Gaming can be more than just a hobby. It’s also a way of bringing people together—be it in a quick Halo capture the flag round or a Mario Kart grand prix. It’s a way to relax and reflect. After a stroke, traumatic brain injury or spinal cord injury, the well-worn standard controllers may not make sense to use. Strength, hand, and finger positioning may have changed. Fortunately, adaptive controllers from console manufacturers have become more widely available for consumers. This advancement has bridged a gap and allowed everyone to game once more.
QLI is proud to have a budding adaptive gaming group that brings together clients who share a passion for games. In these sessions, clients have the chance to utilize and test out major adaptive controllers, getting an idea for how they can best meet their gaming needs. Testing the adaptive controllers provides gamers with ideas about products that will work once they graduate from their inpatient rehabilitation program. Xbox and PlayStation adaptive controllers are in use, along with third-party 3-D printed attachments compatible with the Nintendo Switch.
Read on to see what these major controllers offer, any shortcomings they may have, and where they can go from here.
Xbox
The Xbox adaptive controller, released in 2018, provides a rectangular surface with two large buttons (typically corresponding to the “A” and “B” buttons), along with a large D-pad and menu buttons along the left side. On the back are 19 jacks for assistive device input, corresponding to every button on a normal controller. Simply put, there is a great opportunity for customization. The caveat is that cord management can be tricky to ensure no interference with the other functions.
“QLI was fortunate to meet individuals on the controller development team,” says assistive tech specialist Olivia Ollis. This collaboration enabled the QLI team to better understand key adapters to utilize, as well as a guide on how to put together a joystick. Microsoft has recently released a joystick compatible with the adaptive controller, leading to smooth 360-degree operation.
PlayStation
The PlayStation adaptive controller—Access controller—was released in 2023. Structurally, it contains two large pads, with a ring of buttons along the outside. These buttons (along with the center) can be mapped in any way. Additionally, the buttons feature a joystick. Up to two controllers can operate simultaneously (one for each hand), and there are ports for adding more devices. It is also possible to double-map a button to cover the use of two buttons from a normal controller. However, unlike the adaptive Xbox controller, it is limited to the PS5 and doesn’t lend itself to experimentation with other consoles.
Nintendo Switch
Nintendo lags its competitors and industry peers when it comes to providing accessible controllers. As of 2025, there are no adaptive controllers from Nintendo available for either the Switch or Switch 2. Adaptive gaming is still possible using tech options like the Xbox adaptive controller (along with adapters, some of which can be 3D-printed).
Categories: Adaptive Technology