Riot Games, publisher of the hugely popular League of Legends game, responded quickly to a user reporting a seizure from the game. What happened this month is both a short and sweet case study in customer care, and a mystery.
Two days after a new animated log-in screen for League of Legends appeared, two users reported on a forum that the visual effects of that image caused a seizure. Several others said that the jerking of the image every few seconds produced uncomfortable and unusual sensations.
After the first user posted about his experience, Riot Games:
- took down and replaced the animated image
- announced the fix
- noted the company already uses software to test its games for seizure-triggering images and added, “…but if that isn’t enough we need to know.”
- thanked the user for pointing out the problem so it could be fixed
You can read the respectful exchange that unfolded in the League of Legends subreddit here.
In this instance, the fix was simple. Since the image sequence causing the problem occurs in an isolated part of the code, outside of game play itself. Riot Games simply replaced the login-in screen with a prior version. Riot posted this update: “We take this stuff super seriously and we’re grateful to [the original poster] for raising visibility on the issue so we could solve it.”
The mystery: What triggered the seizures?
On to the mystery. If Riot uses software to test its games for the possibility of triggering seizures, how did this image get through the testing process? Looking at the image (I do not have photosensitive epilepsy) it doesn’t show obvious violations of image safety guidelines. Because there’s an interval of some seconds between the periodic vibration of the image, those shifts don’t create a flashing effect. (One user described it as a “shudder.”) And there are no bold patterns that trigger seizures in some individuals.
I ran the image sequence through the seizure guidelines test software and, sure enough, the periodic shake barely registered. I consulted Prof. Arnold Wilkins of the University of Essex, a leading researcher in visual effects that influence the brain.
He examined the sequence frame by frame (video typically runs at about 30 frames/second) and found a single blurred frame in each “shudder” that differed from the rest. He suggests that the resulting disruption in an otherwise stable image is “profoundly disturbing” to the visual system. Prof. Wilkins advised that even wearing colored lenses, which are remarkably effective in reducing or eliminating seizures triggered by flicker, probably would help only slightly in this instance.
No guarantees of safety
While many of the guidelines for seizure-causing images have been carefully defined through research, we clearly don’t know everything yet. So even developers who follow image safety guidelines and test their products for a gaming experience without seizures can produce visual effects that are unsafe for those with photosensitive epilepsy.
Momentum is growing to eliminate the barriers that make it difficult or impossible for people with disabilities to play video games. An assortment of game accessibility specialists and organizations are advocating with and educating game developers on how to adapt their offerings for gamers with physical, sensory, and/or cognitive impairments many types of disabilities. In addition some of these organizations work with individuals to resolve specific accessibility issues.
Q: How might this trend bring about progress on the seizure hazard that persists in many games?
A: Remains to be seen because game-induced seizures don’t typically receive a lot of attention amid advocacy for other disabilities, many of which are better known.
The leading advocacy players (as it were)
There are also two well-established game accessibility groups—both founded more than 10 years ago—that address all sorts of disabilities and could therefore actively promote the development of games that are unlikely to trigger seizures.
The Able Gamers Foundation is a non-profit, staffed by volunteers, that is supported by donations from individuals and some big names in the industry, including Sony, Harmonix, the Steam storefront, and others. Able Gamers advocates for more accessible games and advises game developers on how to make necessary modifications to equipment and programs.
The organization published a set of game accessibility guidelines written by developers and by gamers with disabilities. The guidelines appear under the title Includification (I love that term). Accommodations for mobility impairments make up the largest category in the Includification booklet: remappable keys, compatibility with specialized input devices, and so on. Accommodations for hearing, vision, and cognitive disability are outlined as well. Able Gamers says that flash and flicker guidelines, not currently in the document, will be added in a revision scheduled for later this year.
Able Gamers does a lot of community outreach to gamers with special needs and tours the country demonstrating assistive technology devices that make game play possible for individuals who cannot use conventional controllers or other standard input/output technology. The group reviews games for accessibility features, and it provides online forums where disabled players can connect with each other. Able Gamers also provides grants to individuals who need customized assistive technology for gaming.
