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Adaptive Controller Overviews
ATAT Adaptive Gaming
Welcome to the Adaptive Gaming page of Mizzou, hosted by the Occupational Therapy Department's Assistive Technology Adaptation and Training (AT-AT Lab)! Comprised of MUOT student and MUOT faculty that combine our passion for OT, assistive technology, and gaming to improve the accessibility of gaming to individuals that want to game but are limited by standard controllers.
Together with the Disability Center and the MizzouRec Gaming Lounge, the AT-AT Lab is excited to be introducing an adaptive gaming program at Mizzou! This effort is generously supported by the BeStrong29 Foundation and the Department of Occupational Therapy.
This webpage serves as an educational resource, introducing the basics of adaptive gaming and highlighting the fundamentals such as types of adaptive controllers, external switches and joysticks, and accessible features within consoles. The focus is on the primary adaptive controller offered by Xbox, Sony, and Nintendo.
Table of Contents
What is Adaptive Gaming?
Adaptive gaming refers to the modification or creation of video game equipment, controls, and setups that allow people with disabilities to participate in gaming in a way that fits their abilities. Instead of relying on traditional controllers, which often require fine motor control, strength, or two-handed use, adaptive gaming uses an array of customized input devices such as large switches, soft-touch switches, sip-and-puff devices, and joysticks with customized shapes, sizes and/or modified resistance. These tools can be plugged into adaptive controllers, such as the Xbox Adaptive Controller or Sony Access Controller, to create individualized setups. In addition to hardware, adaptive gaming also includes software-based accessibility features such as remappable controls, controller assist modes, visual and auditory adjustments, and simplified game play options. Positioning and ergonomics play an important role as well, with mounts, stabilizers, and wheelchair-compatible setups designed to support comfort and function.
Adaptive Controllers Basics
The first thing you will need to begin into adaptive gaming is an adaptive controller. An adaptive controller acts as an alternative to a standard controller. Adaptive controllers feature larger, more accessible buttons, and multiple input jacks allowing you to connect individual buttons and joysticks that best suite your needs. The three major adaptive controllers on the market are the Xbox Adaptive Controller (XAC), the PlayStation Access Controller, and the Hori Flex for Nintendo Switch.
The Xbox Adaptive Controller, created by Microsoft, serves as a customizable hub designed for players whose conditions limit their ability to use a standard controller. It features large, easy-to-press buttons and an array of 3.5 mm ports and USB inputs that allow users to connect external switches, joysticks, pedals, or other assistive devices, making it highly adaptable to a wide range of motor abilities.
This controller can be used with a wired or wireless connection to current generation Xbox consoles or PC (Windows 10/11). It can also be combined with an additional Xbox Adaptive Controller or with a standard Xbox Controller.
Sony’s PlayStation Access Controller is designed for the PlayStation 5 and offers a modular, circular layout with swappable button caps, adjustable stick configurations, and extensive customization through the PS5’s onboard accessibility settings. It allows players to arrange controls in ways that best match their physical needs and can be combined with an additional Access Controllers or paired with a DualSense controller for hybrid setups. This controller can be used with a wired or wireless connection to a current generation PlayStation Console.
The Hori Flex (Nintendo)
The Hori Flex, designed specifically for the Nintendo Switch, functions similarly to the XAC in that it provides a highly configurable hub with multiple 3.5 mm ports and USB inputs for external switches and joysticks. Using its companion software, players can fully remap inputs and create custom profiles.
Button Basics
(Pictured : Logitech Adaptive Gaming Kit for Access Controller (Pictured : Quadstick - UltraStik 360)
and Access Controllers)
Once you have an adaptive controller for your gaming system, users can choose from a variety of switches and joysticks to match their motor abilities, strength, and range of motion. The switches generally serve as a replacement for each individual button found on a standard controller. The joysticks also serve as a replacement for the respective joystick of the standard controller. Keep in mind, placement of each switch and joystick plays an important role in maximizing the user's ability to interact with each one.
Below are some examples of buttons/switches and joysticks that you may find for your adaptive controller. Note that this is far from an all inclusive list. Many switches are custom made using 3d printing, allowing for an endless variation in shape, size, activation force, and activation method.
Choosing Buttons and Joysticks
Large Button Switches
These offer a wide surface area and require light to moderate force to click. Ideal for players with limited strength and/or limited control of appendage movement.
(Pictured: AbleNet - Jelly Bean)
Mini or Micro Switches
Very small and sensitive, these require minimal pressure to activate. Best used for player's with very limited strength and/or movement of an appendage.
(Pictured: AbleNet - Micro Light Switch)
Foot/Floor Switches
Larger, durable switches designed to be activated with a foot or other lower-extremity movement.
