[This article first appeared in the December 2008 edition of our membership magazine Epilepsy Today]
Countless kids – big and small – will be opening up games consoles as gifts over the holiday season. But how many people with epilepsy are avoiding video games because of over-zealous warnings? And how many are sitting down to play, unaware of the potential risks...? Peter Fox explains
Video games are becoming increasingly popular. Particularly after the launch of various ‘sexy’ new consoles and fast, slick games from industry giants like Nintendo, Sony and Microsoft. Contradicting the established image of the nerdy gamer in a Tetris T-shirt and jam-jar glasses, new consoles have made it seem cool to be a gamer again. In the last decade alone, over 335 million computer and video games were sold in the UK.
So, how do these new, increasingly complex pieces of equipment – and the software they run – affect people with epilepsy? We’re all aware of how television screens, computer monitors, even flickering light bulbs can affect people with photosensitive epilepsy (PSE). The wrong colours, patterns or flicker rates can trigger seizures. All television shows broadcast in the UK have to be tested before they are aired to make sure they’re safe. Of course, it’s obvious that games would be similarly tested. Isn’t it...?
Gaye Herford is a dedicated mother. Her son was one of many youngsters who have been seduced by the bright colours and smart graphics of modern video games. Although Gaye could not have realised at the time, he was also one of the few youngsters that would experience a negative reaction to them.
“This was last year,” explains Gaye. “My youngest son doesn’t play a lot of computer games, but for his birthday I bought him a Nintendo DS [a popular handheld games console] and a particular computer game he’d had his eye on. He was very excited to play it. He turned the game on and moments later he had a seizure.
“When I ran to him, his head was twitching to the left. The left side of his face and his left arm were also twitching. It was obviously a partial seizure. When it passed he was tired and confused. We were stunned; it was quite frightening. I had seen a seizure before, but never in my own child.”
Like so many parents witnessing a seizure in their child for the first time, Gaye was understandably panicked. On the advice of an emergency on-call doctor, Gaye’s son was taken straight to the children’s hospital – where it became immediately obvious what had happened.
“From our description, they recognised it as a seizure,” Gaye confirms.
Gaye was understandably confused. Her son had shown no previous evidence of PSE. As is the case in many other people, the condition had lain dormant until triggered by a particular event. In the case of Gaye’s son, that event was a new video game. Gaye had given him what seemed like a harmless birthday gift with no idea of the potential risk involved in using it.
“I knew only a little about the risks associated with PSE at the time. How would you feel about your child watching television? Of course, you don’t mind because the risk is small. All the programmes should have been screened,” Gaye continues. Like many, she simply assumed that similar regulations must be in place to govern the video games industry. There are currently no regulations in place.
Most video games carry some warning somewhere on their packaging that refers to epilepsy. These warnings are a voluntary measure by video games manufacturers to try and keep gamers safe. These warnings are all very well – provided you know that you have PSE. Unfortunately – as in the case of Gaye’s son – not everybody does.
Gaye says: “Three quarters of people – 76 per cent – won’t know that they have PSE until something triggers a seizure.”
These voluntary warnings are not only ineffective in the case of consumers who don’t realise they are photosensitive. They may actually be putting off many people with epilepsy who are not even at risk.
Nintendo, for instance, advises that anyone who has had a seizure – or has experienced seizure-like symptoms – should avoid playing games without consulting a doctor. This warning effectively discourages anyone with epilepsy from playing without the involvement of a GP or neurologist. This is despite the fact that only three to five per cent of people with epilepsy are photosensitive. The other 95 to 97 per cent of people with epilepsy are at no risk whatsoever – but may still be missing out.
Gaye continues: “The warnings show an ignorance of epilepsy. Why shouldn’t these children with PSE – or with undiagnosed PSE – be able to play video games with their friends? At the moment, warnings are put on games, but they’re not all screened – so you don’t know which ones are dangerous and which ones aren’t. They should all be pre-screened – then the risk is infinitely lower.”
Ofcom is the Office of Communications, the organisation that regulates the UK communications industries. Ofcom guidelines require that all television programmes for broadcast in the UK are pre-screened to assess the risk of triggering a seizure in someone with PSE. These guidelines were originally drawn up in 1994.
“Of course at that point, fewer computer games were available and they were not as sophisticated as they are now,” says Gaye. “As a common pastime, I think game-playing is really catching up with television-watching – and I think the games should be brought under the same regulations.”
On the campaign trail
Gaye went about trying to raise awareness of this issue and convince people in the right places to support her cause. She got in touch with Weston MP, John Penrose – and found that her story immediately struck a chord with him.
John says: “I was pretty horrified – it’s a distressing tale for any parent.”
John was in firm agreement with Gaye’s insistence that the games industry needs to ensure the safety of gamers with PSE. He has echoed her request that all video games are screened before their release, in the same way television programmes are.
John explains: “The original approach to broadcasting all those years ago was that prevention is better than cure. It was right for broadcasting and it’s also right for video games. We’re not asking developers to do anything that’s not already tried and tested. The technology has been around for a very long time. There are no expensive, difficult or cutting-edge things to be done – it’s boringly easy.”
The technology John is referring to is that currently used to screen television programmes before they are broadcast. One such system is the Harding Flash and Pattern Analyser (FPA) – devised by Professor Graham Harding, the world expert on PSE. Systems like Harding’s FPA are designed to check television footage. It flags up particular colours or patterns that are known to trigger seizures in people with PSE. These sections may then be removed before the programme is televised. Alternatively, a warning will be added, warning people who are photosensitive not to watch the following clip.
