This chapter surveys assistive technologies which make video games more accessible for people who have an Acquired Brain Injury (ABI). As medical care improves, an increasing number of people survive ABI. Video games have been shown to provide therapeutic benefits in many medical contexts, and rehabilitation for ABI survivors has been shown to be facilitated by playing some types of video game. Therefore, technologies which improve the accessibility of games have the potential to bring a form of therapy to a larger group of people who may benefit. Hardware technologies which may make games more accessible for brain injury survivors are considered. Complementing these devices is the inclusion of accessibility features into games during the development process. The creation of best practice accessibility guidelines among game development practitioners is a nascent field, considered important by the authors. Play testing is common practice during game development. We consider the ethical issues involved when the play testers are brain injury survivors. Overall, the aim of this chapter is to improve the accessibility of future games, and thus their therapeutic potential, for brain injured and other disabled gamers.
TopBrain Injury
Any brain injury which occurs after birth is called an Acquired Brain Injury (ABI). Causes of ABI include CerebroVascular Accidents (CVA, i.e. stroke), tumours, degenerative diseases (e.g. Parkinsons), demyelinating conditions (e.g. multiple sclerosis) and infectious disorders, (e.g. encephalitis) (Murdoch & Theodoros, 2001). Cerebral Palsy (CP) is also an ABI. The term covers a variety of disabilities caused by damage to the infant brain (Bax et al., 2005). CP is the commonest physical disability among children. There are many possible causes of CP, and though the damage may be sustained prenatally, perinatally, or postnatally, prenatal damage is most common (Reddihough & Collins, 2003).
A Traumatic Brain Injury (TBI) is an ABI caused by trauma such as a blow to the head, an impact with a blunt object, or penetration by a sharp object. Common causes of TBI are: motor vehicle accidents, bicycle accidents, assaults, falls, and sports injuries (Hyder et al., 2007; Lindsay & Bone, 2004; Ponsford et al., 1995). Motor vehicle accidents are the most common cause of TBI globally (Hyder et al., 2007), although for children this may be as a pedestrian or cyclist rather than passenger (Murdoch & Theodoros, 2001). There are two main types of TBI: open, where the skull is penetrated; and closed, where the meninges remain intact. Closed head injuries are much more common for civilians, although penetrating injuries are more common in wartime (Murdoch & Theodoros, 2001). In a closed TBI, the brain is subjected to compression, acceleration/deceleration, and rotational forces, causing brain tissue to be torn and sheared. The head may be crushed, but more commonly the victim suffers a brief impact to the head, (or elsewhere, such as in the case of whiplash) causing a sudden movement of the head. The brain may collide with the skull at the point of impact, resulting in a coup injury. Another contrecoup (or contra-coup) injury opposite this point may then occur as the brain rebounds (Murdoch & Theodoros, 2001).