Fortnite: The game–and the seizures–are free

Fortnite’s High Explosives mode fills large areas of the screen with bright, rapidly moving images that can trigger seizures.

Maybe you’ve heard about the video game Fortnite that now has 45 million players? One reason it’s so popular is that it’s free to download — with its seizure-inducing graphics.

Playing Fortnite involves quite a bit of shooting that creates bright flashes. The flashes are especially likely to trigger seizures when the game is played in “high explosives” mode (available during limited release dates). The high explosives create bigger explosions splayed across larger areas of the screen, which in turn affects a greater number of neurons in the brain’s visual processing system. For reasons not entirely understood, in people with photosensitive epilepsy, flashing light and certain other visual stimuli overload the visual cortex in a way that leads to seizures.

A Fortnite “high explosives” weapon in action

In one user-uploaded, 7-minute, 39-second gameplay video using high explosives, 8 separate image sequences failed to meet the standards for minimizing the risk of visually triggered seizures. Each of those failures represents a visual sequence with a reasonable chance of setting off seizures in persons who have photosensitive epilepsy. The test for seizure risk from images is based on guidelines for reducing visually induced seizures, determined by extensive research on the image qualities that can bring on seizures in people with photosensitive epilepsy: motion, brightness, contrast, patterns, color intensity, and flash/flicker .

Please fix this, Epic!

Fortnite’s developer, Epic Games, has come out with remarkably frequent product updates to address performance bugs and keep players’ interest from flagging. (No issues with maintaining players’ interest level — maybe you’ve also heard about parents and teachers struggling to handle kids’ unprecedented preoccupation with this game?) Last week Epic removed a guided missile weapon from the game — for now — due to a bug and some player feedback that using the weapon disturbed the sense of fairness and balance of the game. That still leaves grenades, rocket launchers creating big flashes in high explosives mode.

Problem flash isn’t limited to explosions. The flash in this sequence came from spacecraft lights.

Perhaps the company’s unusually rapid product development cycle would make it possible to modify all the game’s graphics where the image sequences place users at risk of seizures? There are tools available to developers to identify the offending images — what I use to test the gameplay clips is just another version of the same Harding Flash and Pattern Analyzer software. You can read here about the way I do the testing.

Should you be concerned?

Maybe. Estimates are that up to 3 percent of the population has photosensitive epilepsy (among those with any other form of epilepsy, about 5 percent). Photosensitive seizures typically begin between ages 8 – 20, and they can occur in people with no history of epilepsy.  Of the hundreds of children who had seizures during a 1997 Pokémon cartoon broadcast in Japan, researchers found that 74 percent of them had never been aware of experiencing a seizure before.

The prevalence of photosensitive epilepsy is probably underestimated because seizures are not always noticeable, and therefore not always reported or even suspected. The symptoms of a mild seizure may be so subtle that nobody realizes what’s occurred. That doesn’t mean a mild seizure is nothing to worry about; any seizure has the potential to leave disabling physical and cognitive after-effects and mood changes that can last for days.

What can you do?

Parents and teachers are struggling to handle kids’ unprecedented preoccupation with Fortnite. To learn about the effects of video games on the central nervous system, and about finding ways to reduce your child’s screen time, I recommend Dr. Victoria Dunkley’s Reset Your Child’s Brain: A Four-Week Plan to End Meltdowns, Raise Grades, and Boost Social Skills by Reversing the Effects of Electronic Screen-Time.

To learn if your child may be experiencing game-induced seizures, ask about any weird sensations occurring while playing video games. See if you can get the child to wear cobalt blue dark glasses while gaming; in these are extremely effective at protecting against or reducing the severity of seizures.


Riot Games Acts Fast to End Players’ Seizures

Riot Games’ League of Legends

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.

The response from Riot Games

After the first user posted about his experience, Riot:

  1. apologized
  2. took down and replaced the animated image
  3. announced the fix
  4. 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.”
  5. 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.

league-of-legends-passes.png

No violations of seizure reduction guidelines occurred when testing the League of Legends image.

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.

 

 

 

 


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

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:

2016-top-5-shooter-games

Forbes’ Best 5 First-Person Shooter Games of 2016 all failed to adhere to guidelines for reducing seizures.

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. Instead of building games that comply, many developers simply place seizure warnings on games and consoles. People with no history of seizures don’t pay much attention to seizure warnings, though. Why would they?

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

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.”


Safe to play a game that passes the seizure test?

I've been using charts like this one to show results of testing for adherence to photosensitive epilepsy guidelines.