The Game Accessibility Special Interest Group (SIG) of the International Game Designers Association, founded by a member of Stockholm University’s Department of Computer and Systems Sciences, is a mix of game developers and academic and industry accessibility experts. The group presents at conferences, surveys developers, and organizes accessibility competitions for game design students. The goals of the SIG include advocacy, cross-industry cooperation, and creating a curriculum on accessible design that can be incorporated into existing post-secondary game design courses. The SIG is embarking on an ambitious, multi-faceted effort to move this agenda forward.
For developers seeking references on how to make games more accessible, the SIG recommends Able Gamers’ Includification and www.gameaccessibilityguidelines.com, a document that received an award from the Federal Communications Commission (FCC). The guidelines detail 100 accessibility features and include a remarkably clear outline of how to reduce the risk of flash- and pattern-induced seizures. The SIG also promotes a list of 14 accessibility features–such as easily readable closed captioning and colorblind-friendly design–that would have the most impact on gamers with disabilities. (Seizure risk reduction didn’t make the top 14 list.)
How photosensitive epilepsy is unlike other disabilities
I exchanged emails with London-based Ian Hamilton, an accessibility specialist and user experience (UX) designer active in the SIG. Hamilton was instrumental in organizing and producing gameaccessibilityguidelines.com. He respects the importance of seizure safeguards. “…even though epilepsy is relatively uncommon compared to things like colorblindness or dyslexia,” he wrote, “it’s one of the only accessibility issues that can result in physical harm, so it’s absolutely critical to get right.”
He’s absolutely right. Games and game equipment that don’t accommodate users with other disabilities typically make it frustrating or very difficult to play a satisfying game. As an example, a game lacking easily readable on-screen captioning will make users with vision or hearing impairments unhappy that they’re at a competitive disadvantage as players. But the stakes for users with photosensitive epilepsy (including the potential for serious medical issues and life-long limitations) are quite serious.
While designing images to minimize seizure risk belongs in any set of game accessibility guidelines, photosensitive epilepsy differs in some other significant ways from the other conditions/disabilities that need accommodations:
- People with photosensitive epilepsy are not a well-identified group. Many people who are at risk for image-induced seizures aren’t aware they have the condition and are therefore at risk. Either they’ve not yet been triggered or they aren’t aware of seizures they’ve already had. Since a large portion of those at risk don’t realize they need to avoid certain specific types of images, they can’t be expected to avoid those images. Game developers should therefore take some responsibility to minimize the risk of seizures.
- Advocates say many developers are responsive to specific requests for modifications that help those with a particular disability, because many accessibility issues stem from a lack of awareness by product designers of accessible design practices. Although it’s true that accessible design isn’t typically included in the game design curriculum, this argument doesn’t really hold up when it comes to seizure-inducing images. Game publishers have acknowledged for more than 20 years that their games could pose a risk to individuals with photosensitive epilepsy. The legal departments of game publishers should communicate with their own designers and developers about making games less likely to spark seizures. Many popular games continue to contain seizure-inducing images.
- Advocates encourage the involvement of individuals with disabilities in the design and testing of games for the benefit of all parties. For people with visually induced seizures, this isn’t feasible, nor is it necessary. Testing needs to be done without placing people at risk, using existing analysis applications that utilize research-based image specifications. For these consumers there is little chance of developing an ongoing collaborative relationship with the industry.
- Despite a 2005 consensus paper by the Photosensitivity Task Force of the Epilepsy Foundation of America identifying seizures from visual stimulation as a significant public health problem**, there has been no organized advocacy to reduce visual stimuli in our everyday environment that can trigger seizures. Advocacy efforts (in the USA, anyway) to improve the lives of people with photosensitive epilepsy appear to be practically non-existent. In contrast, the interests of people with vision, hearing, and movement impairments are represented by organizations that proactively take on quality-of-daily-life issues.
