New York Magazine’s Top Ten Video Games? Half ignore seizure safety guidelines!

thumper

Thumper, #9 on New York Magazine‘s top ten games list, has many flashing images that could trigger seizures in users. The image here is seen during a sequence that failed the seizure guidelines compliance test.

Five of New York Magazine’s top ten video games of 2016 don’t meet guidelines for reducing the risk of visually provoked seizures. Developers of these popular games could have designed the visuals in a way that lowers the seizure risk to users, but didn’t.

Guidelines for reducing the risk of seizures triggered by video images were published in 1994, when the UK required that all TV programs and advertisements meet those visual safety standards. The same guidelines for making television images safer could easily be adhered to when developing video game visuals. No regulations on seizure-inducing images in video games have ever been enacted, so game developers have no incentive to work within the guidelines.

Instead, for many years game publishers have provided a seizure warning that makes it extremely difficult for consumers to take legal action in case of a seizure. Some games may in fact conform to seizure-reduction guidelines, but because the seizure warnings appear on all games, consumers can’t know which ones are riskier. The warnings began appearing in 1991 in response to the first video-game-seizure consumer lawsuits.

What compliance with the guidelines means

Many popular games don’t meet the guidelines, as demonstrated by my testing of New York Magazine‘s favorite games. A couple of the failing games were among the top five first-person shooter games selected by Forbes.

Thumper, Overwatch, Hyper Light Drifter, Uncharted 4: A Thief's End, Doom, Inside, Firewatch, Kentucky Route Zero Act IV, Owlboy, Overcooked

New York magazine’s top ten video games for 2016

I tested video clips from gameplay and promotional trailers for the games on the list using software that identifies video sequences that don’t comply with the guidelines. The software is designed for game developers and video producers to test their moving images for compliance.

Note that for the games that didn’t violate the guidelines, rather than list them as passing the compliance test, I’ve indicated that they did not fail the test. Although in previous posts with test results I’ve listed games that “passed” the guidelines test, I’m no longer using that terminology. That designation could too easily be misinterpreted to mean that such games will definitely not cause seizures.

Even if a game doesn’t fail the guidelines compliance test, there is still a risk of seizures, for several reasons:

  • I may not have tested a portion of the game with problem image sequences
  • The guidelines aren’t fool-proof. They are designed to prevent seizures in approximately 97 percent of people who have photosensitive epilepsy, the condition where visual stimuli can trigger seizures.
  • Many environmental and personal health variables–such as lack of sleep or illness– can affect an individual’s vulnerability to seizures

Do you need to worry about seizures from video games?

  • The vast majority (97 percent) of people diagnosed with conventional epilepsy can play video games without risking a seizure because–unless their EEGs indicate otherwise–their seizures aren’t triggered by visual effects. These people don’t want others questioning their fitness for gaming.
  • People with no history of epilepsy may be most at risk. Seizures can be triggered by flash and flicker even in people with no history of seizures, which means that many don’t know they are at risk of having a visually triggered seizure until a video game brings on their first event. Of the children who had seizures during the 1997 Pokémon cartoon broadcast in Japan, only 24% had previously experienced a seizure.
  • Visually triggered seizures typically begin between ages 2-18, and most commonly begin around age 12-13. Of patients age 7-19 who seek medical attention for a seizure, ten percent test positive for photosensitive epilepsy. Researchers estimate that only 25 percent of people outgrow the condition, typically in their twenties.
  • It is relatively unusual but not unknown for these seizures to develop in adults. Because in many individuals a number of factors (for example, emotional state and hormone levels) affect seizure vulnerability, a seizure may not actually occur until several of these factors are present simultaneously. Even one seizure can be life-changing if it results in injury or permanently bars an individual from certain occupations.
  • It is also possible to experience subtle seizures and not realize they happened. This doesn’t mean there are no seizure consequences, though. Typically after seizures one’s physical, cognitive, and emotional functioning can be impaired.

More on the guidelines and how games are tested for seizure risk

Want to know more about how I test video games? Read here. Or read more about the image safety guidelines.

 

 

 


5 top first person shooter games of 2016 fail seizure safety guidelines test

2016-top-5-shooter-games, Call of Duty: Infinite Warfare, Battlefield 1, DOOM, Titanfall 2, Overwatch

These five video games were chosen by a Forbes reviewer as the best first-person shooters of 2016. None comply with guidelines for reducing the risk of visually triggered seizures.

