Another flashy music video on YouTube, and this one’s been viewed hundreds of millions of times since its July launch. The viral phenomenon “Gangnam Style” by Korean pop star PSY has lots of flash, but surprisingly, only one instance of exceeding seizure safety guidelines.
In the problem sequence, images of PSY rapidly alternate with images of another Korean performer, Kim Hyun-a. Alternating between the bright, contrasting images at a rate of 3 times per second or more creates a flash effect capable of inducing a seizure.
The wildly popular“Gangnam Style” video was followed several weeks later by the release of a female version,“Oppa Is Just My Style,” that includes more sequences with Ms. Hyun-a. The second video has considerably more flashing sequences that could easily trigger seizures in individuals with photosensitive epilepsy.
In the upper left of the screen grab at left (click on it to enlarge) you can see a dance sequence that is being analyzed for seizure safety. The accompanying graph indicates levels of flash (luminance) that fail to meet photosensitive epilepsy safety guidelines. Visible at the bottom of the screen are the individual frames that make up the moving sequence. The flashing effect is created by the alternating frames of bright and dark images.
How come you haven’t heard about seizures from the #1 YouTube video?
- Viewers may not maximize the video to fill the computer screen. Therefore the image is too small to affect enough neurons to cause seizures.
- Viewers are not staring continually at the screen—maybe they’re laughing, doing the horse dance, or straining to figure out the lyrics
- The seizures are happening but without many outward signs, so they are not recognized as seizures.
If a neurologist tells you that you don’t need to worry about seizures from electronic screen exposure, because you’re not photosensitive, what does that really mean?
It means that when you were tested for your response to a white strobe light, an EEG didn’t detect a particular abnormal electrical pattern in your brain. (I’ve noted some limitations of this procedure elsewhere.) Epileptology looks for yes or no, typically relying on EEG to rule out epilepsy. If yes, possibly medicate; if no, it’s not a case the clinician will pursue.
It does not indicate that bright flashing and/or patterns from electronic screens don’t adversely affect your brain function.
Researchers have gradually come to consensus on exactly what the EEG must look like to indicate photosensitive epilepsy (the photoparoxysmal response): certain spike/wave patterns that appear in both brain hemispheres. In arriving at these criteria, researchers excluded three other types of EEG abnormalities that in prior research “qualified” as a photoparoxysmal response. Epilepsy researchers aren’t certain what the significance of these other abnormalities is, but because the other patterns cannot conclusively be associated with epileptic seizures, there’s little interest in further research.
So these other EEG abnormalities from photic stimulation don’t count, in current neurology practice, and nobody would even tell you about them if they were found in your EEG. You’d be told the EEG was normal, period. But what if these other abnormalities were a sign that neurological function is in fact disturbed by visual stimuli, but not to the point of a seizure?
Let’s say you had one of the three other EEG abnormalities (which you wouldn’t know about, because the EEG was deemed normal). Maybe these indicate that you’re vulnerable to symptoms of a visual-overload-not-to-the-point-of-seizures syndrome. Neurologists have been examining the overlap between epilepsy, photosensitive epilepsy, and migraines. More about this in a future post, but actually there are many overlapping symptoms and correct diagnosis can be difficult. So if video game exposure or photic stimulation produces headaches and visual disturbances, and an inconclusive EEG, it may be that the visual overload is triggering migraines. Or perhaps the exposure is triggering another form of hyperexcitability in the brain’s visual cortex, which has been termed visual stress. While research has been done on this, it’s not part of a conventional neurology practice.
What about patients with more subtle or mood-related symptoms of a visual-overload-not-to-the-point-of-seizures problem? Who is treating these patients? Could be psychiatrists and psychologists, who view altered behavior and cognitive function through the lens of their respective training. Because there’s such a dearth of research of the gray areas of brain dysfunction following exposure to electronic screens, mental health providers have no basis for treating these patients for anything but mental health disorders. It’s clear that more research is needed and that more effects on the brain will be uncovered. One intriguing paper explores the contribution of fluorescent lighting to agoraphobia. The SpongeBob study published last year showed diminished executive function in children who viewed the cartoon.
