamed and then debriefed to clarify what is and isn’t possible. With two years’ experience in this field, Tony feels that accessibility is making good progress, and he hopes that the association’s contacts with developers will help in this direction. In his desire to raise public awareness, Tony has also worked with APF France Handicap on a presentation of existing peripherals. From a local point of view, he feels that his solutions are not sufficiently well known. As we have seen from most of the testimonials, the JV helps with socialisation. This is what enables it to launch all these community projects.

If you have a disability, playing a video game is mainly about experimenting and learning how to find the perfect setup, but the most important thing is to help each other and be kind to each other.

Apart from the associative aspect, Tony also plays for pleasure, which is the best way to leave certain aspects of everyday life behind and take full advantage of the worlds available to him. When the pain is hard to bear, a dive into a virtual universe is a good escape. But don’t forget to come back to reality regularly – that’s advice for everyone. Right now, to play optimally, Tony needs the adaptive controller, contactors (buttons, to put it simply), 3D-printed joysticks (big arcade sticks, if you like) and a touchpad. All this to limit muscular effort but also gain in precision.

Accessibility test carried out by Capgame

This world of accessibility and awareness-raising is also beneficial for its key players. It gives us the opportunity to meet people who can understand the problems associated with certain types of gameplay and, above all, it lets us know that we are not alone. Video games are very inclusive, at least in this context, because disability doesn’t transpire through the screen. Tony took part in a Rocket League tournament with Rayann. In e-sport, he also played Roland Garros on the mobile game Tennis Clash against the world’s best players. Unfortunately, he also encountered problems when he was unable to find a nurse to provide the care he needed. His five-day stay was reduced to two, despite the fifty or so calls made to the 15th arrondissement of Paris. It was eighth place that he managed to achieve, a fine performance, but what he gained was a great memory and some wonderful encounters. To return to the subject of PRM facilities, even access to the Paris metro is very complicated, with very few stations equipped with lifts or ramps, making them difficult to use for wheelchairs and pushchairs alike. Not to mention the incivility of other users, which makes the experience even more complex.

In the future, Tony would like to continue raising awareness, but also continue competing on Rocket League. One thing’s for sure, though, and that’s that he’ll continue to play mostly FPS games. It’s admirable to see how Tony has managed to overcome the ups and downs of life and reach out to others. The JV has been the vehicle for this sense of sharing.

Amelitha

Amelitha is a gamer from the 90s who discovered this medium with Mario Bros and Duck Hunt. The games went on and on with her two brothers. The golden cartridge in Zelda II: The adventure of Link is one of the many things that made a lasting impression on her. Very quickly, it was the fighting games that caught her attention. A challenge, since Amelitha has had paralysis in her right arm and hand since birth.

As a child, Amelitha was very shy. She sent her brother to order for her at the Mc Do. It soon became a tradition for siblings to get together, at Christmas for example, to buy games and consoles. The Super Nintendo was chosen as part of the Street Fighter 2 bundle so that the two of them could play together. And then it was Ken’s turn! Why Ken? Quite simply because the character’s confident attitude echoes her great shyness. Whatever the game, she’s always looking for the cheeky character. There’s a strong link between Amelitha and her character, and she’s still playing Ken in Street Fighter 6. Versus fighting has become an important part of the games she plays with her brothers, and each new console had to have its own.

Then time passed, the children became adults and the fights were put aside. Amelitha’s shyness prevented her from meeting other players. Her discovery of social networks and streams inspired her to try her hand at Street Fighter 5’s online mode, just for the fun of it. In 2018, Chris Klippel, founder of Rockstarmag, organised a tour of France to meet disabled gamers. The fact that the event was taking place not far from her home gave her the opportunity to speak out, but also to realise that many disabilities, other than motor disabilities, required adaptations to be able to play. The project, which is a documentary, also aims to bring together all the participants at Paris Games Week.