None of the five video games picked by a Forbes reviewer as the year’s best first-person shooters meet safety guidelines for reducing the risk of visually triggered seizures.

The fast-moving, flashing images in these five games could provoke seizures in people whose seizures are triggered by visual stimuli, due to a sometimes hidden condition called photosensitive epilepsy. I tested image sequences from these popular games using software designed for checking the adherence of images sequences to the seizure reduction guidelines. All five failed.

Game developers could — should — use this same technology to build products compliant with the guidelines! The application I used to test the games for compliance isn’t a consumer product; it’s intended for developers.  But product developers instead place seizure warnings on games and consoles. People with no history of seizures don’t pay much attention to seizure warnings. Why would they?

Consumers don’t know they may be at risk. Reason #1

This bright flash is seen during a Doom image sequence that fails to meet seizure reduction guidelines.

This bright flash is seen during a Doom image sequence that doesn’t meet seizure reduction guidelines.

Photosensitive epilepsy most often develops in adolescence and remains hidden until it’s activated by particular stimuli and circumstances. If earlier in life visual stimuli didn’t trigger an event, how does one know that’s no longer true?

According to one study, 74 percent of individuals with photosensitive epilepsy first learn they have the condition when they experience a seizure in the presence of flashing lights or another visual stimulus. This study was based on the histories of hundreds of children who had seizures during a 1997 Pokémon cartoon broadcast in Japan.

Sometimes the first seizure triggered by a video game can have life-changing consequences. A Navy pilot who played Oblivion, had a seizure that produced injuries and resulted in permanent loss of his flight clearance. Think of the medical testing he underwent before he was trained to fly–obviously his seizure vulnerability had not yet developed.

Reason #2 consumers don’t know about their risk

A problem sequence in Call of Duty: Infinite Warfare is created by a flicker effect of changing background light in this scene.

A problem sequence in Call of Duty: Infinite Warfare is created by the flicker effect of alternating background light in this scene.

Some seizures aren’t noticeable. This means that included in the 74 percent who (think they) never had a prior seizure, there are some people who may already be experiencing them without realizing it. Subtle seizures involving no body movement may not draw the attention of others nearby, either.

People with no history of seizures aren’t aware that undetected seizures exist and therefore may dismiss any unusual physical or mental sensations while gaming. If the seizure causes a loss of awareness for a few seconds, the person will not be “present” at that moment to recognize what’s happening or remember it later. For more on undetected seizures, see the section “Research shows people often don’t detect their own seizures” in this post.

Note that undetected seizures as well as more obvious events can bring on a range of disabling physical and cognitive after-effects and mood changes that can linger for days.

Reason #3

When the area on the screen lit by a flash and the time interval between flashes exceed guidelines for seizure reduction, the image sequence fails the assessment. This screen shows test results for Titanfall 2.

This screen capture from the Harding Flash and Pattern Analyzer, which I used to assess guidelines compliance, shows test results above the horizontal pass/fail line.

Not all video games violate the image safety guidelines. Even though video games typically carry seizure warnings, the warnings don’t reflect the seizure risk of any particular game. Unfortunately, consumers have no way of knowing which games are in compliance and which are not.

Let’s say you’re an informed consumer, aware that some games can pose a seizure risk and you’d prefer not to take that risk. You understand that a game with lots of bright flashing is more likely to be a problem, but you can’t really know whether a specific game that you want to play is more likely to trigger seizures. How can you play only games that meet guidelines and avoid only the noncompliant ones? (This is where the testing I can do can identify certain cases of noncompliance.)

Also…

  • The vast majority (97 percent) of people diagnosed with conventional epilepsy can play video games without risking a seizure because their seizures aren’t triggered by visual effects. These people don’t want others questioning their fitness for gaming.
  • Want to know more about how I test video games? About the image safety guidelines? Read here.
  • For the record, Forbes states that opinions of contributing writers (such as this guy who picked the five games) are their own, not the magazine’s.

Photosensitive epilepsy in the 2016 election

convention balloonsIn recent weeks photosensitive epilepsy received some media attention because of two developments in the 2016 presidential campaign. Who would have thought? While the public probably didn’t learn much about photosensitive seizures in either case, perhaps both situations contributed something to public awareness of seizures triggered by certain lighting effects and images…

Clinton’s blue sunglasses

After Hillary Clinton’s widely publicized medical emergency on September 11, various bloggers and political writers rushed to speculate about possible causes of the episode. Photos of Clinton taken that day showed her wearing sunglasses that appeared dark blue, and some people wondered whether the glasses provided a clue to an undisclosed medical condition.