In her Psychology Today blog, psychiatrist Victoria Dunckley recently posted a compelling piece about the effects on her patients of electronic screen time. She recommends creating a diagnostic category called Electronic Screen Syndrome to identify a dysregulation of mood, attention, or arousal level due to overstimulation of the nervous system by electronic screen media. She has seen dramatic improvements in hundreds of patients’ mood, behavior, and cognition after they go on an “electronic fast.” (Some have underlying psychiatric diagnoses, some don’t.) Maybe these patients were having very subtle seizures from electronic screens. Maybe the effects on the nervous system weren’t quite what epileptology defines as seizures. Either way, many kids exposed to electronic screens are experiencing diminished quality of life (as are their families) for a problem that medicine has not yet acknowledged.
I read an article this week about video games designed to treat ADHD. The concept sounds appealing: use some time already spent on recreational video games to instead play therapeutic video games, and make ADHD treatment enjoyable enough that kids will stick with it. Another plus that developers point out is that treatment provided via games would not cause the side effects of ADHD medications. Games designed to improve some aspect of physical or mental health or performance are a fast-growing growing sector, and there’s even a scholarly research journal that launched this year, Games for Health Journal.
Video games are not without side effects, though, including seizures. ADHD, video games, and seizure vulnerability haven’t been studied together, but by piecing together some studies dealing with two of the three factors, the interconnectedness between them can be considered. So here is some information on ADHD and video games, and separately, information on ADHD and seizures. Put them together and think about about video games and ADHD being a risk factor for game-induced seizures. Developers of games to treat ADHD need to be conscious that the same neurological abnormalities that cause attention problems may also make people with ADHD more vulnerable to seizures from a video game.
ADHD and video games
Evidence is accumulating that exposure to typical (non-educational, non-therapeutic) video games is associated with later attention problems. It’s a highly charged subject, because scientists can never account for all possibilities and variables in a single study, and people tend to feel very strongly one way or the other about video games. A lot more study is needed because so little has been done that follows the same children over time. Based on findings including the following, the American Academy of Pediatrics issued cautions parents about video game use.
“…[A]mount of time spent playing video games is associated with greater attention problems…[B]oth television viewing and video game playing were uniquely associated with attention problems…[T]he total time spent with screen media (both television and video games) was positively related to attention problems.
…Exposure to screen media was associated with later attention problems even when earlier attention problems and gender were statistically controlled. This provides stronger evidence…that screen media may influence attention problems; controlling for earlier attention problems…rules out the possibility that the association between screen media use and attention problems is merely the result of children with attention problems being especially attracted to screen media.
…[T]elevision viewing and video game playing were associated with attention problems in both middle childhood and late adolescent/early adult samples…These similar associations across age groups raise an important possibility about the persistence of television or video game exposure effects on attention problems. Whatever the ages at which watching television or playing video games may increase attention problems, the consequences may be quite long lasting or cumulative.”
–Edward Swing et al., “Television and Video Game Exposure and the Development of Attention Problems” in Pediatrics, August 2010
ADHD and seizures
While findings from one study were announced regarding the high rate of photosensitive epilepsy in autism, no studies have been published on photosensitive epilepsy in people with ADHD. What studies do show, however, is that in people with ADHD seizures of all types occur at a much higher rate than in the general population. The findings suggest that environmental influences, including video games, could place people with ADHD at higher risk for photosensitive seizures.
There is increasing evidence and acceptance of some underlying brain dysfunction shared by epilepsy and ADHD, and people with one disorder have more than the usual risk of having the other condition as well.
As one study puts it,
“It is likely that there is a common neurobiological predisposition for both a lower seizure threshold and ADHD behaviors that may involve both genetic and environmental factors… We found a 2.7 fold greater incidence of epilepsy among children with ADHD than in controls.”