Under the heading “Ways to further accessibility in the games industry” Ian published a comprehensive list of steps required for making video games accessible to people with disabilities. In addition to game developers and disabled gamers, the stakeholders involved would include educators in game design, game publishers and distributors, platform manufacturers, government bodies, trade groups, development tool builders, and so on. Among the recommendations: “Include basic access requirements in publisher certification requirements, such as subtitles and avoidance of common epilepsy triggers (both of these examples are required at a publisher level by Ubisoft).” Ian notes in his preface to the list that bringing about this accessibility within the game industry amounts to “wide-scale cultural change.”
I applaud the work of the Games Accessibility SIG, the Able Gamers Foundation, and other groups addressing accessibility. They are making strides on an important issue while faced with the task of convincing the industry that design changes for accessibility will pay off in improved overall game design and a larger customer base.
But in order to make possible the massive and broad-based cultural change that’s needed, I believe these talented and dedicated advocates need significantly greater resources, buy-in, and recognition. The industry needs to declare publicly that it is committing itself to making gaming more inclusive of people with disabilities. In the face of frequent challenges about the contents of video games and their influence on young people, the accessibility issue offers a win-win public relations opportunity for video games.
The Entertainment Software Association is just the organization to proactively announce an industry-wide goal of providing people with disabilities easier access to video game entertainment and learning. The ESA should establish and contribute major resources to a game industry consortium for promoting and achieving accessibility education, standards, learning, and collaboration, leading to a more inclusive—and larger—customer base.
** “The Photosensitivity Task Force of the Epilepsy Foundation of America believes that a seizure from visual stimulation represents a significant public health problem. No known method can eliminate all risk for a visually induced seizure in a highly susceptible person, but accumulation of knowledge about photosensitivity is now at a level sufficient to develop educational programs and procedures in the United States that substantially will reduce the risk for this type of seizure.”
— from Robert S. Fisher et al., “Photic- and Pattern-induced Seizures: A Review for the Epilepsy Foundation of America Working Group.” Epilepsia Volume 46, Issue 9 (September 2005), pages 1426–1441.
The 2014 E3 (Electronic Entertainment Expo) just wrapped up in Los Angeles with all the major game publishers previewing their upcoming releases. The big companies publishing these games have mammoth budgets and should be able to fund some quality control that supports the interest of public health. Apparently that line item is still not getting the focus it deserves.
Last week PCMag.com listed the 10 most anticipated games to be announced at E3. How many of them might trigger seizures in people with photosensitive epilepsy?
So far, 4 of them tested positive for seizure-inducing sequences–meaning they failed the Harding automated seizure safety test. This isn’t a final result because not all have enough “footage” available online for me to test adequately. Some may ultimately seem safe.
These tested as unsafe:
Super Smash Bros. (Nintendo)
Call of Duty: Advanced Warfare (Activision)
Tom Clancy’s The Division (Ubisoft)
In other words, the patterns, flashes, and/or red intensity of onscreen images produce the exact type of visual stimulation–that’s been carefully defined by researchers–that places viewers at risk of photosensitive seizures. People with a genetic predisposition for these seizures are vulnerable, whether or not they have ever experienced a seizure before, and whether they even know they have this genetic trait.
Nintendo’s Mario games have been triggering seizures for more than 20 years. Reports began surfacing in 1992 about seizures from Super Mario. As a result, a study on video game seizures published in 1999 used Super Mario World to test subjects known to be photosensitive. And a lawsuit was filed in 2001 by parents of a boy who had a seizure while playing Super Mario Kart.
But what about new games such as Destiny? A whole new game provides the perfect opportunity to create an entirely novel visual experience. Why not architect the whole thing keeping in mind the seizure hazard that persists in many games?
In sum, some of the video game industry’s biggest players are continuing to ignore safety guidelines, placing the public at unnecessary risk. I don’t know where the myth originated that games produced nowadays don’t produce seizures.
Congratulations on last month’s successful launch of BioShock Infinite. The reviews are extraordinary. BioShock Infinite is said to set a new standard for what the video game experience can be. Players are moved and enthusiastic about many aspects of the game and speak effusively about their unprecedented degree of involvement with the story and characters. With all the creative energy, care, and respect for players that went into developing BioShock, though, the game–like so many others–exposes players to visuals that can cause seizures.
