Ultimate Guide to Accessible Gaming

If you consider yourself a disabled gamer, know someone who is a gamer, or would like to start gaming, this ultimate guide is for you! This ultimate guide to accessible gaming aims to give you the knowledge and tools to game the way you want to or to help a friend or family member who’d love to be a part of the gaming community. I have also written this to guide game developers in making their games more accessible. This guide is designed to be updated as products and technologies advance and as we learn more from our community, so check back periodically for more information.

Note: Some of the links provided here are Amazon affiliate links. This means that we get commissions on any purchases made through links in this post. We encourage you to do any additional research as you need prior to making a purchase decision. 

In this guide you will find the following:

Current Accessibility Features

As of 2023, many videogame consoles now sport a slew of accessibility features that are pre-baked into their systems. Whether a game supports them or not is another matter. However, the aim of this section is to bring your awareness to these features so that you can adjust your console to suit your needs as best as you can before buying any potentially expensive assistive tech products. 

Microsoft – Xbox Series X/S

Microsoft is by far the leading company when it comes to accessible gaming. In addition to the accessible gaming controller (which will be covered in the 3rd section of our guide), Microsoft has integrated a slew of different features into their console. Such features include: 

  • Narrator – a screen reader that provides audio descriptions based on what is happening on screen 
  • Magnifier – allows you to adjust the size of whatever is on screen 
  • Custom closed captioning – allows you to customize how subtitles/captions appear on screen for any support DVDs, Blu-ray, and streaming apps 
  • High contrast/Screen brightness adjustment – aids in distinguishing what is on screen 
  • Controller customization – includes button re-mapping and turning on/off vibration 
  • Copilot – a setting that allows two controllers to act as one. This is perfect for couch co-op play for normally single-player games or to allow someone with a motor impairment to use other parts of their body to play.

    Here is a video of one gamer using copilot to play with her brother. This video from LauraKBuzz goes into more depth of how Copilot is used for motor impaired gamers. 
  • Speech-to-text/Text-to-speech – converts in-game voice chat into text and vice versa 
  • Audio adjustments – includes muting certain menu navigational/notification sounds as well as a Mono output instead of stereo 
  • Color filters – applies a general filter to the screen to make it friendlier for gamers who are color-blind 

For more information, check out Microsoft’s Accessibility settings page

Sony – Playstation 5

Sony’s baked-in accessibility options are fairly basic and are fairly similar to how Microsoft handles their baked-in accessibility features minus the Copilot feature. However, there is a specific accessibility settings menu. This can be found by going to the “Home” screen, selecting “Settings” then “Accessibility.” These features include: 

  • Screen reader – provides audio descriptions based on what is happening on screen 
  • Magnifier/Zoom – allows you to adjust the size of whatever is on screen 
  • Custom closed captioning – allows you to customize how subtitles/captions appear on screen for any support DVDs, Blu-ray, and streaming apps. 
  • Text adjustments – includes adjusting text contrast, size, and even auto-scrolling, and adding a visual check mark on enabled settings 
  • High contrast/Screen brightness adjustment – aids in distinguishing what is on screen 
  • Controller customization – includes button re-mapping and turning on/off vibration. These options are available for all of Sony’s controllers including the PSVR2’s controllers 
  • Speech-to-text/Text-to-speech – converts in-game voice chat into text and vice versa 
  • Turning on/off motion effects – great for those who may get motion sickness easily
  • Audio adjustments – includes muting certain menu navigational/notification sounds as well as a Mono output instead of stereo 
  • Color filters – applies a general filter to the screen to make it friendlier for gamers who are color-blind 

More info on Sony’s accessibility settings can be found on Sony’s Accessibility settings page

Nintendo – Switch

Nintendo is lagging a bit behind when it comes to accessibility, which is a shame considering it is the 3rd-bestselling console of all time. It should be noted that the Switch does not have a dedicated accessibility setting. Instead, to make things more accessible, you will have to go to different menus to address your specific gaming needs.

With that, the following options are available on the Switch: 

  • The Joycons – due to their size and ability to function separately from each other, Nintendo’s joy cons can be positioned to suit your needs. Ideas on how to position joycons can be found in this Washington Post article 
  • Button remapping allows you to adjust the functioning of each button to suit your needs. This option is only available for joycons and the Switch pro controller 
  • Invert Colors/Greyscale – helpful for those with any visual difficulties 
  • Standard/Vivid Display mode – as it sounds like, adjusts the brightness of the Switch’s built-in screen 
  • Lower Maximum Headphone Volume – adjusts the volume settings to prevent things from being too loud when gaming with earbudes/headphones 
  • Zoom – enlarges various aspects of the screen to increase readibility. 

Make Use Of has a great article on these specific settings titled “How to Access the Accessibility Settings on Your Nintendo Switch.” 

In-Game Accessibility

Gaming has come a long way since the early days of Pong, Tetris, Zelda: A Link to the Past, etc. etc. Now we have very complex worlds to dive into with complex camera controls, button combos, and a plethora visual and audio effects. These features, like audio or visual effects, can be a core aspect of the games.