– Shanlee Davis et al., “Epilepsy in Children With ADHD: A Population-Based Study” in Pediatric Neurology, May 2010
Another study found that children with the predominantly inattentive type of ADHD have a risk of developing seizures that’s 3.7 times the normal odds. The odds for children with the combined type of ADHD, which includes inattention and hyperactivity, are 3.3 times the normal rate.
“ADHD precedes the development of epilepsy, and ADHD or its determinants must be considered risk factors for epilepsy.”
–Dale Hesdorffer, et al., “ADHD as a Risk Factor for Incident Unprovoked Seizures and Epilepsy in Children” in Archives of General Psychiatry, July 2004***
This was specific to the inattentive type of ADHD, which is presumably the intended market for video games for helping with focus, memory, screening out distractions, etc.
ADHD + video games = higher likelihood of seizures
I don’t know if games-for-health developers, particularly people working on ADHD treatment games, are more concerned about the seizure hazard than developers of games for pure entertainment. Presumably a therapeutic application’s on-screen action would not be full of strobe effects. Without seeing the games, though, it’s hard to know for sure about the kinds of screens and effects that are used to congratulate users on their score, signal the end of the game, etc.
Let’s hope these games don’t do harm in their efforts to do good.
***Note that “incident unprovoked” in the study title refers to means a seizure that is not provoked by a medical situation unrelated to epilepsy: a head injury, fever, intoxication, and so on. A photosensitive seizure triggered by flash is not considered provoked, because that is the nature of reflex epilepsies, that they are triggered by a sensory experience. The terminology is more than just confusing. Because the words trigger and provoke are close to synonymous, the use of “unprovoked” in defining seizures typical of epilepsy seems to to exclude reflex seizures. The terminology both reflects and contributes to the relegation of reflex seizures to the sidelines of clinical training and research funding and and perpetuates the perception that they are rare.
In a Taiwan Internet cafe last weekend, an 18-year-old identified only as Chuang died shortly after playing 40 uninterrupted hours of Diablo III. The exact cause of his death is still being investigated.
What would cause someone to lose touch with his surroundings so completely that a tragedy like this could happen? Whatever is found about the specific cause of death, the loss of this young man’s life is a reminder of the enormous power of some games to draw players in and keep some of them beyond spellbound.
To learn a bit about Diablo III, I read a review on GameSpot that was written shortly after the game’s release in May. In what is now a haunting foreshadowing, reviewer Carolyn Petit alludes a number of times to very positive game attributes that make players want to stay in the game. Staying in can turn dangerous when players lose all ability to connect with their judgment, their own bodies, and the world around them.
The problem with “irresistible” is that some people in fact absolutely cannot resist. Here are excerpts from the review:
- “The constant stream of gold and treasure you earn is irresistible. Blizzard has the recipe for crafting a habit-forming loot-driven action RPG down to a science, and in Diablo III, the results of that recipe are more exciting and more addictive than they’ve ever been.”
- “The rate at which you acquire new skills is part of what makes Diablo III so hard to pull yourself away from.”
- “It’s about employing those skills to slaughter the monsters you encounter as you travel the world, and collecting the loot the fiends drop. This is where Diablo III’s habit-forming pleasures lie.”
- “Loot is doled out at a pace that makes your victories fulfilling and makes fighting the next group of foes lurking in the shadows ahead nigh irresistible.”
- “The cycle of combat and loot and more combat is addictive, but without peril, it would eventually become unfulfilling. Thankfully, the hosts of hell become increasingly dangerous over time.”
- “You may ultimately be victorious at vanquishing the forces of hell, but if their true mission is to give you a compelling reason to sacrifice sleep as you keep clicking your mouse into the wee hours of the night, then they have won a decisive victory.”
I wonder if, since learning about what happened to Chuang, Ms. Petit has had any thoughts about what she wrote in her Diablo III review. Would she write it any differently now? In future reviews of other games would she write about their addictive qualities in the same way? Somehow, describing games with words like irresistible, habit-forming, hard to pull away from, and addictive doesn’t sound quite so positive anymore.
What does it take to put regulations in place that protect consumers from visually induced seizures? A lot, it turns out.
