You’d understand if Matt Victor had trouble finding time to talk about his latest passion. He has spent the last eight months exploring ancient tombs, traveling across the U.S. and honing his military skills on the battlefield. That would be exhausting for anyone. Yet Victor, a C1-2 quad, will eagerly drop all of those pursuits to rave about the QuadStick, a new sip-and-puff-based video game controller. After all, without the QuadStick, Victor wouldn’t have been able to embark on any of those adventures from the suburban confines of his Schaumburg, Ill., home.

“The QuadStick opens up a whole field of entertainment for quads who don’t have access to these kinds of things,” he says. “It’s such an amazing product. It’s opened up a gaming world for me that I never thought I’d ever have.”

Victor, 37, is one of the 58 percent of Americans the entertainment Software Association says plays video games. As a quad who uses a vent, he is part of a smaller but growing number of gamers with disabilities who seek happiness and refuge in those same virtual worlds.

With four video games systems, games strewn around the room and a large PC monitor connected to an even larger TV screen, there is little doubt that his room is just as much a gaming den as it is a bedroom. For years, Victor has been one of hundreds of gamers who have relied upon the QuadControl, a custom controller built as a labor of love by a retired engineer. Watching Victor’s oral acrobatics as he manipulates buttons and joysticks with the QuadControl is enough to make even the most accomplished flutist or sax player tip his or her cap.

But, like any good musician, Victor is only as good as his instrument, and the latest generation of consoles has pushed the available adaptive controls, including the QuadControl, beyond their limit.  “The games are so difficult now,” says Victor. “They require you to do two, three or four things at a time. You are pressing one button to sprint, another to jump and grab onto a ladder and then fire while dangling from a helicopter. Imagine trying to do that with your mouth.” Right now, there is simply no way for most gamers  like Victor to do that.

But for the last nine months, Victor has been testing the QuadStick. He thinks it has the potential to change everything.

Godfather of Accessible Controllers
If there is a godfather of accessible video game hardware, it’s 72-year-old Ken Yankelevitz. Never a gamer himself, Yankelevitz started modifying controllers because he saw a need, but stuck with it because he saw what a huge difference the games made in the lives of customers like Victor.

When Space Invaders and Atari started turning people into gamers in the early 1980s, Yankelevitz was busy designing flight control for commercial airlines for McDonnell Douglas. In his spare time, he rigged up a new controller for the Atari 2600 and peddled it to the company to see if they were interested. “They said they weren’t interested, but told me they had lots of inquiries from the disabled market [about controllers],” he recalls. “They asked if they could refer them to me, and I said sure.”

Yankelevitz was quickly in touch with many people with disabilities who were unable to use the Atari controller. His solution was to use a sip-and-puff controller for the button alongside an easy-to-use joystick. Since he was already gainfully employed, Yankelevitz didn’t worry about making a profit. He priced them starting at $75. They were a hit.

As new video game companies entered the fray, Yankelevitz adapted his QuadControl to meet their specific demands. He avoided doing one-offs, stuck to the sip-and-puff foundation and tried to keep it simple.

“The Atari was not that complicated,” he said. “That was just one sip and puff and a joystick. Then it went to Nintendo and you had two buttons and a joystick. That wasn’t too complicated either, just modify the old Atari joystick. Then came Sega with three buttons and a joystick, still not too complicated. Then came Sony.”

While all those companies were battling for video game supremacy, Yankelevitz was building a growing customer base of people who depended on him. At under $300, his QuadControl was the only affordable option for many gamers. Those who ordered one knew they could rely on personal service and help if anything happened to their unit. OTs and rec therapists were constantly calling him. Broken controllers needed fixing. All the while, he was looking for new testers at VA hospitals and rehab centers.

“People would come over to my house, pick up a controller and I would let them test it out. If that worked, that would become the model,” he says. He got to know many of his customers as friends and followed them as they grew from kids to adults. He worked with all types of people with disabilities, but developed a particular affinity for the more blue collar sector.

“It was these kids that were in the county system who didn’t have any insurance or any settlements,” he says. “I’d see them and say these are the guys that need the help.” He saw firsthand how having access to video games could have a positive impact.

“What motivated me was that video games leveled the playing field,” he says. He told the story of a customer who was mostly homebound after a gunshot made him a high quad. “His ability to have kids come over and play against him, that gave him a social contact that he wouldn’t have had if he just sat in the wheelchair in his house. Now, his friends would come over and hang out, and more importantly, he could play them as an equal.”

With his base of testers, Yankelevitz did his best to keep up with the new console systems despite their growing complexity. By 2001, the two leading systems, Sony’s Playstation 2 and Micorsoft’s XBox, each used controllers with two analog joysticks, a directional pad and as many as 11 buttons. For the PS2 QuadControl, that meant two sip-and-puff tubes — one with three holes, four lip buttons, a mouth-operated joystick and a toggle switch. His XBox 360 control had all of that plus three extra switches. Yankelevitz never ceased to be amazed at his customers’ ability to use his creations.

