Keywords

1 Introduction

In a world of three billion gamers, video games are everywhere—in our homes, workplaces, gyms, hospitals, and classrooms (Tran, 2023). Video games’ purpose is not just to entertain. In fact, there is a whole subgenre, known as serious games, which are employed in diverse contexts and disciplines. Among them, educational games aim to teach players certain knowledge or skills. Applied both to formal and informal educational contexts, they engage and motivate learners by using achievement systems such as points, levels, rankings, and challenges (Laine & Lindberg, 2020). Research shows that, if they are designed adequately and they tailor to players’ needs, educational games have pedagogical potential (Calvo-Ferrer, 2015; Fokides, 2018; Oliveira et al., 2023).

However, most video games, including educational ones, often present accessibility barriers that hinder and even prevent persons with disabilities from playing (IGDA-GASIG, 2021). In the context of educational games, these barriers affect every person’s right to education, information, and technology recognized in the Convention on the Rights of Persons with Disabilities (CRPD) (United Nations, 2008). Players with sensory disabilities such as blindness or deafness may not be able to access the visual or auditory stimuli of the game, while providing input can be the biggest challenge for players with motor disabilities. In the case of players with cognitive disabilities or learning difficulties, the issue lies in determining the response to visual, auditory, and haptic stimuli before providing the adequate input through the controller. For example, complex instructions or unclear goals may cause players to not know what to do next, preventing them from progressing in the game (Yuan et al., 2011).

Solutions related to cognitive accessibility include wording instructions in simple language, giving players the option to review the goals at any point during gameplay, and providing hints to aid progress (AbleGamers, 2018). The implementation of these features depends on the mechanics of the game. It should be tackled at the design stage of the development cycle, so that accessibility is integrated into the game’s budget and workflow (Barlet & Spohn, 2012).

In the past few years, cognitive accessibility in serious games has been examined in academic research. For example, Salvador-Ullauri et al. (2020a, 2020b) performed a systematic literature review to determine how sensory, cognitive, and motor disabilities were addressed in serious games. They focused on web-based games, which should follow the Web Content Accessibility Guidelines, also known as WCAG (W3C World Wide Web Consortium, n.d.). After analysing several therapeutic and educational games, they concluded that few developers include accessibility in their games. In another study, Dutra et al. (2021) conducted a systematic literature mapping of guidelines to develop accessible video games. They offered a series of recommendations for cognitive accessibility mainly based on serious games, even though their search accounted for all disabilities and all kinds of video games. The wideness of their scope can be seen in the terms of their search string (related to guidelines, games, and people with disabilities in general), and in the fact that they included two non-serious games in their sample. These examples, among other research in treatment and rehabilitation contexts (Derks et al., 2022; Francillette et al., 2021; Shapoval et al., 2022), show the growing interest in cognitive accessibility in video games. However, there is a research gap regarding educational games (von Gillern & Nash, 2023).

Therefore, it is pertinent to analyse the state of the art of cognitive accessibility in educational games. This chapter aims to be a resource for game developers and researchers by identifying and gathering recommendations about developing educational games with cognitive accessibility features. This is reflected in the primary research question (PRQ): what recommendations are available in the literature to design educational games with cognitive accessibility features? To deepen the understanding and contextualize the recommendations, the following secondary research questions (SRQ) have been defined: what methods are employed in developing recommendations for cognitive accessibility in educational games? (SRQ1); and who are the targeted players in the recommendations? (SRQ2).

The paper is organized as follows. Firstly, the concept of educational games is defined. Secondly, cognitive accessibility in video games is presented, emphasizing its importance for education. Thirdly, the methodology of the systematic search is explained and selected papers are analysed. Then, a set of recommendations to develop educational games with cognitive accessibility features derived from the literature is presented. Lastly, conclusions and future avenues for research are outlined.

2 Educational Games

Serious games have a purpose other than entertainment, and their applications range from formal and informal education to industry training, social awareness, and health care (Wilkinson, 2016). While gamification means applying game elements to other domains, such as incorporating a ranking on a pedometer mobile app, serious games are explicitly designed to teach players specific information or skills (Kenwright, 2017).

