When Mark Barlet realized there weren't many gaming resources available for a friend with multiple sclerosis, he and Stephen Spohn helmed a solution that would change countless lives. They created AbleGamers and turned a personal mission into a global vision of video game accessibility for all. "AbleGamers hasn't followed any path. We've created our own," Spohn said. He's AbleGamers' COO and has spinal muscular atrophy, which attacks his muscles and limits movement from the neck down.

The Fedex package arrived at Mark Barlet's home in Harpers Ferry, West Virginia, on Christmas Eve 2016. He opened the box and gingerly pulled out a sleek black-and-white device with two large buttons: a prototype for the new Xbox Adaptive Controller. He touched the logo and tears came to his eyes. "I couldn't believe it," Barlet tells me. "I said to myself, 'We fucking did it.' Barlet, 44, is a disabled Air Force veteran. He injured his spinal cord in 1996 at Andrews Air Base in Maryland. He can walk, but he suffers from chronic pain. One evening in 2004, he was at home playing the multiplayer game EverQuest II with a friend in Nevada who has MS. "Suddenly, her right hand just stopped working," Barlet recalls. She didn't regain mobility for months. Deeply affected by the experience, Barlet started emailing and calling game companies to ask about modified controllers and other assistive tech. What he learned was discouraging. Few major gaming companies had even considered developing consoles for players with restricted movement. Later that year, Barlet founded AbleGamers, an organization that advocates for accessible gaming options. Disabled gamers are a very real, very vocal demographic: AbleGamers estimates that there are more than 30 million of them in the US. But across all systems, videogame controllers are configured more or less the same: two thumbsticks, a D-pad, and a slew of buttons. Increasingly complex gameplay--think popular shooters like Call of Duty or fast-paced action games like Assassin's Creed--often necessitates rapid- fire button combinations, like tapping one repeatedly while pressing another, or moving both thumbsticks simultaneously. Motion controls, like those required for Nintendo's upcoming Pokémon: Let's Go games, are another challenge altogether. For years, the disabled gamer community has compensated with switches: devices that allow people with limited mobility to control a game using different parts of their body, like their head, foot, or mouth. But switches, typically made by medical supply companies, can be expensive--up to $200 apiece--and clunky. "A lot of them are comically large or look like a medical device," says Erin Muston-Firsch, an occupational therapist who helps patients with spinal cord and brain injuries at Craig Hospital's Tech Lab in Colorado. Other times, players make do however they can. Michael Phillip Begum is a 30-year-old gamer in Brownsville, Texas. He has a condition that prevents his muscles from growing, hindering physical activity. But for seven years he's been playing Street Fighter competitively under the name Brolylegs, moving a standard controller using his cheeks and tongue. Until the rise of social media, developers were clueless about how gamers with disabilities struggled, he says. "It was simply a choice we had to make.

More than 33 million people in North America play videogames with some kind of disability, ranging from colorblindness to missing limbs, according to AbleGamers, a nonprofit that pushes for more accessibility in the videogame industry. "Social media has made a huge impact on being able to spread awareness of our mission and to gain support," said Craig Kaufman, program director at AbleGamers, which worked with Microsoft on developing its specialized controller. Even so, accommodations for disabled gamers still aren't yet the norm, according to Ian Hamilton, an independent consultant who specializes in helping developers make games more inclusive. For such folks, "buying games can often be a lottery," he said. In recent years, game companies increasingly have added accessibility features, such as letting players remap buttons on controllers to suit their needs. In some games, it is possible for visually impaired players to alter the colors of characters, or for those who can't hear on-screen dialogue to turn on subtitles.

It leaked earlier this week, but Microsoft confirmed today that the Xbox Adaptive Controller is real, a device designed to "remove barriers to gaming by being adaptable to more gamers' needs." Created in conjunction with AbleGamers, The Cerebral Palsy Foundation, and more, it marks the first time a company's created an official first-party controller for people with limited mobility. Despite all the lip service people pay to the comfort of the Xbox One and DualShock 4 controllers, fact is they're unusable for a significant segment of the population--hard to grip, with lots of small buttons crammed into a small space. It works for many people, but not all, and prior to now the only solutions were expensive custom setups either hacked together at home or bought from a handful of third-parties. Enter the Xbox Adaptive Controller ($100 preorder on the Microsoft Store), which actually incorporates that hacker/maker vibe into an officially sanctioned product.

It's an exciting time to be Seven Siegel. Siegel is the executive director of Global Game Jam, the world's largest 48-hour hackathon, but more important, he's a former game developer with an MBA in nonprofit management. This makes him particularly suited to work in an emerging niche market blending philanthropy with cutting-edge technology: video game charities. There are dozens of charities in the video-game industry, including heavy hitters like the Gamers Outreach Foundation, which puts gaming equipment in children's hospitals around the nation; AbleGamers, which helps people with disabilities play their favorite titles; and Take This, which advocates for mental-health awareness in the gaming industry. And there are more community-led nonprofits popping up all the time.