The characteristics of specific sequences and images that provoke seizures are essentially agreed upon by researchers. They have been incorporated by a UN agency–the International Telecommunication Union–into safety guidelines for flash rate, flash involving red wavelengths, and in some guidelines, high-contrast patterns. Any government, standards body, production company, game developer, or educational institution can adopt them without needing to develop expertise in photosensitive epilepsy.
The World Wide Web Consortium (WC3) is the international group that produces standards that enhance Web usability for all types of applications. Within WC3, the Web Accessibility Initiative (WAI) develops Web Content Acessibility Guidelines, which extend the Web’s capabilities to people with a variety of disabilities. Its Guidelines for protection of people with photosensitive seizures are based on the guidelines for flash and red flash that are now mandatory for UK television broadcasts.
I love the clear wording of this:
Guideline 2.3: Do not design content in a way that is known to cause seizures.
The WCAG standards have been adopted by about a dozen countries for government, and in some cases, other public websites.
Here’s how protections have been evolving in the UK:
- In 1993 three people in the UK reported seizures from a TV commercial for Golden Wonder Pot Noodle, and the British government responded by investigating what could be done to prevent another occurrence. The television regulatory agency put broadcast guidelines in place and has subsequently refined and updated them. The regulations apply to programming and advertising. These guidelines were used in developing the ITU guidelines.
- A few years ago Parliament took up the problem of seizure-inducing video games, in response to advocacy by a mother whose son had a game seizure, and her MP. Ubisoft in theUK, which markets the game, responded by publicly committing to producing seizure-safe games. The company has produced a set of guidelines for other game developers in the UKto help them comply with safety limits.
- The British Board of Film Classification, which screens movies prior to their release to rate films for maturity of audience, requests that film makers and distributors provide warnings to audiences about any sequences that could induce photosensitive seizures. When a scene in the Twilight Breaking Dawn movie caused some seizures in the US, the Board requested that notices be placed in British movie theaters.
- When the London Olympics logo was previewed in 2007, the promotional video set off seizures in some TV viewers, resulting in a big embarrassment for the Olympics organizers.
In Japan, following the Pokemon 1997 incident regulation was put in place for children’s television. (I have no details on this.)
So, now to where things stand in the US***:
- Websites maintained by Federal agencies and their contractors are now required to comply with accessibility standards for people with photosensitive epilepsy. Amendments to the Rehabilitation Act of 1973 (accessibility requirements known as Section 508}, which protects employment for people with disabilities, has adopted the WCAG 2.0 standards, designed to increase accessibility to people with disabilities. It’s a start, but because it applies only to federal websites, it doesn’t help the vast majority of Americans, and it certainly doesn’t help children.
- Photosensitivity protection is included in WCAG 2.0 thanks to the efforts of Gregg Vanderheiden of the University of Wisconsin’s Trace Center, which provides a free tool, PEAT (Photosensitive Epilepsy Analysis Tool) that can be used by any Web authors to check material on their websites. Using PEAT, which is based on the analysis engine of the Harding Flash and Pattern Analyzer, authors can check that their media and websites don’t provoke seizures. It’s not for use with commercial software, though, such as games.
- The 21st Century Communications and Video Accessibility Act was passed by Congress “to increase the access of persons with disabilities to modern communications.” Enacted in 2010, CCVA empowers the FCC to make our nation’s telecommunications equipment and services available to people with disabilities. The Coalition of Organizations for Accessible Technology was behind this legislation, with groups representing many types of disabilities pressing for their constituencies. Conspicuously absent: epilepsy advocacy groups. The inclusion of protections for people with photosensitivity was not specifically mentioned in the act. However, if the act or its implementers incorporate the Section 508/WCAG standards, or Section 255 accessibility guidelines (see Telecommunications Act of 1996, below) developed for prior telecommunications legislation, then the photosensitivity protections will apply. Otherwise, photosensitivity protection will not go anywhere without significant effort by national epilepsy organizations.