Hillary Clinton attending September 11 ceremony in New York

Visits to this blog surged for several days. More than 95 percent of the nearly 24,000 visitors from September 11 – 13 read two of my prior posts about blue lenses that protect against visually induced seizures. A few readers questioned whether the sunglasses seen on Clinton were the type worn to prevent photosensitive seizures.

My answer was maybe yes, but probably not. Since photos of Clinton that day showed her wearing them outside during the day, they weren’t likely worn for seizure protection. Flickering light doesn’t generally trigger seizures outdoors in daylight and good weather—for flicker to occur there has to be an extreme contrast of light and darkness in rapid succession. It’s certainly possible to have photosensitive seizures triggered outside in daylight, in specific situations: sunlight reflected on a body of water, or a line of trees seen from a moving vehicle, where sunlight is broken up by trees alongside the road. But Clinton was not in those settings when wearing the glasses.

Seizure-inducing images tweeted by angry reader

In a separate election-related incident, the matter of photosensitive seizures was taken in a troubling direction. In response to articles he wrote critical of Donald Drumpf, Newsweek journalist Kurt Eichenwald received a menacing tweet from an unhappy reader that referred to Eichenwald’s epilepsy and included an embedded video of flashing images. When the video started, Eichenwald dropped his iPad before a seizure could develop.

It certainly wasn’t the first time seizure-inducing images were placed online for the purpose of triggering people with photosensitive epilepsy, but it’s the first instance I’m aware of that’s tied to this rancorous political season. Criminal defense attorney Scott Greenfield claimed in his blog that the episode qualifies as an attempted assault. “Yes, even Twitter can be used to commit an assault, regardless of whether Eichenwald was a victim,” he wrote.

For more on the legal and technology issues raised by the tweet to Eichenwald, check out this Future Tense article, in which UC Davis law professor Elizabeth Joh concludes, “…the existing tools of criminal law probably do address a tweet likely intended to harm its recipient or to create a reasonable apprehension of fear in him.” But she adds, “That doesn’t speak to the likelihood of prosecuting the troll, which may be low.”


Video games inspire theme parks

Mass effect poster

Mass Effect: New Earth debuted May 18 at the Great America theme park in Santa Clara, CA.

People who have photosensitive epilepsy probably are already cautious about going to amusement parks, since lots of rides and other attractions feature fast-moving lights and flashing images. Now there’s another reason they should be wary: video game-based attractions are coming to amusement parks, and some of those games have seizure-inducing images.

“The game manufacturers and game designers want to have a place to show their games at a scale that you can’t do in your house,” according to the CEO of Cedar Fair Entertainment Company, which owns 11 amusement parks. To put it another way, they’re blowing up the visuals of an action video game with seizure risks, and displaying those images on a huge screen!

Here’s the problem with that: Images on an oversized screen have a greater impact on the brain’s visual cortex than the same images viewed smaller. This means that even if a person with some degree of visual sensitivity plays Mass Effect on an Xbox, without incident, that person would be more likely to experience a seizure at the theme park attraction.

Games don’t comply with seizure guidelines

The Mass Effect attraction’s 60-foot screen, behind a live actor (lower right) who's part of the show

The Mass Effect attraction is viewed on a 60-foot screen, behind a live actor (lower right)

An attraction based on BioWare’s Mass Effect opened last month at California’s Great America theme park—on a 60-foot LED screen. Curious about whether the at-home games contain potentially seizure-provoking images, I tested** the images in promotional trailers for Mass Effect 3 and Mass Effect 4. I found violations of seizure reduction guidelines in both. A 15-second commercial for Mass Effect: New Earth also fails the test for compliance with the guidelines.

Plants vs. Zombies Garden Warfare

a frame from the Plants vs. Zombies Garden Warfare PlayStation launch trailer

At North Carolina’s Carowinds amusement park, “the world’s first intra-active 3-D game experience” Plants vs. Zombies Garden Warfare: 3Z Arena opened in March. It’s shown on screens measuring 14.4 x 26 feet.

