Vivek the DysTrophy Gamer

Welcome to my gaming accessibility deep dive. I’m Vivek Gohil an accessibility advocate and consultant who uses his expert knowledge and experience to advise game developers to include accessibility options for gamers with severe mobility disabilities.

I’m 31 and live with the degenerative muscle wasting condition called Duchenne Muscular Dystrophy, caused by my muscle fibres lacking the enzyme used to create or repair muscles called Dystrophin. I’ve used a wheelchair for over 20 years, it’s been pretty sweet transcending the ancient method of mobility called walking. Games usually depict wheelchairs with negative or scary connotations but truthfully, it’s my independence in tangible form.

Now at age 31, I’m left with restricted hand and finger muscle function, strength and flexibility. I have respiratory failure, so I require a ventilator to breathe for me all day. Energy Level Management is an essential part of my life, as I must regularly balance enjoying activities or moderating fatigue. Gaming is a huge passion of mine but as you can imagine it’s a constant challenge just to continue.

“You mustn’t allow yourself to be chained to fate, to be ruled by your genes. Human beings can choose the kind of life that they want to live.”

Metal Gear Solid

My first contact with videogames was at age 7 when I was introduced to Super Mario World on the Gameboy Color, I spent endless hours jumping around with my buddy Yoshi finding every secret.

The game with the biggest impact on me was Halo CE, it solidified my status as a gamer. Halo completely blew my mind, especially when you escape the Pillar of Autumn and crash land on the Halo array. The level of immersion in FPSs was impressive for that 10-year-old boy who was transported to a real alien planet. Obviously, I begged my Mum to buy me an Xbox.

Since then, I’ve owned a PS2, PSP, PS3, XBOX 360, PS4, XBOX ONE, PS5. I have always preferred the PlayStation controller as it was a comfortable fit for my small hands, the parallel stick configuration and buttons instead of triggers are easier for me to press. 

My all time favourite games:

  • Super Mario World
  • Mass Effect Trilogy
  • Halo CE
  • X-Men Legends
  • Ultimate Spider-Man
  • Star Wars: Republic Commando
  • Prince of Persia: Sands of Time
  • Simpsons: Hit & Run
  • Bastion
  • The Witcher 3: Wild Hunt
  • Batman: Arkham City
  • Red Dead Redemption
  • Bioshock
  • Infamous 2
  • Horizon Zero Dawn
  • Star Wars: Knights of the Old Republic
  • The Last of Us
  • Uncharted 2: Among Thieves
  • The Last of Us Part II
  • Marvel’s Spider-Man: Miles Morales
  • Assassin’s Creed: the Ezio Collection
  • Ratchet & Clank: Rift Apart

“We don’t get to choose how we start life. Real ‘greatness’ is what you do with the hand you’re dealt.”

Victor Sullivan (Uncharted 3)

Gaming is an integral mental health tool for me as it’s always been a coping mechanism. It helped me deal with the reality of my condition, escape my limited abilities, release frustration, experience activities that weren’t physically possible for me and created happiness. Alongside comic books it exposed me to morality, resilience, philosophical teachings about overcoming impossibilities, demonstrating the damaging implications of anger and allowed me to experience interesting futures.

Gaming shaped me into the person I am today and guided me to find my purpose in life: accessibility. I only discovered accessibility after the release of the PS4 due to the drastically different controller to the previous generation. It was heavier, bigger, button positions had moved, I found the buttons and sticks difficult to press or move. I’m the type of person to find solutions to my physical limitations so facing this impossible enemy was an unknown. Alongside additional muscle wastage, these issues forced me to conclude that the only option was to completely stop gaming. I felt for the first time in my adult life that Duchenne had finally beaten me. It was only after feeling depressed that I realised the emotional importance of gaming. It was a crucial lifeline so I had to find a solution to preserve my mental health.

Luckily, I discovered the Gaming Charity Special Effect who assisted me in finding the right setup. The OTs that visited me at home brought equipment that could help me, they quickly understood my difficulties and found the right setup. I highly recommend that if you require gaming help then you should definitely contact Special Effect.

“When you’re a disabled gamer, you must think outside the box when your abilities are inside the box.”

My Gaming Setup:

I’m going to provide a detailed insight into my unique gaming setup, the physical barriers I face and the solutions to those barriers.

Accessibility features are critical measures to limit fatigue alongside my specific setup which is another vital energy saving measure. My setup includes an adapted lightweight PS4 controller with light-touch buttons/triggers, loosened analog stick springs, 4 switch ports and a stand for my controller to rest on.

I’ve also raised the D-Pad Up/Left and TRIANGLE & CIRCLE buttons using sticky rubber pads to make them easier to reach, grip and press. I’ve created a lip on the R2 button using SuGru (Mouldable Clay) so that I can press R2 by twisting my right index finger without physically moving it off the default R1 button position.