But if these games were not designed with disabilities in mind, they can alienate an entire audience of gamers. So, what in-game accessibility features should you be on the lookout for? In this section, we will break down these settings by disability category: Deaf/Hard of Hearing, Blind/Low-Vision, Motor, and Cognition.

Note: Because accessibility setting/settings in general have no specific requirements to meet, these settings are based on both my 20+ years of experience as a gamer and ideal functions of each setting. 

Deaf/Hard of Hearing

Those who are Deaf or Hard of Hearing would have difficulty hearing game and cutscene dialogue as well as audio cues for key actions that take place, such as in Sekiro: Shadows Die Twice, where a perfect parry makes a distinct metal-on-metal clashing sound. For gamers, this can mean missing out on important moments in a game’s story or a crucial timing in gameplay that would allow awesome follow-up attacks. So, to make a game more accessible the following settings are things you want to look out for:  

  • Adjusting volume settings. Ideally volume settings would include: 
  • Master volume – Typically adjusts all sounds in one go. Great for making everything louder after adjusting each setting individually.  
  • Effects – Adjusts any sounds related to non-speaking and non-music audio. This can include sounds related to footsteps, the metal-on-metal sounds from Sekiro, gunfire, wind blowing, etc. 
  • Voice – Adjusts audio related to NPCs (non-playable characters) and PC (player character) as they talk and interact with each other. 
  • Music – Adjusts the music that plays during gameplay and cutscenes. This would be a good setting to adjust if audio mixing is particularly terrible, overriding the sounds of dialogue or any needed effect sounds that communicate important gameplay cues
  • Audio input:  
    • Mono – This setting makes it so left and right sounds all come through one channel (most noticeable when gaming with a headset). This is helpful for those who may have specific hearing deficits in one ear over the other.

      Some games split audio to be left or right specific such as when walking past a talking NPC. You may hear the audio from both left and right but as you walk past them, they’re now on your right side. This causes the dialogue to come through only on your right side.
  • Subtitles: Most games only have a toggle of “enable/disable” or “yes/no.” These typically just provides subtitles for dialogue, though some also indicate ambient sounds like wind blowing in the forest.

    Ideally, subtitles indicate who is speaking and pairs it with colored names to better communicate the speaker.
  • Much less of a setting but more of a tip for game developers but include visual effects when planning out your gameplay mechanics.

    This better communicates key gameplay moments so that the player understands when to pull off a combo or to back away from attacks. Again, Sekiro does something similar and that is a game notorious for difficult but fair gameplay mechanics 


For blind and low-vision gamers, many settings that can assist deaf/hard of hearing gamers apply here. These include: 

  • Audio sliders would be music, dialogue, effects, and a master volume 
  • Colored subtitles that indicate specific speakers between main characters, NPCs, enemies, etc. 

More specific to blind/low-vision gamers include: 

  • Color-blind modes: These settings are admittedly not always the best, as most games put on a general filter to the screen 
  • High contrast modes: This setting “highlights” your character, companions, enemies, and other necessary interactables. This is a newer setting more likely to be present in 1st-party games such as Sony’s God of War Ragnarök. 
  • Adjusting font sizes and types: Again, less games provide this option, but it is essentially what it states. This setting allows players to adjust fonts to make subtitles bigger or smaller as well as the type of font the subtitles are displayed as. 

For developers, while hand-written text found in things like lore notes and books look aesthetically pleasing they should also be “translated” into dyslexia friendly fonts like arial, times new roman, or calibri. 


For those with motor disabilities, developers have been adding a few accessibility features. Though, you may get more mileage looking through the peripheral’s section as there are a plethora of assistive tech to help you game. That said, here are some features to be looking out for: 

  • Alternative button inputs: Button-mashing is a gameplay mechanic found in a lot of modern games, however, some games like Sony’s Spiderman series, allow you to hold down a button instead of mashing them  
  • Toggling to crouch: Many FPS games have this option where you can press down till you hear a click on the thumb stick or hit control (if you’re a PC gamer) to go into crouch instead of click-and-holding to sprint or crouch 
  • Remapping: More games are including this, but this option simply allows you to remap your controls to better suit your needs 


Perhaps a more overlooked part of gaming accessibility is cognition. Cognition for those unfamiliar is essentially our brain’s ability to react to situations, make decisions, remember important events, numbers, or clues and understand what is going on in the world around us.

Features to look out for in games include: 

  • UI Adjustments: This option allows you to change different elements of the User Interface (UI) to show more/less information on screen, keep certain elements on while others fade away and appear only at specific times/contexts 
  • Hint timer/button: Particularly helpful when solving a puzzle in a game. This setting allows you to adjust how long it will take for a hint to pop-up or even provides a button you can press on your controller to feed you a hint 
  • Bolded/Colored subtitles: Similar to the blind/low-vision and deaf/hard of hearing settings, bolded/colored subtitles are helpful to identify who is speaking as well as any key items to be aware of. 
  • Auto-prompts: This is for game developers. If you require a passcode or a manual answer input to solve a puzzle/access the next area, either automatically fill out the answer or have the answer pop-up when the player discovers the answer.