Until now I’ve posted charts in this format to show whether a game meets photosensitive epilepsy guidelines…

According to a Reddit post, a game that I’ve said “passed the seizure test” triggered a seizure. Recently the same game—Hearthstone—could have been implicated in a professional gamer’s seizure that happened during a live stream. What’s going on?

I write about games I’ve tested to alert readers to the games that don’t meet internationally recognized image safety guidelines. But I don’t want to create undeserved confidence that a game that passed the seizure test will be safe for anyone with photosensitive epilepsy.

Ian Hamilton, a user interface designer who specializes in and advocates for game accessibility, clarifies the role of testing this way:

“Passing the Harding test doesn’t mean that a game is safe. It means ‘reasonably safe’ because common triggers have been avoided. Something that gets a ‘pass’ can still absolutely cause seizures.”

I regularly write that your experience may differ, that I’m not trained in quality assurance, that I test excerpts of game play, and that health and lifestyle variables affect every individual’s vulnerability to seizures at any given time. Still, the meaning of my findings could be misleading without an understanding of the limitations of the seizure test itself:

  1. the pass/fail guidelines aren’t expected to prevent seizures in all individuals
  2. the test was designed for TV images, not video games

What the Pass/Fail guidelines mean

The guidelines originated in 1994, when the UK’s agency for regulating TV broadcasting (now known as Ofcom) inserted into its code of standards some technical guidelines to accommodate viewers with photosensitive epilepsy. These guidelines, based on studies of photosensitive epilepsy and consultation with Prof. Graham Harding and other photosensitive epilepsy experts, detail flash rates and spatial patterns that typically trigger seizures in people with photosensitive epilepsy. Specifications regarding saturated red images were added later, after the 1997 Pokémon incident in Japan.

Some compromises in the guidelines were made for the sake of practicality. Criteria for acceptable images (commonly referred to as the Harding test) were developed with the understanding that they would realistically protect most individuals with photosensitive epilepsy, but not all. For example, the guidelines permit images that flash at a rate of up to 3 times per second because flash at that frequency affects only 3 percent of photosensitive individuals. UK regulators decided that was “an acceptably small risk.”

I'm taking the word "safety" out of the chart since passing the test doesn't guarantee seizure safety

…but I’m updating all the charts by removing the word “safety” since passing the test doesn’t guarantee seizure safety.

The introduction to the guidelines states that their purpose is “reducing the risk of exposure to potentially harmful stimuli.” It also concedes that even when broadcasting images that comply with the guidelines,

“it is…impossible to eliminate the risk of television causing convulsions in viewers with photosensitive epilepsy.”

Applying TV guidelines to video games

There are no formal guidelines for reducing the seizure risk from video games. A 2005 consensus paper by experts on photosensitive seizures acknowledges that additional work would be required first on the existing guidelines for TV. In the meantime, it is reasonable to use the television guidelines since the impact of screen images on the visual system is the same.

The biggest challenge in applying TV specifications to video games is explained in the consensus paper:

“These principles are easier to apply in the case of fixed media (for example, a prerecorded TV show), which can be analyzed frame-by-frame. Interactive media, such as video games, may afford essentially limitless pathways through the game, depending on user actions. Therefore …in the case of video games, the consensus recommendations apply to typical pathways of play but cannot cover every eventuality of play.”**
Also,when players set their own viewing perspectives and preferences in newer video games, they may create unanticipated seizure risks.

Reducing risk going forward

In sum, a game that fails the Harding test is best avoided by those with photosensitive epilepsy. A game that passes is less likely to act as a trigger. Despite all the qualifiers, I believe there’s value in reminding people that seizures can happen to anybody, that certain video games can trigger them, and that you can lessen the risk by selecting games without lots of flash and patterns. Other strategies to lessen the risk of photosensitive seizures can be found here and here.

Tip of the hat to Ian, who suggested that I avoid the word “safe” when describing games that have passed the test. I also will be revising my prior posts to do some rewording.

Gamer’s seizure on live stream

Here’s a reminder that seizures can happen to anyone. A professional gamer known as Lothar had a seizure recently during his live feed while playing Hearthstone on Twitch. Lothar apparently has no history of seizures and the seizure may or may not have any connection to Hearthstone. In updates about his condition and hospital stay, Lothar didn’t mention photosensitive epilepsy nor has he said he’s been advised to limit his gameplay. 