I examined several BioShock launch trailers and some other “footage” – a total of eight clips of a few minutes each – and assessed them using an application that identifies video sequences that can trigger seizures. Most of the material was fine, but three of the clips contained brief flashing sequences that don’t meet criteria for safe viewing. It doesn’t take more than a brief exposure to trigger seizures in those who are vulnerable.
Contrary to what many gamers assume, eliminating seizure triggers doesn’t make a game boring to look at or play. Irrational Software created a visually stunning, highly engaging experience in which most of the scenes don’t pose a seizure risk. Reports of video game-induced seizures began surfacing in 1981 in newspapers and medical journals. A great deal is known about what types of images and sequences can provoke seizures.
Guidelines for seizure-free video sequences were developed in the UK more than 20 years ago. Since 1991 all television programming and commercials there are required to pass a seizure-safety test. Japan put in place a similar measure following the 1997 Pokémon broadcast that led to hundreds of seizures. In 2005 the International Telecommunication Union published recommended universal guidelines for reducing photosensitive seizures from televised material.
While all these efforts were made to reduce the risk to consumers of photosensitive seizures, video game publishers took their own action—providing printed seizure warnings. The warnings began appearing in the early ‘90s, after a few consumers filed personal injury lawsuits. Putting a seizure warning on video games has thus far provided legal cover for your industry, but offers little protection for customers.
The warnings all state that photosensitive seizures happen to “a very small percentage of people.” Seizures from flashing images are not rare, but people believe they are because that’s what the warnings say! The wording of these warnings is based on researchers’ estimates that were made decades ago, before today’s sophisticated graphics and before more recent studies that suggest that many photosensitive seizures could be going completely unnoticed. Many doctors continue to think these seizures are rare because that’s what they were taught.
If you haven’t heard many reports of seizures happening while playing BioShock, don’t assume the seizures aren’t occurring. They’re just not being identified. A person experiencing seizures is likely to lose awareness and not even realize what’s happening, or notice that a bit of time has passed that they can’t account for. Furthermore, most seizures don’t involve convulsions, and the only sign others might see could be as subtle as a short period of staring.
Whether or not a seizure is noticeable, it’s a serious event with real risks to health. It can impair health, thinking, and behavior for days afterward. Sometimes a seizure results in permanent disability.
It’s not reasonable to expect parents to continually monitor their kids for possible signs of a seizure, particularly given that video games are played while people face a screen. So let’s turn to older teens and adults in the midst of a game, who might theoretically be more self-aware and responsible for their own well-being. Will they be vigilant for seizure symptoms such as odd sensations or altered consciousness?
Just last month in a New York Times interview your creative director Ken Levine said, “We work really hard to wear down the audience’s ability to even process. If players are immersed enough, they stop treating it as a piece of artifice and just start experiencing it.” Do you see the problem here? In this ideal game experience, how can players be expected to “immediately stop playing and consult a doctor” as the warning advises, if they develop symptoms consistent with a seizure?
With BioShock Infinite now brought to market, people are asking what your company will do next. You could easily raise the bar further for the industry by publicly committing to developing seizure-safe games. I live in the Boston area and would welcome the chance to begin a conversation about this at your headquarters in Quincy.
Despite their limited usefulness to consumers, seizure warning notices do seem to provide legal protection to game publishers. And juries have a hard time awarding damages to plaintiffs with a pre-existing condition, even if plaintiffs didn’t know of their photosensitive epilepsy prior to the seizure(s) triggered by a video game.
In one case Nintendo actually conceded that its game had in fact triggered seizures, but that didn’t get in the way of the company winning the case. A judge later overturned the jury’s verdict because Nintendo had withheld critical information in contempt of court.
The cases date back to 1991, but the apparent total number of cases–ten–is pretty small. One has to wonder what percentage of the seizures triggered by exposure to video games are ever identified as visually induced seizures.