When compared to traditional teaching methods, the interactivity element in video games may contribute to players’ engagement and interest in learning, which may result in increased knowledge and retention of information (Riopel et al., 2019). Educational games take different forms and address several topics, such as computer programming in MIT Media Lab’s Scratch, USA history in MECC’s Oregon Trail, or marine wildlife in E-Line Media’s Beyond Blue. Moreover, games that were originally designed for entertainment may also be applied in educational settings (Martinez et al., 2022). For example, there is a website created by Microsoft that offers resources about how to use the game Minecraft for educational purposes addressed to institutions, teachers, and learners (Minecraft, 2023).

According to teaching practice and academic research, educational games bring several cognitive, emotional, and social benefits to students. First, games may enhance cognitive skills such as critical thinking, problem-solving, decision-making, and long-term retention of information (Barz et al., 2023; Reynaldo et al., 2021). Second, the active participation of the player in education may elicit emotions, engagement, and motivation to learn (Plass et al., 2015; Vankúš, 2021). Lastly, and particularly in multiplayer modes, educational games may promote communication and teamwork among students (Mikropoulos & Iatraki, 2023; Sun et al., 2018).

However, some scholars question educational games’ pedagogical advantages, particularly because there is a lack of research on how games are used in actual teaching practices (Backlund & Hendrix, 2013), and on how they compare to traditional teaching approaches (Hainey et al., 2016). In addition, there are concerns about games turning complex issues into an oversimplified, playable product, and the ideological implications this entails (Sanford et al., 2015). In spite of all, authors highlight the learning benefits of these games and their overall potential as educational tools of the future (Girard et al., 2013; Lau et al., 2017). This potential, of course, entails designing them with accessibility in mind, or their benefits may be compromised, particularly for learners with disabilities or difficulties.

3 Cognitive Accessibility

Cognition is an umbrella term that refers to “mental tasks, including conceptualizing, planning, sequencing thoughts and actions, remembering, interpreting subtle social cues, and manipulating numbers and symbols” (LoPresti et al., 2008, p. 29). Thus, according to ISO standards, cognitive accessibility means preventing or avoiding barriers related to tasks that involve cognition (Steel & Janeslätt, 2017). The issue may be approached, as originally described by Marks (1997), from two angles: first, according to the medical model of disability, the product or service stays the same and users improve their performance via training and rehabilitation if they want to use it, and second, according to the social model of disability, the product or service changes to cater for users’ accessibility needs, aiming to include as many people as possible (Retief & Letšosa, 2018).

Whereas the medical model sees disabilities as an illness, the social model considers them one of the many traits of a person. The latter is therefore less stigmatizing and more inclusive than the former. In fact, there is a trend in sociopolitical environments of adopting the social model, as can be seen in policies such as the aforementioned CRPD (United Nations, 2008). Following the same principle, this chapter is concerned with including everyone in education, regardless of their (dis)abilities, as summarized by Wolff (2009, p. 406): “Changing the world rather than the person is a way of accepting individuals in their differences, rather than making them adapt to the world”.

Persons with cognitive disabilities and learning difficulties may find it challenging to learn in the traditional classroom. According to Eurostat (European Statistics Department, n.d.), they tend to stop studying before ending secondary education. Among the reasons, one common theme seems to be that they feel socially alienated (Cobb et al., 2006). This might be worsened by the lack of transparency: some disabilities are noticeable from a young age, but learning difficulties might not start posing barriers until higher education (Tops et al., 2012); at that point, the inability to progress adequately might affect self-esteem, which is frustrating and stigmatizing at the same time (Abraham et al., 2002). In this respect, serious games represent a way of creating accessible paths to education. This is where initiatives such as the Universal Design Learning (Rao & Meo, 2016) gain importance: if lessons offer several ways of accessing and processing information, learner diversity will not pose any barriers to education.