    This facilitates gameplay for those with memory challenges. If a player does not like it, then make the option toggleable with the default set to on! 
  • Difficulty settings: This is a controversial one for sure. Many games are now including a “story mode” as a replacement for “easy mode.” But for games that do have them, choose the difficulty setting you feel is right for you. 

    For games that don’t, such as FromSoftware games (Dark Souls, Bloodborne, Elden Ring, etc.), there may be character builds or items in-game to make it easier. 

    Difficulty settings are definitely a point of contention in the gaming community. I plan on writing my thoughts on this debate in an upcoming article. To be notified of when this article is posted, make sure you sign up for our newsletter

Assistive Technology Ideas and Products

Like the previous section, we will be categorizing each assistive tech (AT) ideas and products into the following categories Deaf/Hard of Hearing, Blind/Low-Vision, Motor, and Cognition.

Note: I am not sponsored by any of the companies that produce these products. This information is purely informative, and your miles may vary depending on the product and the additional services their parent company provides 

Deaf/Hard of Hearing 

  • 2E1 Headphones: Developed independently by a reddit user named u/Biblos_Geek created headphones that create true stereo audio for those who are single-sided deaf.

    They have a variety of models and is open to communicating with customers to find the best set-up for them. You can find their products on his official page


  • Screen Magnifiers: If you like to play games on your phone or tablet, then a screen magnifier may be the cheapest way of enlarging your screen to make it easier to see and read. Because these are just larger magnifying glasses, visual quality may look weird from certain angles. From my research, this screen magnifier is the best in design overall (Note: we do receive commission for any purchases made using our Amazon links).


  • Xbox Adaptive Controller (XAC): This is the big-ticket item for many gamers. Essentially, this controller acts as a hub to plug in many of your pre-existing peripherals such as buttons, sip-n-puffs, and joysticks. The XAC is compatible with PC as well and can be compatible with other consoles (like the Nintendo Switch), however, it does require additional peripherals to set up. 

    To purchase one follow any of these links:
    Best Buy or Target 
  • Flex Controller: This is the officially licensed Nintendo accessible controller. While Nintendo does not make it themselves, it is guaranteed to work for the Switch. It functions similarly to the XAC and can also be used for the PC.

    You can purchase it from AbleGamers 
  • Quadstick: A controller specifically made for those with quadriplegia. This is compatible with all “hub” devices (like the XAC and Flex controller).

    You will want to look into the Quadstick FPS Game Controller or the Original Quadstick Controller. The FPS controller allows for more precision aiming due to a “more rugged joystick module” according to Quadstick’s official website.

    Here is a comparison video that goes over both: 
  • Tobii eye-tracker: An eye tracking program that allows users to control what is done on screen with their eyes, though the use case depends on each game.

    That said the Flex controller does have software (called FCEA) that allows this program to be used when playing on your Switch.

    The Tobii Eye Tracker 5 is their latest product and can be purchased using this link. Tobii also has a YouTube channel that shows how the eye tracker can be used 
  • Project Gameface: Google’s open-sourced face tracking controller which allows gamers to use their facial movements as a controller.

    I’ve tried this out personally with Total War: Warhammer III and while it is still finicky, it does work, and I was able to almost win a custom battle with it.

    The good thing about this one is that it is free to use on your PC. You can download Project GameFace here. Just click on the latest version under “Releases” and follow the instructions provided. 
  • Project Leonardo (a.k.a. the “Access Controller”): This product is Sony’s attempt at providing an adaptive controller for their console. A release date has yet to be announced so we will need to wait and see how Sony’s attempt pans out.
    Information on this project can be found in this article.


Coming soon 


This ultimate guide to accessible gaming aimed to provide you with the knowledge and how-to’s on making gaming more accessible to you or a family/friend. As disabled gamers become more and more visible, large corporations such as Microsoft, Sony, and Nintendo are taking notice.

With that, we hope that you feel better equipped to meet your specific needs as a gamer. At OTernative Perspectives, we aim to provide content that can assist you (or a loved with a disability) lead the life you love.

If you or someone you know are seeking help on navigating the world outside of gaming, make sure to check out our other ultimate guides on Higher Education, Independent Living, and Employment.


  • AbleGamers Charity: https://ablegamers.org/ 
    • A non-profit organization that touches upon all aspects of accessible gaming including peer counseling, engineering research to create accessible controllers/peripherals 
  • https://gameaccessibilityguidelines.com/
    • Quick and easy website to look at inclusive game design elements, principles, and features. This is a great reference tool for those who may be interested in game development 
Author Nathan Baniqued, CEO and Founder of OTernative Perspectives

About the Author

Nathan Baniqued (he/him)

Nathaniel (Nathan) Baniqued OTD, OTR/L is an Occupational Therapist who received his doctoral degree in Occupational Therapy from Washington University in St. Louis, MO in 2023. Originally from O’ahu, HI, Nathan has had 7+ years of experience working with individuals with disabilities in various jobs and settings such as public education, supported employment, and outpatient clinics. The spark that began his desire to work with people with disabilities was after a medical event at 11 years-old when he was diagnosed with Chronic Kidney Disease Stage 3A.

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