One of the few consumers to reach a settlement is John Ledford of Alabama, whose settlement agreement bars John from discussing his own case. John has found another way to raise awareness of video game seizures. He has researched other cases and reached out to epilepsy organizations around the globe to raise their awareness of the continuing seizure hazard from video game images. John’s Facebook page contains most of the history I’ve assembled here:
|1991||MI||15-year old Laura Moceri had grand mal seizure while playing.||Kid Icarus (Nintendo)||Lost|
|1993||IL||Chicago boy suffered occasional seizures during many hours of game play.||Nintendo||Dismissed|
|1995||AL||John Ledford had his first ever grand mal seizure while playing game at an arcade. The seizure damaged his optic nerve and caused blindness in one eye.||King of the Monsters II (SNK Corp.)||Settled|
|1998||LA||13 year-old Joey Roccaforte had clusters of violent seizures||Mega Man X (Super Nintendo)||Jury ruled for Nintendo; judge later vacated the decision because Nintendo withheld critical information before and during trial.|
|2001||LA||Esther Walker, mother of 30-year old Benjamin Walker, who died from hitting his head on a table and sustaining internal injuries during a game-induced seizure.||Nintendo 64||Lost|
|2001||LA||11 year-old Michael Martin, son of Eric Martin, mayor of St. Martinsville, LA. Seizures that began happening during games began occurring also during sleep.||Super Mario Kart (Nintendo 64)||Settled personal injury claim; lost case advocating better warnings.|
|2001||LA||6 year –old Kynan Hebert, son of Lynette Benoit||Nintendo||Dismissed|
|2002||FL||16 year-old Dominic Zummo||Star Wars Episode I: Jedi Power Battles (LucasArts Entertainment, SONY)||Unknown|
|2007||NY||While watching his brother play a game, 4 year-old boy had a seizure causing permanent injury.||Spyro: Enter the Dragonfly (Vivendi, SONY Playstation 2)||Last available information: attorney for plaintiff was seeking other plaintiffs for class action suit|
|2011||CA||Navy F-18 pilot John Ryan McLaughlin injured in a grand mal seizure that causes permanent loss of flight status||Oblivion: The Elder Scrolls IV (Bethesda Software), Sony Playstation 3.||Still pending; no other information available.|
What constitutes product liability?
In 1997 the criteria for product manufacturer’s liability for a product that has caused harm were revised by the American Law Institute, an independent body of legal experts that drafts and publishes restatements of common law in order to clarify and simplify it. Its work is used as a resource by state lawmakers, judges, and lawyers. Every state has its own laws concerning burden of proof, the awarding of damages, and the like.
The 1997 restatement of product liability law states, “a product is defective when, at the time of sale or distribution, it contains a manufacturing defect, is defective in design or is defective because of inadequate instructions or warnings.” These conditions are then defined separately:
- A product “contains a manufacturing defect when the product departs from its intended design even though all possible care was exercised in the preparation and marketing of the product.”
- A product “contains a design defect when the foreseeable risks of harm posed by the product could have been reduced or avoided by the adoption of a reasonable alternative design by the seller or other distributor, or a predecessor in the commercial chain of distribution, and the omission of the reasonable alternative design renders the product not reasonably safe.”
- A product “is defective because of inadequate instructions or warnings when the foreseeable risks of harm posed by the product could have been reduced or avoided by the provision of reasonable instructions or warnings by the seller or other distributor, or a predecessor in the commercial chain of distribution and the omission of the instructions or warnings renders the product not reasonably safe.”
A BBC report on Nintendo revealed that the company knew more than 20 years ago which of its games were most likely to cause seizures–and downplayed the seizure risk to customers. A former Nintendo customer relations employee interviewed for the story said that many customers called to complain about experiencing seizures. Because he wanted to advise customers concerned about the seizure risk, he asked the company’s R & D group for a list of the games most likely to cause seizures.
Developers came up with a list of more than 30 games. Before the list was released to customers, he said, the company’s lawyers pared down the list to 12 – 15 titles. As customer complaints about seizures grew, Nintendo stopped releasing any seizure information about specific games. The Nintendo executive interviewed asserted that the company began making its games safer and started including seizure warnings with game instructions as soon as the problem came to their attention—in 1991.