For the record, Lothar is also a body builder—he’s obviously a guy who has enjoyed good health and takes good care of himself. Lothar has a large and caring following and has been receiving lots of well wishes as he recovers. Why do I mention this incident here? Viewing the incident (you can find it on YouTube) and seeing how it affected so many fans who care about him reinforced for me the seriousness of seizures and the importance of preventing those that are preventable.

** Graham Harding et al. (2005), Photic- and Pattern-induced Seizures: Expert Consensus of the Epilepsy Foundation of America Working Group. Epilepsia, 46: 1423–1425.


CNET endorses 7 video games that can trigger seizures

Uncharted: The Nathan Drake Collection is the only one of CNET's recommended games where I didn't find image sequences that can provoke seizures.

Uncharted: The Nathan Drake Collection is the only one of CNET’s recommended games that didn’t fail the seizure test.

Wouldn’t it feel terrible to give someone a present that could set off an epileptic seizure? If you consult the CNET guide to video games for 2015 holiday giving, you’ve got 8 games to choose from–of which 7 contain seizure-inducing images. In the 3+ years that I’ve been testing selected video games for seizure-provoking graphics, this is easily the most lopsided result I’ve found.

The following table shows the games recommended in CNET’s “The best video games to give this holiday season” feature, with results of testing them for image sequences capable of triggering seizures. Testing is done with an application designed for this specific purpose (more info on that is below in the testing methdology section).

Uncharted: The Nathan Drake Collection, Call of Duty: Black Ops 3, Fallout 4, Halo 5: Guardians, Just Cause 3, Super Mario Maker, Star Wars Battlefront, Rise of the Tomb Raider

CNET’s choices for best video games to give this holiday season

Interpreting the results

Passing the seizure guidelines test means that in the 1.5+ hours of gameplay and cutscenes I tested, all image sequences meet well-defined guidelines for reducing visually induced seizures. I am not set up to test every possible sequence (video game developers should be able to do this, though). To get a “fail” on my tests, all that’s needed is one violation of the guidelines, which could occur within the space of a second or two. Again, since I do not test every possible sequence, it’s very possible–and likely–that the game also has other problem images that I didn’t test.

Your results may be different. Each person’s seizure threshold can be affected by a number of factors apart from the visual stimulus itself: illness, hunger, stress, fatigue, alcohol, medications, length of play, and others. So a game played without incident may trigger a seizure in the same player under different conditions. Also, players can be exposed to new and different image sequences in subsequent games.

CNET selected conventional action/adventure titles for its gift-giving guide. These games typically have plenty of shooting, explosions, and rapid movements that produce flicker in the seizure-inducing range of more than 3 flashes per second. In contrast, recent video game recommendations from both the New York Times and Los Angeles Times, with less tech-focused audiences, added some unconventional titles to their top picks. It’s worth noting that the less traditional games were less likely to fail the seizure test.

Uncharted: The Nathan Drake Collection–the one game CNET chose that meets the seizure reduction guidelines–is an action/adventure game, too, with some shooting and the occasional explosion, but designed without flickering images or other visual overload.

 Call of Duty Black Ops 3 Fallout 4 Halo 5: Guardian Just Cause Super Mario Maker Star Wars Battlefront Rise of the Tomb Raider

Images in Uncharted: The Nathan Drake Collection show explosions yet stay within seizure prevention guidelines.

Why it matters

Nobody wants to think about the risk of seizures that can be triggered by video games, figuring they’re extremely rare (they aren’t) and that the risk only applies to “people with epilepsy” (not so). Also, people assume that seizures are always of the grand mal type, with loss of consciousness, lots of involuntary movements, etc., so that they would be very obvious events (most seizures are not like this).

If you assume seizures are very obvious, then you also assume you’d hear a lot more about seizures that happen in front of computer screens and consoles. But many seizures are much more subtle, some so subtle that nobody realizes they’re happening. Even in these instances, though, the after-effects may mean impaired functioning for up to several days, or longer, affecting energy, concentration, memory, sleep, and mood. You can read here about how game-induced seizures we couldn’t see affected my daughter.

Vulnerability to seizures from bright flashes and rapid flicker, known as photosensitive epilepsy, is a genetic trait that’s latent in an unknown percentage of the population. This means that there are people with no idea they have this sensitivity to visual stimuli–until they are triggered and experience a noticeable seizure. So these people assume the seizure warnings accompanying video games don’t apply to them, or they just ignore them.

Testing tool and methodology

I run downloaded gameplay clips, cinematic clips, and promotional trailers for each game and submit the sequences to 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. I don’t know how many of the major game developers in this country use the FPA–they keep such information very much to themselves.