- The Federal Communications Commission (FCC) needs to adopt Section 508/WCAG 2.0 standards for video games played over the Internet, and broadcast and cable TV programming and advertising. Packaged software that doesn’t involve the Internet probably comes under some other agency, like the Consumer Product Safety Commission.
- The Telecommunications Act of 1996, governing telephone and internet service providers and telecommunications equipment including telephones, computers with modems, fax machines, etc., contains provisions in Section 255 for accessibility to people with disabilities. Section 255 includes recommendations for minimizing flicker and flash and keeping it within safe intervals.This doesn’t pertain to the content of applications, though, just underlying connectivity service.
- Is the prevention of photosensitive seizures under the jurisdiction of Centers for Disease Control and Prevention? Apparently the agency was at a meeting in 2004 regarding the possibility of regulation in the US.
When Congress has the will, that drives everything. Congress passed legislation giving a mandate to the FCC to regulate the loudness of TV commercials. The bill passed unanimously in the Senate and by a voice vote in the House! A year later (December 2011) the FCC voted unanimously to implement a set of rules prohibiting advertisers from making their commercials any louder than the actual programming. This is great–starting in mid-December when the regulations go into effect, we can all be less annoyed and our eardrums will be protected during TV advertising. Now, if we could only get some more attention paid to the public’s health when it comes to photosensitive seizures.
***My thanks to Gregg Vanderheiden of the University of Wisconsin’s Trace Center for ensuring the accuracy of the above.
Earlier this month in Los Angeles the annual E3 (Electronic Entertainment Expo) trade show for computer and video games was held, providing an opportunity for game companies to showcase products that will be released in the coming year.
On the basis of demos, official marketing trailers, interviews with developers, and, no doubt, heavy lobbying behind the scenes, reviewers and game publications then choose their favorites in various game genres/categories (shooter, puzzle, strategy, action, etc.) for the major hardware platforms. Widely read IGN.com, the website of IGN (which describes itself as “a leading online media & services company obsessed with gaming, entertainment and everything guys enjoy”) also selected what it considered the best trailers at the show.
A compelling trailer shows the latest/greatest/neatest special effects, story lines, and characters, packaging them in a way to draw in viewers and help create that all-important “buzz” of anticipation. Parents and others can have a look at the content, age appropriateness, and perhaps get a sense whether seizure-provoking visuals are likely to be present. So, which trailers got top billing by IGN, and how much risk do the trailers themselves pose for people with photosensitivity?
None of the 4 games named in the best trailer category were clearly seizure-safe—they all included visual sequences that could provoke seizures in some people. Three of the four didn’t actually fail the seizure safety test, but they contained sequences that flirted with the guidelines for photosensitive seizure safety, meaning that very sensitive individuals under the right circumstances could experience a seizure. When tested for seizure safety, the three runners-up were given neither a Pass or Fail—they received a Caution rating by the Harding Flash & Pattern Analyzer.
Best trailer of show? The guys at IGN chose Tomb Raider, which during its three minutes exceeded seizure safety guidelines for flashing a couple of times and came close to failing in others. In addition, the moving title at the end that explodes in a screen of solid red was close to going over the guidelines not only for bright flash but also for the amount of bright red on screen. When the game is released next March, it will most likely affect photosensitive players. Trailers aside, Tomb Raider was also selected as best overall game in show…
“I believe that when the science is in, we will see that people with autism are ‘canaries in the coal mine,’ the most susceptible, who are affected first by problems that may eventually reach us all.”
–from The Autism Revolution by Martha Herbert, MD, PhD, with Karen Weintraub (Ballantine Books, 2012)
Martha Herbert reasons in her remarkable book that the rapidly increasing prevalence of autism indicates the disorder can’t possibly be due to genetics alone. She makes the case, based on findings in diverse fields of medical research and on her own clinical experience, that autism is not a genetic trait destined to be lifelong. Instead, she’s suggesting that the rise in autism is a consequence of the environment we live in, and that many autism symptoms can be reduced by making environmental changes. It’s compelling reading whether or not someone you love has autism, because many of the environmental influences that probably contribute to autism will likely affect all of us in time.