While there, Amelitha met David’s son-in-law Théo, who told her his story and about his desire to set up an e-sports team made up of people with disabilities. The fact that Amelitha had never competed didn’t stop her and she joined the project. This enabled her to overcome her shyness thanks to the idea of being a member of a group that wants to open up the path of e-sport to players who think it’s inaccessible. And the team is off to a great start, with its first tournament being the 2019 Gamers Assembly. As well as being her first tournament, it was also the first time she had discovered a number of initiatives in the world of video games, such as Women In Games. There she met Valhanya. Valhanya also played in her first tournament, finishing in second place on Soul Calibur to everyone’s surprise. They went on to become friends. Amelitha has developed a taste for this kind of event, more for the social side than the competitive. She loves being with people who share her passion. Goodbye shyness, you won’t be missed.

It’s true that there’s still a long way to go, but if we don’t do anything, we’re not likely to make any progress.

In retrospect, what struck her most about the event was how few women there were in the world of e-sport. With her disability, she knows full well that it’s not looks that make the difference, so she’s trying to find out why. What quickly emerged was the omnipresence of men in e-sport. Most of us have that feeling of security when we’re in a group at a big event that we don’t have when we’re on our own. Few women are inclined to enter their first tournament when they know they’re going to be alone throughout. Hello impostor syndrome! Let’s face it, when you add to all that the difference in treatment between men and women, it’s not easy to make your mark in the industry. Without hesitation Amelitha, Valhanya and Liv, a renowned commentator on fighting games, founded Fight Forward. The group’s mission is to help women, non-binary and trans people who want to get involved in e-sports to do so. The aim is not just to compete, but also to help people discover what goes on behind the scenes, meet new people and enjoy the cool stuff. Amelitha is the perfect example of what e-sport can bring to someone. Looking back, the results are very positive: self-confidence, friends, a project. A lot of things that little Amelitha could never have imagined. There’s only one thing that counts, and that’s not just the competition: the desire! They’re there to have fun, have a good time and dare to compete, whatever the results. In practical terms, they offer help with registration, explanations of what’s involved, advice on accommodation, not to mention meeting up at the venue. The next step should be to become an association to carry more weight and also to approach partners or helpers to create an event.

Video presentation of the Tour de France dedicated to players with disabilities

As if that wasn’t enough, Amelitha is also part of the Cap Game testing team, where she does Twitch lives that are then uploaded, with subtitles, to Youtube. Although this project is also growing, she would like to see them become a consultancy group for developers on the accessibility of their games.

When you take a quick look at what Amelitha has told me, you go from a very withdrawn little girl to a woman at the head of a project that is undoubtedly going to grow. What strikes me most is that she is now completely turned towards others, with this desire to help them in turn. If this isn’t proof that video games can be a beneficial medium, I don’t know what you need.

Fred

Fred has development in his blood. He started coding on Amstrad at the age of 9. As a gamer, it was the first Nintendo consoles that attracted him. At the same time, his results at school weren’t what he’d hoped for, so he opted for a career in building and civil engineering. At the time, it was impossible to envisage a career as a programmer through school. So he began his working life as an electrician in a building and then in a factory. A few years later, Fred suffered an accident that caused him to lose a lot of mobility in one hand. The usual route is to tip him over in the office, but Fred being dyslexic, not to mention having memory problems, this option is not for him. Unfortunately, when you don’t fit into the boxes, things get complicated, so he was sent home with a disabled adult allowance.

Mais c’est mal connaître Fred, hors de question de tirer au flanc. Il faut savoir qu’une de ses filles est, elle aussi, handicapée et que le rôle de père demande beaucoup de temps. Sur son temps libre, il revient à son premier amour, la programmation. Dans un premier temps, il commence en autodidacte, puis demande une formation qualifiante à Pôle Emploi (ou France Travail, peu importe le nom). L’entrée dans ces formations passe par des tests qu’il réussit, il lui attribue un niveau bac +2, mais la formation lui est refusée car il ne parle pas anglais. Abandonner ? Jamais ! La démocratisation d’internet (oui oui, on est un peu loin dans le passé) lui permet de trouver de quoi apprendre Unity et Unreal. Rapidement, il crée DF Games Studio afin d’essayer de s’en sortir tout seul.

But you don’t know Fred very well, and there’s no question of him taking the easy way out. One of his daughters is also disabled, and being a father takes up a lot of his time. In his spare time, he returned to his first love, programming. He began by teaching himself, and then applied to Pôle Emploi (or France Travail, whatever it’s called) for a training course leading to a qualification. He passed the tests and was awarded a Bac +2 qualification, but was refused because he didn’t speak English. Give up? Never! The democratisation of the internet (yes, we’ve come a long way in the past) enabled him to find enough money to learn Unity and Unreal. He soon set up DF Games Studio to try and make it on his own.