In the case of video games, cognitive accessibility is particularly important, since they are interactive and, therefore, entail a cognitive load that is superior to the one required in other non-interactive audio-visual products (Mangiron, 2012). Some mainstream video games include cognitive accessibility features, such as Gears 5 (The Coalition, 2019), which allows pausing videos at any time and turning off notifications, or Grounded (Obsidian Entertainment, 2020), which allows to customize the rate and the amount of auto-savings, and includes a “creative” mode that can work as a training ground. However, other games, even if they are widely recognized (and even prized) for their accessibility, lack dedicated settings for cognitive features. It is the case of The Last of Us Part I (Naughty Dog, 2022) or God of War: Ragnarök (SIE Santa Monica Studio, 2022), which include presets for visual, hearing and motor accessibility, but not for cognitive.

There are also several guidelines that address cognitive accessibility in video games, such as the Game Accessibility Guidelines (GAG) (Ellis et al., 2017), the Accessible Player Experiences (APX) (AbleGamers, 2018), the Cognitive Accessibility Guide (Cassidy, 2019), and the Xbox Accessibility Guidelines (XAG) (Microsoft, 2023). An important contribution of these guidelines to our research is that they show the diversity of potential players and, consequently, potential students. After all, the guidelines take people with intellectual disabilities (such as Down syndrome), learning difficulties (such as dyslexia), and mental health issues (such as depression) into consideration. These may seem too different, but all affect cognition in some way: in the cited examples, mental tasks related to comprehension and attention might be at stake (Franceschini et al., 2012; Keller et al., 2019; Laws et al., 2016).

However, these guidelines are not specific to educational games. While some recommendations may be applicable, it may be challenging for developers to choose which ones are relevant for their games, especially due to their great level of detail and technicality. Aiming to ease the creation of an educational game with cognitive accessibility, this chapter gathers a series of recommendations that could be useful during that process.

4 Methodology

A literature review was conducted to identify recommendations for developing educational games that take cognitive accessibility into account. This methodology consists of carefully reading and critically assessing what is known about a certain topic (Bryman, 2012). To that end, a systematic search was performed in several databases to gather pertinent documents. Then, recommendations about how to develop an educational game with cognitive accessibility features were extracted.

Firstly, these five databases were chosen due to their importance in the research world and in social research in particular: Web of Science (WoS), SAGE Journals, ProQuest, Google Scholar, and Scopus. The following search string was entered in all of them:

“game accessibility” AND cogniti* AND educati*

The term game accessibility ensures that results are related to the area of interest, and the terms cogniti* and educati* are truncated to include variances such as cognitive or cognition, and educational and education.

Secondly, the search was conducted, retrieving a total of 159 documents: 1 in WoS, 3 in SAGE Journals, 40 in ProQuest, 55 in Google Scholar, and 60 in Scopus (Table 1).

Table 1 Results of the systematic search by database (N = 159)
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Thirdly, duplicates were identified and erased. Then, by reading the title, abstract, discussion, and conclusion, papers were included on the corpus according to the following selection criteria: to be peer-reviewed to ensure results are based on research evidence; to be published after 2013 to ensure representativeness of the current research landscape; to be written in English or Spanish (both working languages of the researchers); and to include recommendations for game development (Table 2). Likewise, these exclusion criteria were applied: to not have access to the full text, and to not be related to game accessibility, cognition, or education (Table 3).

Table 2 Criteria followed to include studies in the review
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Table 3 Criteria followed to exclude studies in the review
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After the process, ten documents were included in the corpus. The systematic search may be summarized as follows (Fig. 1).

Fig. 1
A flow diagram of the systematic search overview depicts 159 results at the initial search. After the exclusion of 23 duplicates, 14 with no access, 21 unrelated to accessibility, 42 unrelated to cognition, and 49 unrelated to education, the total result at the end is limited to 10.

Systematic search overview

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All accepted papers were read through for data extraction, which consisted of noting the following information on a Microsoft Excel spreadsheet: title, author, date of publication, methods (SRQ1), targeted disability (SRQ2), and recommendations for game development (PRQ).

5 Results and Discussion

After performing the systematic search and the review of the retrieved documents, ten papers were selected (Table 4). They are sorted by date of publication.