Pre-screening video games should work in a similar way. Once problematic images, patterns or colours have been identified, they can be removed – resulting in a safer gaming experience. Gaye has some concerns that gameplaying purists may feel short-changed if sections of a game are removed before its release. She insists, however, that the gaming experience will not suffer.
“If games are pre-screened, the odd problematic sequence can be taken out,” she explains, “but I don’t want the games spoiled. We’re talking about the odd second or two here and there. No one will find the game any less fun or exciting.”
Some games manufacturers have already begun pre-screening their latest games. These manufacturers include Ubisoft, the games developer responsible for the title that triggered a seizure in Gaye’s son. These manufacturers are demonstrating a conscientious attitude towards the safety of gamers. They inspire some confidence that regulations may not be necessary if manufacturers will all voluntarily screen their products. But would all manufacturers be as conscientious?
“The games industry has tried to be responsible,” says John. “But if measures remain voluntary, there is the possibility that a small-scale manufacturer from another part of the world may not adhere to it. You may get one or two rogue games creeping through. Nevertheless, starting off with a voluntary approach may be the fastest way to get this done. Getting laws through Parliament is a slow and careful process. A voluntary code may be the fastest way to get a lot of the benefit, even if the system is not perfect.”
A voluntary code encouraging manufacturers to screen all games would definitely be a start. Some manufacturers may be reluctant to introduce new testing procedures on the grounds of cost. Manufacturers like Ubisoft are showing competitors that pre-screening software need not be too expensive.
“There are several different bits of software out there that do the job,” says John. “I don’t mind which one games developers use, as long as it’s an effective pre-screening tool. Manufacturers can pick and choose without the procedure adding too much to their costs – which is what we don’t want. We want to add this layer of safety cheaply, so it’s an easy thing for them to do.”
The ultimate goal of the campaign being mounted by John and Gaye is to make it illegal to retail a video game in the UK that has not been pre-screened. This may seem like a tall order. Fortunately, John managed to secure a commitment over the summer months that may make this goal a reality.
“[John] was good at formulating a campaign and took it to the House of Commons,” says Gaye. “He had a Parliamentary debate with Margaret Hodge about it.”
Margaret Hodge is Minister of State at the Department of Culture, Media and Sport. The debate Gaye is referring to took place on the 1 July. It resulted in a firm promise from Margaret Hodge that the need for a new code of conduct governing the screening of video games would be investigated.
ELSPA is the Entertainment and Leisure Software Publishers’ Association. At the time of going to press, the government had requested that ELSPA produce a voluntary code for pre-screening procedures among games developers. Although this is a positive step on behalf of the government, ELSPA have already received several letters from John Penrose. None of these letters received a reply. Whether this is a worrying sign or not is impossible to say at this stage.
One way or another, it seems that the games industry is at least finally taking some account of people with PSE. Manufacturers are trying on some level to make sure that their products are safe for everyone. If we can get to the stage where all video games are screened before their release, the virtual world may be a safer place for everyone.
“Then all people who know they have PSE can sit and play without worrying that they might have a seizure,” concludes Gaye. “All those who have no idea that they have undiagnosed PSE will not be at risk. It seems to make very good sense.”
The soft sell
European software developer Ubisoft has changed its testing procedures as a direct result of Gaye’s story. Publicist Mary Beth Henson explains what the company has done to keep gamers safe
Were you aware of the issues surrounding PSE before the incident with Gaye Herford and her son?
We were aware of the issue. We used manual guidelines to check all of our in-house produced games, as well as including warnings on our game packaging.
Do you think the video games industry is well-informed about these issues?
It’s hard to speak for the rest of the industry. I would say that there is a certain high-level awareness of the subject.
Do you think it should be made law that developers test games before their release?
Our feeling is that voluntary measures are usually more successful than legislation.
Some games consoles discourage anyone who has had a seizure from playing – photosensitive or not. Does this show ignorance of epilepsy in the games industry?
Rather than showing ignorance, the warning shows a level of caution on the part of the manufacturer. Each person reacts differently to the next person – even with the same image or situation. It’s understandable that a manufacturer would want to fall on the side of caution with its warnings.
What was your response to Gaye’s story?
When Gaye contacted us, we were heartbroken to hear that a game that we had made would have caused a crisis for her son.
Gaye asked us to look into the Harding Flash and Pattern Analyser (FPA). The FPA is made to test television images. In many instances this is fine for testing video games – since most console games and PC games are viewed on a television screen.
In this case, however, Gaye’s son had been playing a game on a handheld console with two screens. The Harding FPA was not made to analyse such a situation.
We worked with the people at Cambridge Research Systems Ltd to adapt the Harding FPA to take two screens into account. They were able to provide us with a product that could test all of our games – both the classic console games and the ones made for handhelds with two screens. Since September 2007, we have used the Harding FPA to test all our games.
As we work on game testing and debugging, the images are analysed by the FPA. We receive a report flagging up any images that might pose a strong risk for people with PSE. We re-work images or sequences that are flagged up, until they fall into the non-risk category.
Do you think other games developers will voluntarily do the same?
We can’t speak for other developers, but we’ve been able to smoothly integrate testing into our development processes. We are happy to have been able to do so.
[This article first appeared in the December 2008 edition of our membership magazine Epilepsy Today]