Graham Harding, 1937 – 2018

charles at aston2

Prof. Harding hosted Prince Charles at the opening of the new Vision Sciences Department building at Aston University in November 1987.

Prof. Graham Harding, a pioneer in photosensitive epilepsy research, has died at age 81. His recent obituary in The Times aptly described him as a world authority on photosensitive epilepsy. Prof. Harding published more than 350 research papers and co-authored a seminal book on photosensitive epilepsy. He was among the first to recognize the risk of seizures from television and video game graphics.

Perhaps most important of all, he crafted image guidelines that reduce the public’s risk of photosensitive seizures from environmental triggers, and he advocated for safer video games. His own research and studies by others showed that specific, measurable qualities of a flashing or patterned image determine its risk of triggering epileptic seizures in individuals with photosensitive epilepsy.  Identifying the risk factors and danger thresholds from the flash interval, and the brightness, size, and color contrast of images enabled him to create guidelines for minimizing the chances of seizures.

The need to protect the public 

In 1993, flashing images in a commercial on British TV caused seizures in three viewers the first time it aired. In response, the British regulatory agency for television asked Prof. Harding to draft guidelines to limit the public’s exposure to seizure-provoking television images. Four years later, after the Pokémon incident in Japan, the Japanese government asked him to do the same.

Nearly 700 children had arrived at hospitals in Japan for suspected seizures during a Pokémon cartoon broadcast. Prof. Harding later recalled in an interview, ‘The first I knew of it was when my secretary said, ‘The Japanese embassy is on the phone, 400 children have just had seizures,”’ and shortly afterward he was flown to Japan. Doctors found that 560 of the children had probably experienced seizures; 76 percent of them had never had a seizure previously.

Practical solutions

Prof. Harding was clear that seizure warnings on video game packaging and instructions do not provide adequate protection for consumers, citing the 76 percent of Japanese children whose first seizure occurred during the Pokémon cartoon.

While Nintendo, for example, warns that anyone who has had a seizure induced by flashing lights or patterns should consult a doctor before playing a video game, Harding said, that doesn’t protect against a first attack. ″Warnings are good except for people who don’t know they are photosensitive,″ said Harding.

Knight-Ridder Newspapers, December 25, 2002

Ensuring that the guidelines were observed was very time-consuming; he analyzed broadcast video images frame by frame. “Some days I spend four to five hours watching the television,” he said at the time. “It is nice in that it is real applied medical science. Part of my job is stopping people having seizures, so if this is how I do that I don’t really mind.”

With the help of his wife and Cambridge Research Systems, Ltd. he then created the Harding Flash and Pattern Analyzer (FPA) to automate the process, which was nominated for a Royal Television Society technical innovation award in 2001. I have used the FPA many times to check images of video games and music videos.

Harding and Jeavons book cover tiny

Prof. Harding co-authored the first monograph on photosensitive epilepsy in 1975.

Other accomplishments

Prof. Harding received his PhD at the University of Birmingham in electroencephalography (EEG) and psychiatry. He spent 40 years at Aston University in Birmingham, where he headed up the Vision Sciences Department and was the first professor of clinical neurophysiology in the UK. When the department opened a new building in 1987, Prof. Harding hosted the Prince of Wales at the opening ceremony. Although he did not have medical credentials, his contributions to medicine were recognized with membership and then fellowship in the Royal College of Physicians.

Prof. Harding was also one of the developers of guidelines to standardize photic stimulation testing, a diagnostic procedure for identifying photosensitivity, and he wrote about the risk of photosensitive seizures precipitated by wind turbines.

It is hard to overstate Prof. Harding’s influence on the study, diagnosis, and prevention of visually induced seizures.

Selected papers

Televised Material and Photosensitive Epilepsy

Regulations: What Next?

Persistence of Photosensitivity

Characterizing the Patterned Images that Precipitate Seizures and Optimizing Guidelines to Prevent Them

Photic- and Pattern-induced Seizures: Expert Consensus of the Working Group of the Epilepsy Foundation of America Working Group

Wind Turbines, Flicker, and Photosensitive Epilepsy

 


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.


Seizures from 2017’s best video games

What Remains of Edith Finch, Gorogoa, Everything, Night in the Woods, Divinity: Original Sin 2, Legend of Zelda: Breath of the Wild, PlayerUnknown's Battlegrounds, NieR:Automata, Persona 5, Super Mario Odyssey

The New Yorker’s Top 10 video games of 2017. Five contain scenes that could trigger seizures.

When you play a game ranked in the GameSpot or New Yorker Top 10 video games of 2017, the chances are about even that you will be exposed to images that could trigger photosensitive seizures. These images, which violate established guidelines for reducing the risk of photosensitive seizures, appear in 6 of the games in a combined Top 10 list. In 7 games these images were not found (some games are on both Top 10 lists).

What are photosensitive seizures?

Resident Evil 7, Horizon Zero Dawn, Wolfenstein 2: The New Colossus, Hellblade: Senua's Sacrifice

GameSpot’s 2017 Top 10 list includes 6 games that contain images that can trigger seizures.

Photosensitive seizures can occur when people with photosensitive epilepsy are exposed to intense visual stimuli: bright, rapid flashing light and bold patterns with strong contrasts. An unknown segment of the population has photosensitive epilepsy, including people with no history of seizures. It is under-reported and under-diagnosed.

In those who develop the condition, photosensitive epilepsy typically is hidden until the first noticeable seizure occurs in the presence of bright flashing or patterns. Most people with other types of epilepsy are not photosensitive. In other types of epilepsy, seizures are much more unpredictable.

Seizures can be of any type, from tonic-clonic episodes with loss of consciousness to brief absence seizures that can be as subtle as a brief hesitation or stare. Most people do not have photosensitive epilepsy, but many who do are unaware that they have the condition until a they experience a seizure during or after exposure to flashing or patterned images. Some individuals may have seizures that are too subtle to notice.

Screen grab from a sequence in The Legend of Zelda that could provoke a seizure in individuals with photosensitive epilepsy.

The seizure reduction guidelines test 

Guidelines for seizure reduction originated in 1994, when the UK adopted technical guidelines to accommodate TV viewers with photosensitive epilepsy. These guidelines, based on studies by photosensitive epilepsy experts, outline the characteristics of flash rates and spatial patterns that typically trigger seizures in people with photosensitive epilepsy. They were later updated and some have been adopted by the World Wide Web Consortium (WC3), the international group that produces website standards for all types of applications, and the International Telecommunication Union.

The guidelines define criteria for photosensitive seizure risk involving:

  • flash rate greater than 3 per second and less than 60
  • stripes and geometric patterns with high contrast
  • large areas of very bright (“saturated”) red
  • any of the above problem images taking up more than one quarter of the total screen area

Visuals adhering to these guidelines are unlikely to provoke seizures in 97% of people with photosensitive epilepsy.

Testing video games for compliance with guidelines

Although most games carry seizure warnings, not all games contain the types of images that can bring on seizures. The warnings are not specific to the content of a given game, so consumers who pay attention to the warning don’t know whether it pertains to the game they are about to use. So I test them.

I tested the games using downloaded clips of gameplay that I loaded into an application called the Harding Flash and Pattern Analyzer. The FPA is widely used by TV producers and networks in the UK—including by the BBC—to reduce the risk of seizures from material on broadcast TV, and is used by some game studios. It examines video sequences frame by frame for very specific and measurable image qualities that research shows can trigger seizures.

For more specifics on how to interpret the test results, please see this prior post. For more on my testing process, see this one.


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.

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 that 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.

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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.