The story, featured on the BBC’s Outrageous Fortune program in 2004, also includes an interview with photosensitive epilepsy expert Prof. Graham Harding. Using his own flash and pattern analyzer Prof. Harding shows the results of testing some Nintendo games for seizure safety.
To view the ten-minute segment about video game seizures in the report on Nintendo, first go to www.youtube.com/watch?v=0aFhW56c2Vg and fast forward to about 5:15 into the clip. The seizure segment continues at the beginning of this clip.
The documentary was never aired in the US, and I’d long since given up searching for it online. But I recently came upon it thanks to John Ledford, who has been tracking seizure lawsuits filed against the game industry. John became blind in one eye as a result of his first grand mal seizure—which occurred while he was playing a video game in 1994.
Have you noticed that watching TV is less annoying lately? Commercials are now required to be no louder than the programming surrounding them. On December 13 an FCC regulation went into effect that was designed for just that. The CALM Act, approved by Congress in 2010, directed the Federal Communications Commission to make it possible to watch TV without constantly turning down the volume of advertisements.
Since the introduction of television in the 1950s, many consumers have complained to the FCC about the loudness of commercials. What prevented the FCC from doing anything in response was that the issue was technically complicated. Multiple factors can contribute to the perceived loudness of a broadcast, including the strength of the electrical signal, the degree to which the sound signal is compressed. In addition, there was no standard method for content creators and broadcasters to measure broadcast volume.
In 2006, the International Telecommunication Union–the same UN-affiliated standards body that has published specifications for protecting TV viewers from photosensitive seizures–proposed a new technique for measuring broadcast volume that allows uniform evaluation across national boundaries. In addition, the ITU proposed a numerical “target loudness” using the new loudness gauge. Thanks to the ITU, it became possible to define, comply with, and enforce limits on loudness.
Four years later the United States Congress passed the CALM Act with little debate, by unanimous vote in the Senate and by a voice vote in the House. California Congresswoman Anna Eshoo, who introduced the bill, said it was by far the most popular bill she’d ever sponsored. She said the bill “gives consumers peace of mind, because it puts them in control of the sound in their homes.” She was quoted saying, “If I’d saved 50 million children from some malady, people would not have the interest that they have in this.” By that time the UK, France, Norway, Italy, Japan, Brazil, Israel, Germany, Austria, Switzerland, Poland, and the Netherlands were already limiting the loudness of commercials or had begun action on the issue.
These days even the video game industry is paying attention to some kind of audio standards, if only for consistency across products. According to an July 2012 interview in Designing Sound, Sony Computer Entertainment Europe is looking at smoothing out the volume among their own game titles.
Unfortunately, in this country making TV safer to watch for the visually sensitive–or making video games safer to play–isn’t on the legislative agenda. Consumers and policy makers aren’t aware of the need. The technical groundwork is already in place for regulations to prevent screen-induced photosensitive seizures, thanks to ITU specifications (and similar versions developed by the UK and Japan), and to similar guidelines adopted by the World Wide Web Consortium for web-based content.
Here’s where things stand at the moment in making US electronic screens safe for those with photosensitive epilepsy: Photosensitive epilepsy protection standards now apply to all federal agency websites. The Photosensitive Epilepsy Analysis Tool (PEAT) downloadable from the PACE Center at the University of Wisconsin at Madison makes available to website designers and software developers a free tool that tests screen content for compliance with seizure safety guidelines. The tool is not intended for entertainment industry developers, however; these companies need to buy commercially available assessment tools.
I’ve written previously about some of the complexities of bringing new screen safety standards to the American telecommunications industry. I”m going to learn more about the legislative process in coming months. My State Representative filed a bill last week to create a commission to study the issue of video game safety for minors at home and in school here in Massachusetts. It will take considerable time to even bring the bill to a public hearing, but as I’ve recently learned, all bills filed in the Massachusetts legislature receive a public hearing at some point in the two-year session. The two years just began this month. Stay tuned.