While the development of autism may begin with genetic vulnerability, she argues, the emergence of the disorder begins after a tipping point is reached following a multitude of modern-day environmental exposures. The cumulative effects of these environmental stresses influence the expression of genes associated with autism, leading to a cluster of dysfunctions in the brain and body we call autism. Autism rates are sharply rising because the biological systems of growing numbers of young people are running out of the resilience required amid burgeoning environmental challenges.
Dr. Herbert explores environmental influences including toxins, emotional stress, infection, diet, and sensory overload. She cites many cases where people with autism got a lot better when specific changes in these environmental factors were made, thereby reducing stresses on the brain and body. Eliminating the right stressors, which may require considerable trial and error, can allow some children to become significantly higher-functioning, healthier individuals. (I’m a believer. I’ve seen for myself how powerful the effects of the environment can be. When the visual system of a child with hidden photosensitivity is no longer overloaded by daily video games, lives can be transformed.)
To be quite clear, I’m not suggesting that video games cause autism, nor does Dr. Herbert. But she says preventing seizures can be a major stepping-stone to wellness. This is true of course whether or not a person has autism, given the physical, cognitive, and emotional problems and the general unwellness following seizures. Dr. Herbert discusses seizures, though, because they are common among people with autism, and suggests some problem behaviors may be due to hidden seizures. Identifying them and finding ways to control them might be a key strategy that brings about big improvements in the autism symptoms.
Of course, f you’re looking to control seizures in people with autism, it makes sense to observe carefully for evidence of visually induced seizures. The only study done to date on autism and photosensitivity indicates children on the autism spectrum have much higher rates of photosensitive epilepsy.
While there’s not much you can do about the genes your child inherited, Dr. Herbert outlines many steps parents can take, beyond seizure reduction, to limit exposure to things that can exacerbate the symptoms of autism and may contribute to its emergence. While not every approach works for every child with autism, she provides a range of additional strategies such as eliminating gluten, dairy, or food additives, regulating sleep, getting rid of toxic household chemicals, and reducing sensory overload.
“Too much sensory stimulation, trouble being coordinated, not enough sleep, seizures, not being able to say what you want—all can contribute to frustration and stress. Looking for solutions at each of these levels can help reduce the stress and increase the time spent truly learning and enjoying life.”
Another thing: Dr. Herbert doesn’t assume that “no seizures” on an EEG means “no problem.” The consequences of brain waves that are “somewhere between ‘normal’ and ‘disease,’” she contends, could be “subtle but still important”–even if no seizures are triggered. In other words, even mildly abnormal rhythms in the brain, which can be provoked in some individuals by exposure to visual overstimulation, may result in impaired neurological functioning. Even if your child has not been experiencing actual seizures, Dr. Herbert says these abnormal rhythms due to excessive sensory stimulation from visual media may actually affect the brain’s ability to process information.
“…A lot of kids with autism might be having ‘gray zone’ electrical problems—too mild to meet the formal definition of seizures, but enough to interfere with their quality of life.”
These “gray zone electrical problems” are not limited to those with autism. Other populations likely to be in this gray zone include people with learning disorders, intellectual disability, or psychiatric conditions—the more vulnerable among us. In other words, it may not make sense to dismiss as irrelevant the EEG abnormalities that don’t have all the characteristics of seizures.
Whether or not your child is on the autism spectrum, if you have concerns about your child’s health and performance, try eliminating video games for a few days and see if your child begins to feel better and struggle less with learning, attention, emotions, and behavior. (Of course, your child may be initially resistant to this experiment, which will temporarily make things more stressful. To get a fair reading on the effect, you need a few days free of any withdrawal symptoms.) During this time all visually overstimulating media should be avoided, including fast-paced cartoons, movies, and music videos.