The attraction is based on the Plants vs. Zombies franchise. In my tests, some clips from the Plants vs. Zombies Garden Warfare game violate seizure reduction guidelines. I didn’t have video I could test of the park’s big-screen experience.

When designing an attraction based on a game with seizure-provoking images, shouldn’t the theme park industry be especially mindful of patrons with photosensitive epilepsy? Warnings at the park about rides that could be hazardous to patrons with certain medical conditions such as pregnancy, heart conditions, or epilepsy aren’t enough. Many people don’t even know about their vulnerability to seizures from certain visual effects until they have an unmistakable seizure. Not all seizures are easily noticeable! And even small seizures that aren’t seen can leave impairing after-effects.

Coming next: Entire theme parks based on games 

Video game-based attractions at amusement parks are expected to multiply. Universal Studios and Nintendo signed a deal last year to bring Nintendo-based attractions to Universal’s theme parks. The first of these, slated for 2020 completion, will be a whole section of Nintendo-based attractions  at an existing theme park in Osaka, Japan. Industry observers suspect that Universal’s recent land purchase in Orlando is intended for a Nintendo-based expansion of its Universal Orlando theme park. Ubisoft has announced an entire “next generation theme park” scheduled to open in 2020 in Kuala Lampur, Malaysia, with rides and attractions based on its portfolio of game franchises.

**Seizure reduction guidelines and testing images for compliance

You can read about seizure reduction guidelines here–they were developed in the UK to reduce the risk of seizures induced by TV. All material broadcast on UK television must comply with the guidelines.

To test images for the likelihood of provoking photosensitive seizures, I run downloaded video clips through an application called the Harding Flash and Pattern Analyzer. (Graham Harding is one of the world’s leading experts on photosensitive epilepsy.) The FPA is widely used by producers and networks in the UK—including by the BBC—to reduce the risk of seizures from material on broadcast TV.

The analyzer examines video sequences frame by frame for very specific and measurable image qualities that researchers have found can trigger seizures. When such images are found, it displays  and indicates the specific frames that violate seizure reduction guidelines. Violations occur with:

  • rapidly alternating light and dark images (flash/flicker)
  • certain stripes and geometric patterns with high contrast
  • large areas of very bright (“saturated”) red
  • problem images take up more than one quarter of the total screen area

 


Video game images migrate to movies

Hardcore Henry poster

Hardcore Henry was filmed in the style of a first-person shooter game.

Terrible idea. Take a genre of video games—first person shooter– that is especially likely to provoke seizures. Make an action movie filmed entirely in that style. Put it on the big screen for release in theaters. The larger an image is, the greater the area affected in the brain’s visual cortex, and therefore the risk of visually triggered seizures is increased in those who are vulnerable.

Hardcore Henry opened (and in most cases, also closed) in theaters this month. It’s described by the student newspaper of Washington College as 90 minutes of “non-stop chase scenes, splatterhouse shootouts, and barely comprehensible fistfights that often end in ridiculous dismemberment.”  Glenn Kenny’s New York Times review explains the film’s R rating thusly: “for not letting a minute pass without subjecting one character or another to grievous bodily harm or worse.”

I suppose it’s possible to produce such subject matter without seizure-inducing images, but given such descriptions of the content, I wanted to check. Without going the movie. So I tested** the movie’s promotional trailers for compliance with seizure reduction guidelines. The guidelines were designed to protect all but 3 percent of those who may have seizures triggered by visual stimuli. After watching the trailers (I do not have photosensitive epilepsy), I was not at all surprised that the movie does not comply.

FAIL in red from FPA

This is hardly the first movie to include images that could trigger seizures. But based on the trailers and reviewers’ accounts of a relentless pace of action, most likely there are many potential seizure triggers during the film. Researchers of photosensitive epilepsy believe there is a cumulative effect on the brain; the risk of a seizure increases after prolonged exposure to potential triggers.

“non-stop chase scenes, splatterhouse shootouts, and barely comprehensible fistfights that often end in ridiculous dismemberment.”

Review: “non-stop chase scenes, splatterhouse shootouts, and barely comprehensible fistfights that often end in ridiculous dismemberment.”

Strong stomach required

Many reviewers of Hardcore Henry cautioned readers about motion sickness. One reviewer interviewed the movie’s producer about apparently significant (yet not entirely successful) efforts to minimize it. The producer said those efforts were begun long before film production began, with many tests and test screenings.