“Most of my customers over the years have made that controller work better than I ever believed they could make it work,” he says. “Once they got online, with the XBox and the Playstation, they were able to play over the Internet against people who didn’t know they were being beaten by a mouth control.”

But even with all of those switches and wires, newer games often required joystick-button combinations that simply weren’t feasible for the QuadControl. While Yankelevitz worked on solving these new issues, he dealt with another, even more difficult obstacle: Parkinson’s disease. He kept wiring the time-consuming controllers right past his 70th birthday, but after wiring what he guesses to be around 700 controllers over the last three decades, he recently decided it was time to stop.

Visitors to his website now will find a note in red italics, “Attention: Valued QuadControl Customers. I am not taking orders now due health reasons but may in the future.”

Seeing the Need
With a white beard and a jovial smile, you’d be more likely to peg Fred Davison as Santa Claus than a savior of accessible gamers, but he very well might be the latter. Despite a long career working with microprocessors and software development, Davison, 60, posits that he missed the video game era by a decade. His road to gaming started about 10 years ago watching his mother deal with ALS. Her speech left her, then her mobility deteriorated. “She had been so active,” he says, “and now she was just bored. That was hard to watch.”

Davison considered writing software to help his mother speak and interact with her environment. He ended up deciding the existing technology was as good or better than he could have hoped to achieve. His mother eventually died, but Davison’s eyes had been opened.

“It was the first time I’d really looked at computers being used to help people out,” he says. “I saw how they could directly help a person and I wanted to make a difference.”

Davison was reading the paper in his Great Falls, Mont., home in the summer of 2011 when he came across an AP article on Yankelevitz and his impending retirement. Video games seemed like a perfect way to help people with limited entertainment and social options.

“There’s a total social aspect to games today that didn’t exist, say, 10 years ago,” Davison says. “People play with each other, on teams or against each other, and while they’re playing they may be chatting back and forth. So for somebody that’s stuck in one place, it would give them a way of associating with other people. It could make it so much easier for them.”

Not only did taking on Yankelevitz’s shoes fit with Davison’s skillset, but Yankelevitz lived less than three hours away in Bozeman, Mont.

“It all kind of hit me at once when I saw the article. I thought this was something I could do. The elements that went into the joystick were all elements I had been working with,” he says. “I called him up right away and sent him an email that night. He called me the next morning. Then we started talking and within a couple of days I went down to his place and saw how he built them.”

Quadstick Levels the Field
Yankelevitz saw Davison as a possible successor. Davison saw a world of potential for the controllers, while also realizing he would need to overhaul Yankelevitz’s design. Using circuit boards and powerful microprocessors, he could easily ramp up the controller’s abilities.

Davison laughs when he recounts the “kitchen sink” approach he used in his early prototypes. Working out of his downstairs workshop, he created a behemoth half video game controller and half environmental control. The initial design had ethernet, wifi, relay outputs, displays and more. Davison sought out testers who could give him feedback and educate him about gaming and what disabled gamers needed.

With no one to fix a broken controller following Yankelevitz’s retirement, Victor’s brother found Davison’s website. “I was desperate,” says Victor. “I told Fred, ‘I will be your guinea pig. I will turn this controller into whatever it needs to be.’”

Victor’s experience as a gamer and his high level of paralysis made him the ideal candidate to test the QuadStick. “I figure if Matt Victor can use it, any C4 or C5 can do it, too,” Yankelevitz postured.

The initial model showed Davison he had a lot of learning to do about his customer’s limitations. “I had my mouthpiece set up so he could lean forward and bite it, and (I figured) Matt would be able to reach over and grab the side,” Davison says. “Well, that wasn’t going to happen — there was a scramble right at the beginning to get it usable.”

Despite the early learning curve, Victor immediately saw the potential in Davison and the QuadStick. “The QuadStick allows me to play anything that’s out there. It has the ability to control all the buttons for pretty much every system,” he says. “It’s not completely seamless, but it’s pretty close. It’s not anything that any quad could have ever done before.”

Victor’s feedback sent Davison back to his workshop. He slimmed down a bunch of superfluous options, focused more on the controller aspect and made some key additions, including a voice control feature that would allow gamers to execute multi-button combinations. He also added more holes for the sip-and-puff, a bite switch and a sleeker design. The changes have taken the controller “light years” beyond the QuadControl, according to Victor.

Instead of settling to play sports games and games that didn’t require the most complex joystick combinations, Victor is now trying his hand — make that mouth — at the latest games. That includes many online multiplayer games that he couldn’t keep up with using previous controllers.

Victor’s first experience playing a first person shooter game online ended with one of his teammates “swearing at him like nobody’s business” because he was unfamiliar with the setup,  but the mere fact he was able to play was a big step for gamers with similar disabilities.