Table 4 Basic information of the accepted papers
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With the aim of contextualizing the content of the papers before reviewing their accessibility recommendations, their core concepts are summarized hereunder:

  • P1 uses the video game My First Day at Work to present the steps of developing an accessible educational game.

  • P2 discusses the implementation of a system to evaluate the accessibility of texts in community-driven games.

  • P3 considers the WCAG (W3C World Wide Web Consortium, n.d.) to evaluate the accessibility of 82 serious games.

  • P4 designs an interactive adapted system and assesses its validity through a cognitive walkthrough and a think-aloud protocol with target users.

  • P5 develops the video game PC TRAVEL in Roblox incorporating the guidelines from APX (AbleGamers, 2018) and GNOME (Gnome Developer, n.d.).

  • P6 presents a state of the art of serious games for people with mental illnesses by analysing whether they apply available recommendations.

  • P7 employs a user-centred design method to develop SimpleTEA for people with autism.

  • P8 performs a literature review and gathers a series of suggestions for developing accessible extended reality (XR) experiences applied to education.

  • P9 conducts a literature review to highlight how educators can re-evaluate and re-design aspects of their classrooms and instructional practices via the design of games with intentional learning.

  • P10 works with volunteers to develop the video game EnLang4All using the GAG (Ellis et al., 2017).

With regard to the primary research question, the objective was to identify what recommendations are available in the literature to design educational games with cognitive accessibility features. The authors of the selected papers present them in a variety of ways. While some have explicit lists of recommendations, others describe their design choices more broadly. These are explained hereafter.

The analysis shows that the content and format of the information provided by the game are key aspects of cognitive accessibility. On the one hand, four papers (P4, P5, P6, and P8) mention different ways in which the player can receive feedback from the game, such as visual or audio cues, vibration, icons, and text in the form of subtitles or descriptions. This evidences the need for communicating information through multiple channels, which may take the form of transcriptions from audio or video to text, or speech-to-text/text-to-speech technology (P3, P4, and P8). On the other hand, the information should also be easy to understand, regarding either the simplicity of the language and its format (P2, P5, and P10), or the simplicity of the core concept of the game (P1, P7, and P9).

Other accessibility features that are recommended by the selected papers are related to pacing, difficulty, graphics, and control devices. Authors advocate for flexibility with regard to time constraints, not only allowing pauses or having a flexible pacing (P5 and P9), but also allowing the repetition of events or challenges (P5 and P7). This should be accompanied by a difficulty that gives a sense of progression (P5 and P7), and that includes transparent levels, from easier to harder (P10). For the game to be as compelling and attractive as possible, the graphic style should be carefully considered (P6, P7, and P10), so that it can portray facial expressions while still being eye-catching. To guarantee interaction, a variety of external devices should be supported: different controllers, headsets for virtual or augmented reality, and smartphones or tablets (P3, P8, and P10).

Certain features are mentioned less frequently in the selected papers but seem equally relevant. Button combinations should be simple and easy to memorize (P5 and P6), there should be options to adjust photosensitivity for those people that might experiment seizures (P3 and P5), and text size, colour contrast, controller layout, and height should be customizable (P7 and P8). In relation to navigation, a contextual help in the form of scaffolding or a similar method could serve as guidance (P3 and P9). Concerning the interface, what is seen on the screen should be as simple and uncluttered as possible (P6 and P8). Saving should be available in strategic points or throughout the whole game (P5 and P10). Regarding engagement, rewards should be offered as a way of keeping motivation, whose importance in education is fundamental, as previously mentioned (P5 and P7). Finally, people with disabilities should be included in the design of the video game’s accessibility from the beginning of the development process (P1 and P8).

P6 adds two unique features not found in any of the other papers. These authors suggest, firstly, the avoidance of blood and gore, which may be triggering for some users, and secondly, the inclusion of a multiplayer option. This last feature has been used to foster engagement and social interaction for people with disabilities; concretely, it has proved to be effective in teaching social rules to people with autism (Gallup et al., 2016; Stone et al., 2019).

In Table 5, the recommendations for cognitive accessibility found in the selected papers are summarized. All of them may be applied to games that are not explicitly educational or even serious, potentially benefiting entertainment games as well.