So, for those with children on the autism spectrum, reduce your child’s sensory overload. One way to do that is to limit screen time and content. For those whose children aren’t on the autism spectrum, take note. Using the canary-in-the-coal-mine model, we may yet learn that visual overstimulation can profoundly affect the functioning and health of increasing numbers of people. Could anyone in your family be affected?
It’s something to think about.
A piece last week in the Wall Street Journal questioned whether there might be effects on brain development when really young kids play with iPads and similar devices. The answer is simply: nobody knows. The article points out that
“…In many ways, the average toddler using an iPad is a guinea pig. While the iPad went on sale two years ago, rigorous, scientific studies of how such a device affects the development of young children typically take three to five years.”
and it quotes a couple of experts:
“‘There is ‘little research on the impact of technology like this on kids,’ says Dimitri Christakis, director of the Center for Child Health, Behavior and Development at Seattle Children’s Hospital….”
“’Unfortunately a lot of the real-life experimentation is going to be done by parents who now have young kids,’ says Glenda Revelle, associate professor of human development and family sciences at the University of Arkansas.”
The article was written by Ben Worthen, a father who was concerned about the trance-like state he and his wife observed in their 4-year-old son playing with an iPad. Worthen notes that it soon became a battle every night when his son was asked to turn off the iPad.
“’It gives him a dopamine squirt,’” says Michael Rich, director of the Center on Media and Child Health at Children’s Hospital in Boston, referring to the brain chemical often associated with pleasure. Many apps for kids are designed to stimulate dopamine releases—hence encouraging a child to keep playing—by offering rewards or exciting visuals at unpredictable times.”
Some people say that after all the dopamine rewards from video games, it’s not as easy to pay attention to activities that don’t deliver regular bursts of dopamine. And while many parents are pleased with the way educational apps appear to help with early learning, they also speak of their kids’ immersion for hours at a time. When I think of toddlers, it’s hard to come up with any other activities that hold their attention for that length of time. Maybe the toddler brain isn’t designed to focus for so long on one thing at a time when they’re exploring the world around them?
A few small studies have shown gains in vocabulary in young kids who used educational apps. Some researchers think the iPad may not have the same neurological effects as video games and TV, which the American Academy of Pediatrics has cautioned can be harmful in very young children, whose brain development is at a critical stage in their first few years. But the technology is so new, there aren’t any such studies yet.
We don’t really know what effect major doses of screen time has on older kids, either, or on adults. Kids growing up today with so much fast-paced visual technology from such an early age may display differences in brain development in ways we haven’t uncovered yet. The issue is much broader and more complex than whether or not these young brains are experiencing seizures brought on by video action. There could well be subtle changes in brain function that wouldn’t register as seizures but that affect processing nonetheless. More on that in my next post.
In the meantime I encourage you to check out the article that started off the discussion, with accompanying video and audio reports.
What do these massive, multi-player, online role-playing games (MMORPGs) have in common?
Guild Wars 2
The Secret World
World of Warcraft
I tested all of them for photosensitive seizure safety. Five out of these seven games tested within photosensitive seizure safety guidelines, meaning they’re unlikely to provoke visually induced seizures. Judging by what I found, this genre of video games is probably one of the safest, in contrast to, say, racing or shooter games. Those that failed contained just one failure apiece, based on what I looked at, anyway.
Lots of factors contribute to the risk of a game provoking seizures.Visual overload results from certain styles of directing (close-ups, quick cuts and zooms, overall pacing, image brightness), the artistic “look” (bold outlines, bright colors rather than a more “painterly” approach), and production (maximizing speed, violence, and explosions). In general the MMORPGs show a wide-angle view of the action, which lessens the visual impact of each individual blow, shot,or explosion that is shown with a screen flash. The scenes are built by designers who pride themselves on the careful crafting of the game’s elaborate and fantastical story lines, landscapes, creatures, and structures. The pace is slow enough for players to appreciate the scenery and plan strategies.
To get an unbiased sample of MMORPGs to examine, I turned to the GameSpy newsletter. Its current issue contains reviews of seven highly anticipated video games to be released or updated this year. I decided to test those. To determine whether these games could provoke seizures, I downloaded official marketing teasers and trailers plus gameplay clips from the Web and submitted them for analysis to the Harding Flash and Pattern Analyzer. I have no financial interest in any of the companies involved in developing, producing, testing, or marketing any video games.