The analyzer examines video sequences for very specific and measurable image qualities that researchers have found can trigger seizures:

  • 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

If the first clip I test of a game fails the seizure guidelines test, I then move on to test the next game. If no guideline violations are found, I typically test at least 4 or 5 additional clips of that game–usually more, if I have a hunch due to the game genre and/or overall look of the sequences that there might be unsafe “footage” that I haven’t yet found. Most image sequences that fail the test do so because of strobe-like flicker.

Games that pass could have seizure-provoking sequences that I was unable to locate. I don’t do this testing while actually playing video games. Instead I work with video clips available online, some of which are official marketing and gameplay trailers; others are cutscenes and gameplay sessions posted by reviewers or fans. I avoid testing any clips of gameplay that were made using modifications to the original game software.

Other games I tested in 2015

This year I’ve tested also tested some other highly praised video games for their seizure risk (plus the games recommended by the New York Times and Los Angeles Times as noted above). Those results are here and here.


LA Times’ best video games of 2015: 4 can trigger seizures–and that’s progress

The mobile game Prune is about cultivating trees. The object is to prune branches in order to let the tree grow around obstacles.

In the game Prune, players help trees grow.

The Los Angeles Times’  list of 10 best video games of 2015 includes 4 with images that could provoke a seizure. While this isn’t great, it’s not as bad a ratio as I typically find. Usually the best of year/best of show lists contain a higher percentage of games with a real seizure risk, so this is actually better than I expected.

The Times reviewer, Todd Martens, noted that this year there was a broader selection of games and they offered a wide range of player experiences and perspectives. And a number of his favorites are refreshingly novel in their imagery.

Martens writes about his choices in an accompanying piece entitled “Games in 2015 were better when they stepped away from the guns.”

“For a medium that for much of the last decade has been overrun with machismo, 2015 in video games represented a year of powerful role reversals. It was time, finally, to put down the guns… At a time, culturally, when mass shootings are part of our daily conversation, the industry’s over-reliance on games with guns is not only no longer fun, it’s exhausting.

The idea of swapping weapons for actual stories should be celebrated in any medium, but in gaming, where guns, bullets and senseless bloody murder have long ruled the day, it felt downright revolutionary.”

So here’s another reason to celebrate the appearance of appealing games that don’t rely on guns: without the widespread shooting, mayhem, and destruction that have dominated in many top-selling games, there are fewer scenes with flicker and flash that can provoke seizures. (It is quite possible, though, to depict such scenes without creating large, rapid, and bright flashes on the screen.)

I tested clips from the Los Angeles Times Top Ten list using an application that detects image sequences that can trigger seizures in vulnerable individuals. If you’re still doing holiday shopping, you might want to consider these results when choosing gifts. Here’s what I got:

Best video games of 2015 chosen by the Los Angeles Times

Disclaimers

Please remember that there are no guarantees your results will match mine and that many variables affect a person’s susceptibility to visually induced seizures. Each person’s seizure threshold can be affected by a number of factors apart from the visual stimulus itself: illness, hunger, stress, fatigue, alcohol, medications, length of play, and others. So a game played without incident may trigger a seizure in the same player under different conditions. Also, players can be exposed to new and different image sequences in subsequent games.

Testing methodology

I run downloaded gameplay clips, cinematic clips, and promotional trailers for each game and submit the sequences to an application called the Harding Flash and Pattern Analyzer. 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. I don’t know how many of the major game developers in this country use the FPA–they keep such information very much to themselves.

The analyzer examines video sequences for very specific and measurable image qualities that researchers have found can trigger seizures:

  • 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

If the first clip I test of a game fails the seizure guidelines test, I then move on to test the next game. If no guidelines violations are found, I typically test at least 4 or 5 additional clips of that game–sometimes more, if I have a hunch due to the game genre and/or overall look of the sequences that there might be problem “footage” that I haven’t yet found.

Games receiving a PASS could have seizure-provoking sequences that I was unable to locate. I don’t do this testing while actually playing video games. Instead I work with video clips available online, some of which are official marketing and gameplay trailers; others are cutscenes and gameplay sessions posted by reviewers or fans. I avoid testing any clips of gameplay that were made using modifications to the original game software.

Other games tested in 2015

I’ve tested additional video games this year for their seizure risk. You can find results herehere, and here.