Some representative remarks:

“…many people are going to feel ill when they try to watch Hardcore Henry on the big screen…make sure everyone in your party either has no issue with motion sickness, has taken their Dramamine, or rolls into the theater with an empty stomach…” — The Daily Dot

“…as I waited for my nausea to subside, I began to appreciate the dastardly marketing plan built into Hardcore Henry: It’s essentially a dare to see if audiences can finish the whole thing without throwing up.”  — Vox.com

“Hardcore Henry will probably go down as the film of 2016 that is most likely to make you feel nauseous from watching it (due to motion sickness, that is, not the gory, over the top violence).” — Screenrant.com

Back-handed seizure warnings

A number of reviewers mentioned seizures, but not with the same concern with which they write about motion sickness. Sure, motion sickness is unpleasant, but a seizure is not only unpleasant, it can be dangerous and life-altering, and its effects on the brain can linger. You wouldn’t know it from these reviewer comments, though:

“It’s remarkably watchable, in fact, with none of the motion sickness you might expect, which is especially amazing given the film’s unswerving dedication to full-bore, seizure-inducing action.” – The Georgia Straight 

“…Hardcore Henry is a 90-Minute Cinematic Seizure…a frenetic editing style that can make you feel like you’re having some kind of seizure…I don’t see how anyone could watch it and not experience motion sickness…I definitely felt like I’d suffered from some sort of brain trauma when I walked out of the theater. (Can you get a concussion just from watching a movie?)” — Esquire  

Treating seizures (and those who have them) with respect:

Just 2 reviews of dozens I read seemed to be genuinely concerned about the movie’s potential to trigger photosensitive seizures in audience members:

“If 3D gives you a headache, Hardcore Henry is enough to bring on epilepsy.” Moviehole.net

“I left the theater wondering if the jittering, disoriented feeling I had buzzing through my skull was some sort of sudden onset epilepsy.”University News

Review: "like sensory assault and battery"

Review: “like sensory assault and battery”

If you live in the UK, there are real warnings about the risk of visually induced seizures. Listings for movies with images that don’t comply with seizure reduction guidelines warn of “a sequence of flashing lights which might affect customers who are susceptible to photosensitive epilepsy.” That’s because the UK regulates the appearance of TV, movies, and advertising to protect those individuals. Some of these people with photosensitive epilepsy don’t realize they have the condition. It may have developed only recently or it’s quite possible they were never aware of experiencing a seizure. Not all seizures look like what you typically see portrayed.

What lies ahead?

What’s most worrisome is that the consensus among reviewers — regardless of how well they liked Hardcore Henry — is that the influence of video games on movie-making is only going to grow.

 “Virtual reality is on the way. Video games and movies will soon start to blend and borrow from one another in many ways. And this movie, imperfect and nasty and often astonishing, is a vanguard.”  Slashfilm.com

“…the visual language of games will soon come to have as much of an impact on up-and-coming film directors as cinema does… and it’s safe to say that we won’t be short of films based on video game properties…With an increased push towards the home viewing experience in movies and interactivity in media, it will be interesting to see how the cinema of tomorrow is influenced by gaming perspectives. “ Den of Geek

We will certainly see more of the first-person perspective, too. Some  hailed the project as a technical marvel and “a revolutionary approach to narrative filmmaking.”

**How I tested the movie trailer

I run downloaded video clips through an application called the Harding Flash and Pattern Analyzer. (Graham Harding is one of the world’s leading experts on photosensitive epilepsy.) The FPA is widely used by producers and networks in the UK—including by the BBC—to reduce the risk of seizures from material on broadcast TV.

The analyzer examines video sequences frame by frame for very specific and measurable image qualities that researchers have found can trigger seizures. When such images are found, it displays  and indicates the specific frames that violate seizure reduction guidelines. Violations occur with:

  • rapidly alternating light and dark images (flash/flicker)
  • certain stripes and geometric patterns with high contrast
  • large areas of very bright (“saturated”) red
  • problem images take up more than one quarter of the total screen area

 


Yes, video games and the reviews are “broken”

review-iconIt’s no secret that the relationship between powerful game publishers and the press has a long history of conflict of interest. To stay in the good graces of game studios to ensure continued early, confidential access to forthcoming products, it’s in game  reviewers’ interest–and the interest of the outlets where they write–to write favorable reviews.