I wouldn’t be able to game without this adapted controller, as regular strength buttons are nearly impossible for me to press and regular sticks would be totally unmovable. Without the stand I wouldn’t be able to press buttons as my arm and hand muscles would only be focused on holding the controller instead of being able to enjoy the game.  

The second part of my setup is a Titan 2 crossover device, which allows me to further alter my setup by creating personal accessibility options through the Gtuner software. It allows me to use my PS4 controller on any console and write scripts to:

  • Remap buttons
  • Create button toggles
  • Assign buttons to different directions on the sticks
  • Create button combos mainly used to press D-Pad directions or stick buttons
  • Split the Touchpad into Left or Right zones so when tapped they press either OPTIONS or TOUCHPAD

“I’ll show these people what you don’t want them to see. A world without rules and controls, without borders or boundaries. A world where anything is possible.”

Neo (Matrix)

Accessibility Options

Even though I can use the Titan 2 to write scripts for missing accessibility settings in games, these options should be already designed in by the developer. It took me months to learn the code, it’s time-consuming and you need to do mental gymnastics to find a comfortable remap for a game with a complicated control scheme.

The accessibility options that I use and gamers with a motor disability need are:

  • Button Remapping so controls can be altered to your preference but it’s good practice to show how your settings would affect actions requiring multiple presses.
  • Toggles so that multiple presses are eliminated especially useful when you lack flexibility or strength. Furthermore, keep in mind that if you have a weapon wheel toggle remember to allow it to be navigated using the left stick so gamers who assign that action to a face button can still choose weapons.      
  • Changing Holds to Taps, limiting length of press doesn’t seem much but each hold saps energy and would ultimately shorten play time.
  • Aim Assist or Aim Magnetism are extremely useful tools to limit right stick use when you lack precision or reflex speed. However, the issue with aim magnetism is that current implementation is quite strong and seems to target enemies at chest height even when hidden behind cover.
  • Slow-Motion when Aiming appeared in The Last of Us Part 2 and is an option that all games with aiming mechanics should implement.  
  • I always use Subtitles because the ventilator I wear/use is quite noisy so constantly disrupts my hearing.  

 “There is no innovation and creativity without failure. Period.” –

Brené Brown


Positioning is a vital element of my setup as my hands only work efficiently when placed in a precise position with the correct support. My setup relies on a table so that my hands and controller stand have a strong and secure foundation to rest upon. Due to poor circulation, my muscles don’t function once stiff or cold so before gaming I need to exercise my hands and shoulders to stimulate blood flow to bring warmth to my extremities.

I require 2 sponges placed on my wheelchair armrests to support my elbows whilst still allowing some movement. I also use 2 sponges to support my wrists, so that my hands are in a higher position than my controller stand so that I can reach the sticks without stretching my thumbs too far.

The controller stand doesn’t attach to the controller, it’s only used as support since I require free 360-degree movement to tilt, rotate or turn the controller as an additional way to move the sticks or reach buttons without having to regularly move hand positions. When gaming I must sit with my lower back supported by a small cushion so that my back muscles can just  be used for arm or hand mobility.

In-Depth Analysis of the DualShock 4

Legend: Yellow = No Button Adaptation Blue = Adapted Buttons

I will examine each button or stick on the Dualshock 4 controller, explain the reasons behind my difficulties pressing them and then present my solutions to the issues.

The CROSS button is physically easy for me to press whilst allowing me to quickly swap between the right stick for aiming. I’m also able to quickly press CROSS if a game requires speedy reflexes or rapid taps. I’d usually assign actions such as dodging, rolling, entering cover or crouching so I can perform sliding actions.

I’m able to press the SQUARE button quickly in a game requiring rapid taps whilst allowing me to quickly swap between the right stick so I assign actions like melee, dodge or reloading. In games with control schemes that assign light or heavy attacks onto R1/R2 buttons I usually remap heavy attack to SQUARE so I can easily swap between multiple types of melee due to distribution across 2 different fingers.

“Life’s greatest adventure is in doing one’s level best.”  

Arthur Morgan (Red Dead Redemption 2)

The CIRCLE button is easier to press so I assign actions like Interact, Crouch or Weapon Swapping. In games like Spider-Man pressing both TRIANGLE (Web attack) and CIRCLE (Dodge) activates a finisher. My thought process is that a simultaneous press of 2 face buttons using 1 thumb must be distributed across 2 fingers so I can consistently use the Finisher without frustrating input error, so I remap Dodge to R1 and swapped Web Attack to CIRCLE.