Admittedly, I’m not using rigorous sampling techniques. I don’t have a staff of reviewers or statisticians to ensure total methodological correctness in this investigation. So here’s what I did. If the FPA found no problem segments in the first trailer I looked at for a particular game, I tested another trailer or clip for that same game. My thinking was that if one trailer/clip contains no seizure-inducing segments, that doesn’t mean another clip would fare the same. In the case of World of Warcraft, though, I looked at four or five trailers that all passed the FPA. At that point it seemed reasonable to judge that the game is probably not teeming with undiscovered flashing material.
On the other hand, if I came across any material that failed the safety test, I didn’t feel the need to look for additional samples of that game just to show it has safe sequences, too. If a developer/publisher demonstrates unsafe video sequences in a trailer used for marketing, that suggests there may well be more unsafe material. Assuming the trailers posted online are reasonably representative of the game content, this exercise in looking at trailers can provide some idea of how risky the games might be, photosensitive seizure-wise.
Here are the results. And the disclaimers. The results are based on only the visual sequences I downloaded to be analyzed by the FPA software. Your results may vary! Certainly other excerpts, levels, expansions, versions, etc. of any given game may produce different results, as may extreme levels of photosensitivity. And any game using anime style–whether it calls itself an MMORPG or not–is very unlikely to be safe. With all the disclaimers, what is the value here? It’s exactly this: if you have any concerns about the possibility of video games triggering seizures, it does seem that for the most part this type of game presents a lower risk than fast-action close-up shooting and racing. I’ll look at these other genres in upcoming posts.
TERA – some segments stayed just inside the safe zone, and its Frogster (European publisher) logo-in-motion didn’t pass
Passed, but limited “footage” was available for testing
World of Warcraft
Civilization V – 1 brief sequence noted in 3 trailers/gameplay clips
The Secret World — 1 sequence noted in 3 trailers/gameplay clips
Click on each screen for a better look at images (upper left) within video segments that could trigger photosensitive seizures. Degree of compliance with seizure safety guidelines is shown in the line graph, where anything beneath the horizontal line falls within the guidelines.
“Kanye West loves strobe lights,” cooed the Huffington Post the other day, reporting the release of the performer’s most recent flash-filled music video. “…the Chicago rapper…seemingly earns an epilepsy warning with every new project. His new video for the not-so-new song ‘Lost in the World’ certainly doesn’t deviate from the pattern.”
Apparently he loves strobe lights so much that–despite being informed, two music video releases ago–that his flashing visuals provoke seizures in some viewers, he is determined to use these effects anyway. Wow, you have to really respect a man who refuses to let the health of the viewing public get in the way of his artistic freedom. The Huff Post article continues in the same admiring tone: “…the rapper is known for his emphasis on quality videos (his half-hour ‘Runaway’ short film was perhaps the biggest statement of the rapper’s visual aesthetic).”
The rapper’s acknowledgement of a potential seizure problem has followed a strange path. In February 2011, accounts of seizures triggered by West’s “All of the Lights” video spurred UK-based Epilepsy Action to request that the video be removed from YouTube. In response, the video was temporarily removed and a warning was placed at the beginning:
This video has been identified by Epilepsy Action to potentially trigger seizures for people with photosensitive epilepsy. Viewer discretion is advised.
A year later the “N—-s in Paris” video was released with this same warning, although Epilepsy Action was never contacted about it.
And now there’s a warning at the beginning of the “Lost in the World” video that doesn’t even explain why the warning is important for viewers. All it says is:
Warning: Strobe effects are used in this video.
I expect Epilepsy Action will probably make a statement regarding the risks of viewing this latest release, and perhaps take issue with the less-than-explicit warning that was provided. How about some advocacy in the US? It’s time to confront the very preventable public health problem created by strobe effects in entertainment media.