“It puts them on the same level with other gamers,” he says. “With practice, they could be exactly the same as any ‘able’ gamer out here. When I play my brothers I don’t want to lose; I’ve beaten them plenty of times. They beat me, I beat them. The QuadStick equals the playing field.”

Getting the Product to Market
After over two years in development and months of testing, Davison introduced his product to the public with a crowdfunding campaign on Kickstarter on February 4. The goal was to raise $10,000 to fund the construction of 25 QuadSticks for further testing and more feedback. Just over 24 hours later the project had met its goal. By the time funding closed, Davison had raised $27,905 from 336 backers.

Yankelevitz contributed $5,000, as did AbleGamers, a nonprofit whose mission is “to improve the overall quality of life for those with disabilities through the power of video games.” Since its inception over 10 years ago, AbleGamers has been trying to open the eyes of game developers and publishers to the needs and potential of the disability gaming audience.

“For those of us who can’t go and see a sporting event or a concert, or are stuck in a facility or homebound, video games become a very cheap alternative form of entertainment that can provide hours and hours of bang for your buck,” says AbleGamers COO Steve Spohn.

Spohn hopes the QuadStick will help fill the gap left by the “surprising lack of hardware manufacturers” focused on addressing the needs of the disabled. Spohn makes it clear that beyond hardware and software issues, a bigger obstacle to increased access for gamers with disabilities is getting the industry to see the potential market it is missing out on.

“Until we really get it through to them that this market has money that it wants to give to them, they’re never going to listen,” he says.  “It doesn’t matter if every developer has a heart of gold, if the publishers still say it’s either the accessibility options, or a video that might sell more copies, it’s the video that’s going to make it.”

(We reached out to Sony and Microsoft through multiple channels for this article, but neither responded.)

Yankelevitz understands the money side of the equation, but says he is still surprised the big players never embraced the potential of the disabled market more. “I hope that Microsoft or Sony will see Fred’s controller and get involved with it,” he says.

Victor is equally excited by the product’s potential. “There is nothing comparable on the market,” he says. “It’s such an amazing product … I don’t even think we’ve tapped its full potential yet.”

To that end, Victor continues to test new games and new controller configurations to see what works best.

Davison is also hard at work. In addition to troubleshooting and modifying the existing QuadSticks based on Victor’s feedback, he has been building many parts of the next wave of 25 controllers. He finally got access to the contributed funds in mid-March and will use them to order the supplies he needs to finish. He still thinks the May ship date he promised to his backers is achievable.

Going from one test unit to 25 will surely present logistical problems, but Davison sounds excited about the
project’s growing potential. He has talked with Yankelevitz and others about what it would take to ramp up production. With more volume and more automation, he thinks the controllers could be profitable selling for as little as $400 — significantly less than many other alternatives currently on the market.

“It would be a really rewarding business to be in,” he says. “This technology could lead to other products to help disabled people control the environment around them.”

Still, for now, Davison is not in for the money. The overwhelming public response to his Kickstarter only reaffirmed the selfless reasons he initially got involved. “It got me from the moment I read the article about Ken. I thought that the same might happen with other people, and it really has.”

For Victor, the explanation of why he has spent so many hours testing the controller and working with Davison is even simpler — “What else am I going to do? This is my life.”

A Gamer’s Take

Joseph Giampapa reviews games from an accessibility angle for the AbleGamers website. Giampapa, 22, has been a gamer his whole life. He didn’t let a C6-7 injury in 2009 change that. “Gaming is something that can help people through tough times and take their minds off stuff,” he says. “It did that for me.”

Like many gamers with some mobility but little to no hand dexterity, he eschews a custom controller and tries to play with as few adaptations as possible. “It helps me feel a little more independent,” he says. “It’s not that I’m against using that stuff, but at the level I play games, I don’t think I really need it.” Giampapa plays lying down or slouched and uses his palms to control the joysticks. He says this approach works well for role playing games and some other, slower genres, but doesn’t give him the precision needed for some faster games.

Despite using a normal controller, Giampapa wishes developers gave players more control over accessible settings, including key mapping (allowing players to determine which button does what), colorblind options and font settings. “For big companies to not include that stuff shows a lack of oversight and a commitment to doing the bare minimum,” he says. “I don’t think developers should have to design their games around the needs of everyone, but I think there should be settings to tailor the game for different needs.”

Playing video games with friends and online has always played a big role in Giampapa’s social life, but having a spinal cord injury has changed the nature of that role.

“Before the accident I had a lot more people around me. Now that I’m stuck at home more, [playing video games] definitely does give me that social interaction,” he says. “Playing online games and hearing that other person’s voice really brings that experience of being in a group of friends. It helps fulfill that void where I’m not in a group of friends as often as I used to be.”

Gaming can also provide positive reinforcement.

“It makes me feel good to be as good as everybody else, [even] with a disability,” he says. “I’m a competitive person and there is a sense of accomplishment about overcoming the odds that are against me.”