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.

Purpose This paper reports a pilot experiment to test if multi-player online video games could provide a measurable cognitive therapeutic benefit for brain-injured people. Design Single-subject research design with n=3 brain-injured participants. Four alternating intervention and non-intervention weeks. Battery of cognitive tests taken at the start of the experiment and at the end of each week. Findings Widely varying results with large standard deviation overall. Research limitations The experimental design was heavily reliant on multiple participants logging in at the same time. Server logs showed that this happened relatively rarely. Practical implications Implications for the next iteration of the experiment are to refine the game design to avoid the need to synchronise the participants. The findings presented may be of practical use to other researchers in this area. Social Implications Acquired brain injury has been described as an epidemic, and is rising, with stroke being a leading cause. Traumatic brain injury (e.g. due to road traffic accident) has increasing prevalence in lowmiddle income countries. This research aims to provide a form of therapy to people for whom physical access to rehabilitation services is limited. Originality/value The use of multi-player online video games as rehabilitation is a relatively unexplored area. A positive result in an experiment of this nature would indicate the potential for a new, complimentary form of cognitive therapy for brain-injured people.

This document describes the author's PhD work done to date. The motivation and background is described, and the hypothesis presented, which is that an online multiplayer video game could provide cognitive therapy for brain-injured people. The proposed experiment is described, explaining the design decisions made. The expected contribution of this research is stated.

The number of people with brain injuries is increasing, as more people who suffer injuries survive. Some of these patients are aware of their surroundings but almost entirely unable to move or communicate. Brain-Computer Interfaces (BCIs) can enable this group of people to use computers to communicate and carry out simple tasks in a limited manner. BCIs tend to be hard to navigate in a controlled manner, and so the use of “one button” user interfaces is explored. This one button concept can not only be used brain injured personnel with BCIs but by other categories of disabled individuals too with alternative point and click devices. A number of accessible button interfaces are described, some of which have already been implemented by the authors.

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