Game critic Jason Evangelho stepped forward last week in Forbes  to declare that both video games and the way they are reviewed by industry press are broken. He called on his colleagues in the reviewing business to stop running reviews that primarily serve their respective sites and the game publishers. “Remember who reviews are for,” he admonished. They’re for consumers who count on reviews to help them decide whether to spend their money on specific games.

Evangelho pointed out how reviewers are not doing their jobs properly: “…the gaming press is shielding your eyes from serious issues,” he wrote. “If we want fewer games to launch broken, we have to hold publishers accountable.” Jason admits he’s guilty of the reviewing practices he feels need to change. “I’m not perfect, but I’m trying my best to course-correct and do what’s right for the industry and especially for its consumers.” Jason, I so totally agree…even though you aren’t talking about the seizures that games can provoke.

What he’s really getting at

Jason’s particular beef is that publishers are increasingly releasing games before they’re fully functional, and that reviewers turn a blind eye to this practice. Reviewers don’t penalize incomplete products in their ratings but instead rate the game as though all the features are already in place. This is routinely done even performance suffers due to inadequate server capacity, or some features are still missing or aren’t working right at product release. Readers are then misled by reviews that give the publishers a “pass” on missing functionality.

He then calls on readers to speak out on the review process:

“If we want fewer games to launch broken, we have to hold publishers accountable. But that first step absolutely starts with me, and with my fellow critics in the game industry. And you need to tell us that’s what you want. Ultimately, the games and the coverage of games is done for you. So wield the power you have and make your voice heard.” 

So, in a nutshell: studios should stop lifting the embargo the day before product release and should stop releasing games before they’re ready, news outlets should wait to run reviews until their reviewers can evaluate the same product version that users receive, reviewers should call out missing features and rate games accordingly, and users need to speak up about the status quo.

Kudos to Jason, especially for calling out the lack of candor by reviewers due to their focus on priorities other than their readers. Of course, in so doing, Jason’s piece brings to mind other ways that reviewers could help and advocate for their readers, if they chose.

jTxEyAKrc

Reviewers could alert consumers to games likely to provoke seizures, while signalling to publishers that this issue deserves their attention.

Tell reviewers you want them to assess games for seizure risk

If you agree that game reviewers should be more accountable to their readers, more responsible and more cognizant of their potential to influence publishers, then why not urge reviewers to address the seizure issue? It wasn’t what Jason was asking readers to do — but it’s all part of better serving readers. Certainly reviewers could influence the industry by writing about video game seizures and thereby holding publishers accountable.

I responded to the Forbes piece, commenting that consumer product reviews should address product safety issues. Here’s what I wrote (with a few minor edits):

Holding publishers responsible goes further than what you’ve described. Responsible reviewing for any consumer product should consider basic safety issues, and this has never been the case in video game reviews. We don’t expect consumers to test product safety, but in the case of video games, reviewers have left crash-safety testing to the consumer.

Many games expose consumers to a serious health hazard: seizures–many of them undetected— provoked by excessive flash, but game reviews fail to identify those games with a higher likelihood of inducing them.  It would be very beneficial to readers if games were evaluated on this risk. Applications exist that scan images to find those with the potential to provoke seizures.

For more than 30 years game manufacturers have been acknowledging the seizure risk by routinely slapping a warning on their games. This protects the studios from legal action and allows them to continue producing images that can be a serious health threat. Including seizure risk in reviewers’ rating criteria would certainly encourage game developers to adhere to seizure reduction guidelines established for visual media.

Not every game contains image sequences that could provoke a seizure. But since all games carry the seizure warning, those consumers who know about the risk have no way to know before using/buying whether a particular game contains images likely to cause them a problem.

Regrettably, most consumers still have little awareness of the seizure risk from flashing graphics or that regardless of whether there’s a seizure history. People with this genetic vulnerability (photosensitive epilepsy) typically don’t realize they need to be cautious around particular visual stimuli, that is until they experience a seizure that’s noticeable enough to be identified. Most people don’t know—I certainly didn’t—that seizures don’t always look like a big event.

Seizures can go on for years before being identified. Certain populations—kids with ADHD or autism in particular—are at higher risk of seizures, and the symptoms caused by unidentified seizures in these kids can exacerbate and hide behind existing behavioral difficulties. Nobody is holding publishers accountable.

Perhaps the reviewing community will show some interest in the visual safety issue in the future…Anyone else want to weigh in with Jason on this? He’s reachable on Twitter and Facebook.