 


Seizure-inducing images found in 6 video games from NY Times 2015 holiday gift guide

boy opens presentWhen choosing a video game for someone on your holiday gift list (or for yourself), wouldn’t it be good to know whether the game contains images that could trigger a seizure? The seizures caused by certain video game visuals are a health risk that most people don’t stop to consider.

They’re also more common than people realize.

So at this time of year I like to provide some guidance on seizure likelihood in the games you might be thinking of buying. I test the games recommended in holiday gift guides, looking for the types of image sequences that can provoke seizures.

Today I’m reporting on the 10 video games suggested as gifts this year by the New York Times. Take a look at the introduction to the video games section of the guide.

“Buying someone a new video game can be a little like sending a family member on an unexpected foreign trip. It’s a nice gesture, and will surely be appreciated, but it’s awfully hard to know whether you’ve picked the right destination….Here are a few places to consider taking yourself, or your loved ones, on vacation this winter.”

— New York Times 2015 Holiday Gift Guide

There’s no hint in the prose above that the “right destination” could involve more than the entertainment value of the game. The narrative reads as though the worst possible consequence of your buying choice could be a less-than-totally-fun game experience. The “right destination” stakes actually are much higher for some people, since seizures are pretty serious business.

How to know the level of risk

  • There is no practical way for consumers to know in advance whether a given video game contains the types of flashing and pattern movements that can provoke seizures. Games are rated for mature content and violence but not for seizure risk. One obvious clue, sometimes provided by the game studios, is the presence of lots of quick flashes in the promotional trailer.
  • Visually provoked seizures can happen in individuals with no history of seizures.
  • There is no way to know whether an individual might be at risk for visually induced seizures. They may not have encountered the specific visual provocation that leads to a seizure. Or they may have had a seizure while playing, without realizing it.
  • Seizures can be hard to identify–many are very subtle and don’t involved falling down or lots of movement. Even subtle seizures, though, can be followed by significant impairments: difficulties with concentration and disruption of emotional control and sleep patterns.

Which games in the Times gift guide appear to be OK?

Using software that analyzes visual sequences for the types of rapidly flashing images and moving patterns that can produce seizures, I tested the 10 games recommended by the Times buying guideIncidentally, this software is intended for developers, not for folks like you and me–it allows them, should they opt to use it–to deliver a safer consumer product. This chart shows the results:

Minecraft: Story Mode, Splatoon, Sage Solitaire, Her Story, Until Dawn, Super Mario Maker, SOMA, Star Wars: Battlefront, Metal Gear Solid Plan: The Phantom Pain, The Witcher 3: Wild Hunt

Recommended games from the 2015 New York Times holiday gift guide

I’ll get to the details in just a bit of how I do the testing—there is no way I can test anywhere near all the scenes and story lines in a game. I’m not a one-person quality assurance department! Basically, after looking at and submitting multiple clips of a given game to an analysis tool designed for detecting seizure-inducing images, I eventually either find material that poses a seizure risk, or determine that further testing won’t uncover any.

Please remember that there are no guarantees your results will match mine and that many variables affect a person’s susceptibility to visually induced seizures.

Testing methodology 

I run downloaded gameplay clips, cinematic clips, and promotional trailers for each game and submit the sequences to an application called the Harding Flash and Pattern Analyzer. 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. I don’t know how many of the major game developers in this country use the FPA–they keep such information very much to themselves.

The analyzer examines video sequences for very specific and measurable image qualities that researchers have found can trigger seizures:

  • 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

If the first clip I test of a game fails the safety test, I note that and move on to test the next game. If no safety violations are found, I typically test at least 4 or 5 additional clips of that game–sometimes more, if I have a hunch due to the game genre and/or overall look of the sequences that there might be unsafe “footage” that I haven’t yet found.

Games I’ve listed as safe could have seizure-provoking sequences that I was unable to locate. I don’t do this testing while actually playing video games. Instead I work with video clips available online, some of which are official marketing and gameplay trailers; others are cutscenes and gameplay sessions posted by reviewers or fans. I avoid testing any clips of gameplay from modified game software.

Disclaimers

Each person’s seizure threshold can be affected by a number of factors apart from the visual stimulus itself, including illness, hunger, stress, fatigue, alcohol, medications, length of play, and the player’s menstrual cycle, among others. So a game that ordinarily seems OK may trigger a seizure in that same player under different conditions.

Other games tested in 2015

Holiday buying/year-end isn’t the only season for seizure guidelines compliance testing. I’ve tested additional titles this year. You can find results here and here. Also here.