In 1984, Def Leppard drummer Rick Allen lost his arm in a tragic car accident. Considering his role in the band there couldn’t have been a worse injury to suffer. Many looked at him and were convinced that this was it. How does a drummer drum without two hands? Allen, determined to continue his career with the popular rock group, persevered. With the help of friends and people within the music injury, he was able to develop a drum kit specially designed so that those actions he would have once performed with his left arm could be replicated with his left foot. In 1986, Allen returned to the drummers seat and the band went on to continue their success, selling millions of albums and remaining popular, even today.
It might be hard to imagine ever playing video games without the benefit of two, or in some cases, any hands at all, but similar feats of recovery can be found throughout the gaming world. Men and women who were born with physical disabilities or suffered grievous accidents restricting their bodies have been able to find alternative methods of control to help keep them in the game. Modified video game controllers have even been used to help injured war veterans through physical therapy. Wii-hab, as some professionals who have integrated Nintendo’s motion controlled console into health care call it, has become more and more common. Tech whizzes have even found ways for injured gamers to play games like Guitar Hero, using controllers adapted for their physical handicaps.

The development of accessible controllers isn’t a new idea. Tinkerers, generally working independently from the mainstream gaming industry have been working with video games since the days of the Atari. Ken Yankelevitz was one the earliest people working in this field. He began his work in 1981, when Atari referred him to a quadriplegic teenager who, lacking the means for conventional recreation, wanted to play video games. He would go on to do much more of this work through his company KYE, designing custom controllers based on the personal and individual needs of each client, a process which has grown increasingly complicated as games and controllers have advanced.
The alternative methods of control have become more complicated as time has progressed. While in the past the needs of disabled patients could at times be accommodated for via simpler fixes like bigger or differently placed buttons, the difficulties of modifying the increasingly multi-buttoned controllers used by modern consoles have become more prominent with time.
"The way I interface to the different game consoles is by wiring into one of the manufacturer’s game pads and connecting my custom setups to the game pad. The Atari was very simple: Start, Select, one button, and an 8-way joystick. Now the game pads have twelve switches and two analog and one digital joystick. Since some games use all these operations I try to offer them on my custom setups," said Yankelevitz.
The part I find most interesting is that MS/Sony/Nintendo won’t help out third party companies at catering to this audience.