(Pictured: Glassouse - GS04 Foot Switch)
Sip 'n Puff Switches
These are activated by the player performing a sipping or puffing action to activate. Note, strong control of mouth and breathing abilities are required.
(Pictured: Enabling Devices - Sip and Puff Switch)
Bite Switches
These switches are placed in the mouth and activated by biting down. Note, that these switches often require good muscular control over one's bite force.
(Pictured: AirTurn - Bite Switch)
Proximity Switch
A proximity switch works like a motion detector. To active this switch the player brings a part of their body within a set distance of the switch. This style of switch can work great for those with limited strength, preventing them from clicking a button.
(Pictured : Special Needs Computers - Contactless Proximity Switch)
Pad Switches
Pad switches are flat thin switches that require very little force to activate. With many sizes available, these could be a good choice for those with limited movement and limited strength.
(Pictured : Adaptivation - Pal Pads)
Joystick Basics
Joysticks With Removable Toppers
This style of joystick features a larger sized housing with various interchangeable shaped toppers allowing the player to interchange the topper for the shape that works best for their abilities.
(Pictured : Quadstick - UltraStik 360)
Touch Pad Joystick
Similar to a track pad on a laptop, this joystick senses the players touch, rather than requiring movement of a physical stick.
(Pictured : SevenMileMountain - GlidePoint Touch Joystick)
Xbox Adaptive Joystick
Recently released and unique to Xbox, this switch features a joystick with the ability to interchange the joystick topper. Additionally, the joystick includes a total of 7 buttons and seamlessly integrates with the Xbox Adaptive Controller.
(Pictured : Xbox Adaptive Joystick)
Mini or Micro Joysticks
A mini or Micro joystick is much smaller than usual joystick options. Great for player's with good fine motor control but limited range of motion.
(Pictured : SevenMileMountain - JoyCon Style Joystick)
Button and Joystick Placement
Strategic button and joystick placement is essential to an effective adaptive gaming setup as it ensures that the controls match the player's unique movement abilities, reduce fatigue, and support consistent and accurate inputs. Thoughtful placement of each button and joystick should be within the player's strongest and most reliable motion, while avoiding the need for excessive effort. We recommend that you trial many different methods and positions for the player to try. Creativity in placement may be needed. For example, rather than simply laying buttons on a table, buttons could be mounted to an adjustable arm or Velcro'd to a closer location.
(Pictured : All Access Life Xbox XAC Review)
Controller to Button/Joystick Compatibility Check
While compatibility may appear straight forward, it is highly important to confirm compatibility with the manufacturer. Especially when looking at more complex or multi functional buttons and joysticks as they may have unsupported features.
Xbox
The Xbox Adaptive Controller accepts switches using a 3.5mm inputs and USB 2.0 for both buttons and joysticks. This controller does not natively work with wireless buttons or joysticks.
(Pictured : Logitech Adaptive Gaming Kit for Xbox)
Sony
The Sony Access Controller accepts switches using 3.5mm inputs or USB 2.0. Joysticks with a 3.5mm input are compatible, however joysticks with a USB input is not compatible. The Sony Access Controller is not compatible with wireless buttons or joysticks.
(Pictured : Logitech Adaptive Gaming Kit for Access Controller)
Hori Flex for Nintendo
The Hori Flex accepts 3.5mm inputs for switches. Joysticks only work with the USB 2.0 input. Joystick compatibility is limited with the Hori Flex, as Nintendo's uses different components for their joysticks. The Hori Flex is not compatible with wireless joysticks or buttons. So, it is especially important to check with the manufacturer to ensure that the joystick is specifically made for the Hori Flex.
(Pictured : Pretorian Technologies - Optima Joystick)
Accessibility Settings
In addition to accessible controllers with external buttons and joysticks, all consoles offer a range of accessibility features within their system settings. These settings can assist users with a variety of impairments, through visual and audio modifications, as well as enhanced user interface options.
A unique feature offered by Xbox and PlayStation is Controller Assist (formerly Xbox Copilot) and Shared Controls (PlayStation), which allows two controllers to function as one. This enables a player to use two controllers simultaneously, opening up a number of adaptive setups. For example, a player could use a standard controller in one hand and have an adaptive controller setup for the other.
The feature can also allow a helper to assist a disabled gamer by splitting controls between the controllers. For example, in a racing game, a helper could control the gas and brakes with one controller, while the disabled gamer focuses on steering with their own adaptive controller.
Accessibility Feature Comparison
Additional Resources
Interested in additional Resources? Visit our Resource Page!
Have a question? Email us at umhsshpatatlab@health.missouri.edu
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