The first productions to come out of his studio were intended for psychologists, particularly in the treatment of phobias, but also Android games. Today, with his Survival Bunker project, it’s PC games that are putting him to the test. As he says himself, this project is the game of a lifetime. At the same time, he is working on other titles, including one for his daughter. The aim is to make a no-pressure farm management game. The programme carries out the actions that the player doesn’t do, leaving room for pure, uninhibited fun. Originally, the idea was to meet his daughter’s needs, but after talking about it on Reddit, it turned out that quite a few people were interested in it, and he was asked to release it. Some families of autistic children think that this sandbox without the mental load could benefit them. In order to help them, Fred is planning to extend his project and market it. Come what may.
Let’s look back at these famous games developed as part of a therapy. These are virtual reality applications that he designs with the help of a psychologist, and a dozen or so have already seen the light of day. Fred also works with training organisations, particularly in fire safety. The aim is to create an immersive simulation so that the patient or trainee can learn how to react in given situations. However, the calculation of the disabled adult allowance does not allow him to really develop his business. Selling an application can bring in two or three thousand euros at a time, but it’s not a regular income. He has already found himself with his benefit suspended for a year without any regular income, so he has had several months without any income.

I’m not keen on games that copy reality. People need to be able to immerse themselves in a world that makes them dream.

Video games were very much a part of his life after his accident. The process of having his disability recognised brought Fred face to face with the harsh realities of this world. The accumulation of all this was complicated, and he fell into depression. Social isolation quickly set in and JV, multiplayer gaming, helped to counteract what seemed inevitable. His condition as a disabled person does not show through in his online games. As well as providing a social link, JV has enabled him to accept his disability and understand that even if he never regains his former abilities, there is still a lot he can do.

From this experience, Fred deplores the fact that hospitals, and the medical world in general, have not yet grasped the opportunities offered by video games. He is thinking in particular of the use of VR to help relaxation, especially for children. He has tried to put his expertise to work in healthcare establishments and in the field of security, by writing directly to the MP, but has received no response, not even a negative one.

A little tease for Survival Bunker

We’re not going to let Fred go without telling us a bit about his game, though. Survival Bunker is the most advanced game he can make as a solo dev. It’s a post-apo survival game in which you have to manage a bunker. He got the idea from his experience of Fallout 3. As a reminder, you start the game with our character as a child and, during the introduction, we see him grow up and then emerge from the shelter, a bunker. Fred felt a great deal of stress when he realised that he wouldn’t be able to return to the underground structure once he was out. So he promised himself that if he could, he would make a game where you could go back into the bunker. It’s a combination of exploration, management, RPG and management, a big project in itself. I’ll give you the link in the sources section. For the music, he contacted the composer of the Tomb Raider soundtrack, who agreed to work on Survival Bunker.

As we’ve seen, Fred is a fighter. He’s one of those people who pick themselves up every time life throws them off balance. He infuses this strength into the video game to try and pass it on to those who need it – his daughter, patients, anyone who wants it. It’s further proof of what can be done with lines of code that go far beyond the confines of a screen.

The last word

I think we’ve already got a good overview of video games beyond entertainment. We met professionals, enthusiasts and gamers. Whether as a complement to therapy or as a way of socialising, we’ve seen that video games have many advantages, far from preconceived ideas. I hope I’ve succeeded in giving you some material to help you understand that we’re far from having discovered the full potential of this medium. Even as I write these lines, I’m surprised by what I’ve found and by the kindness of everyone I’ve met. A lot of things happen by word of mouth. I’m not necessarily asking you to share this paper, but below you’ll find a whole bunch of links that I’ve used as sources, as well as the contacts of all the people involved. Don’t hesitate to explore all this and to follow these people. If you’ve learnt something, tell people about it – it could be useful to someone else. I’d like to finish by thanking Mathieu, Sebastien, Valentin, David, Alexandre, Jeremy, Rayann, Tony, Amelitha and Fred who do so much for video games. It’s people like that who make things happen, so keep up the good work, we need you!

Spider-man 2: sequence where we play Hailey, a deaf person