The TRIANGLE button is difficult for me to press quickly because it requires me to stretch my thumb and reposition my hand to reach the button, this means that I spend half a second to move my thumb back to the right stick position. So, I assign actions that are not necessary to use during combat (such as Detective Mode) factoring in the time delay. I can’t press TRIANGLE before quickly moving my thumb to press another face button due to the distance and slight alteration of hand/controller position.

Using the TITAN 2 software I usually create a combo to click either the TOUCHPAD or OPTIONS button by simultaneously pressing  SQUARE and CROSS. This combo doesn’t require me to move hand positions compared to when I assign it to tapping the left zone of the touchpad.

“The process is as important as the result.”

Legion (Mass Effect 2)

When gaming I can use both the RIGHT Stick (RS) and LEFT Stick (LS) at the same time, but I lack precision or aiming speed. I find pushing the LS fully in the right direction stretches my thumb so moving in that direction can be sluggish. To counterbalance lack of finger flexibility I tilt and twist the controller as an additional way to move both sticks. I also use the strafe technique (Moving side to side rather than moving the recticle) to enhance RS aiming as compensation for slower reflex actions. I have added a stick cap with spiky edges so that I can grip the LS from the side rather than stretching my thumb to rest fully on top which would drastically reduce speed when swapping between stick and face buttons.

Using the Titan 2, I write scripts to assign stick button presses (R3 or L3) to directions on the sticks as it’s a physical impossibility for me to click them. For example, I assign:

  • Sprinting (L3) to a quick full forward direction push of the LS.
  • Clicking the OPTIONS button to a quick full forward direction push of the RS.
  • Crouch (R3) to a quick tap of the backward direction push of the RS.
  • In games with a heal ability like Spider-Man I assign Heal (Up D-Pad) to a quick full backward direction push of RS. This solution is literally a lifesaver.

“You of all people should know there’s plenty wrong with me.”

Joker (Batman Arkham City)

The L1 Button is usually used for Aiming Down Sights (ADS) as my Left index finger has the strength to hold buttons down or for a single quick press. For example, L1 is assigned actions like dodging in TLOU2, blocking or parrying with your shield in God of War or countering in Batman Arkham series.

The L2 Button is pressed with my left middle finger which allows me to simultaneously use the action assigned to L1, however this finger can only tap buttons instead of button holds. I assign actions such as opening weapon wheels or ADS if the action assigned to L1 requires quick taps. For example, in TLOU2 dodging is mapped to L2 and is crucial to avoid damage but requires quick taps so I remapped it to L1 whilst swapping ADS to L2 due to a toggle option. Naughty Dog introduced the slow motion while aiming option which made it much easier for me to assign ADS to L2 without loss of precision.

“Perhaps you were expecting some surprise, for me to reveal a secret that had eluded you, something that would change your perspective of events, shatter you to your core. There is no great revelation, no great secret. There is only you.”

Kreia (Knights of the Old Republic 2)

The R1 Button is pressed using my right index finger which has the capability for finger speed, long duration holds or multiple quick taps for actions such as Firing a weapon, Melee attacks or Hot Swaps (You hold a button which opens an additional layer of buttons).

The R2 Button is also pressed using my right index finger, the adapted lip means that I can press R2 by twisting the finger rather than fully moving it. Due to gravity I’m able to quickly hold for actions like crouching, web-swinging, opening weapon wheels (without a toggle) or throwing/aiming grenades due to still being able to move RS. However, once I have pressed R2 there is a slight delay for me to move my finger back to the ideal position to press R1. Occasionally my finger gets stuck between the R1/R2 gap which causes a frustrating press error.

“I Chose More…I Chose The Impossible…I Chose Rapture.”

Andrew Ryan (Bioshock)

I’m able to stretch my left thumb to press DOWN or RIGHT on the D-Pad but it requires a finger position change, so it takes a second to shift my left finger back to the neutral LS position. It’s impossible for me to reach or press UP or LEFT on the D-Pad so I study a game’s control scheme to discover a button combination that wouldn’t hinder gameplay. For example, in Assassin’s Creed Valhalla to open the quick item menu you must press UP so I decided to create a combo by pressing both Interact (TRIANGLE) and Heavy Attack (R2) as Interact isn’t used for multiple purposes so wouldn’t affect gameplay.     

I’m physically unable to reach and click both the TOUCHPAD Button and OPTIONS Button so my solution was to write a script to split the TOUCHPAD into 2 sections so that I can click either button. In TLOU2 I didn’t assign a button to the left section of the TOUCHPAD because I wanted to benefit from the games swipe action remapping capability. 


Accessibility is the future. It continuosly evolves the gaming industry. Progress doesn’t just come from game developers or console companies but also from disabled gamers, our voice is powerful to enact change and will effectively continue to do so. I’m proud to be part of the fantastic accessibility community and to spread awareness of gaming with a severe motor disability.      

“Sir, Finishing This Fight.”

Master Chief (Halo CE)

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