Table 5 Extracted recommendations for cognitive accessibility from accepted papers
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Regarding the methods employed by the selected studies to develop recommendations for cognitive accessibility in educational games (SRQ1), there seems to be a two-direction trend. On the one hand, five papers (P1, P4, P5, P7, and P10) use the actual development of a game as a case study, putting the recommendations into practice and performing reception studies to evaluate the adequacy of the design. On the other hand, four papers (P2, P6, P8, and P9) carry out a literature review of a particular aspect of cognitive accessibility to gather and assess a series of recommendations proposed by other authors. An interesting case is P3, which does not fit in any of these two categories: the authors develop a method to assess the accessibility of serious games and implement it in a corpus to have a general view of the accessibility landscape.

The variability of the method in the selected papers elucidates the first limitation of this study. Some authors do not assess their recommendations; instead, they summarize results found in other research, as is the case of P8. Others use guidelines during the development process of a game (P1 and P10) or to check if they have been implemented (P6). P1 and P10 do include a validation process as part of their methodology: P1 evaluates usability with target users, but this concept does not equal accessibility, since being usable is just one of the several factors that make something accessible (Mangiron, 2011), and P10 evaluates the adequacy of the developed game, but with questionnaires that are addressed to volunteers with no mention to any disabilities. In conclusion, none of the aforementioned papers (P1, P6, P8, and P10) include target users in the creation or the evaluation of accessibility features.

Regarding the target users of the recommendations, the selected papers are aimed for as many users as possible with disregard to their abilities, but always including players with cognitive disabilities or learning difficulties (SRQ2). However, there are two papers, P4 and P7, which only address players with autism. Interestingly, their recommendations are not particularly similar among them, probably because P4 is aimed at students with autism, but also visual, motor, or hearing disabilities, while P7 uses a method specifically tailored for players with autism.

Likewise, analysed papers focus on different aspects of educational games: while P10 is centred on XR for educational purposes, P2 deals with the accessibility of community-driven games in education, and P6 includes in its review all kinds of serious games, whether they are educational, therapeutic, or other. As a result, some of these recommendations might be too specific or too broad to be applied to all educational games for people with any kind of cognitive disability or learning difficulty, which is the second limitation of this literature review.

In summary, and bearing these two limitations in mind, Table 6 presents the main contribution of this literature: a set of recommendations to develop educational games with cognitive accessibility features.

Table 6 Set of recommendations to develop an educational game with cognitive accessibility features
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Many of these recommendations are not specifically related to learning, but educational games have to be accessible in order for players to learn. That is, these suggestions potentially work for video games with purposes different to education or with the sole purpose of entertaining. Nevertheless, some of the recommendations gathered here, such as the cartoon aesthetic to portray emotions or the rewards to motivate learners, are not included in the guidelines for entertainment games, for example, XAG and GAG. To sum up, developers should apply the accessibility recommendations they consider feasible and appropriate depending on the purposes of their games, whether they are educational or not.

6 Conclusions and Future Work

The use of games for a purpose other than entertainment is on the rise. Among these so-called serious games, educational games are both enjoyable and instructive, as they are designed to teach players specific skills or new information. Interactivity differentiates these games from other learning methods, and it contributes to keeping players engaged and interested. Moreover, educational games have shown to enhance cognitive skills, elicit emotions and motivation, and promote communication and teamwork among players (Barz et al., 2023; Mikropoulos & Iatraki, 2023; Plass et al., 2015).

However, educational games might present accessibility barriers for persons with disabilities, hindering their rights to education, information, and technology. Particularly, for players with cognitive disabilities and learning difficulties, determining the required response to progress in the game might be difficult, which could affect their self-esteem and trigger social alienation. Accessibility in this context may contribute to creating more inclusive educational experiences.

In this chapter, a literature review was conducted to identify which recommendations could be followed to create educational games with cognitive accessibility features. Ten papers were selected, and their analysis shows that the main suggestions to ensure cognitive accessibility are providing stimuli through alternative channels, allowing the pace to be customizable, and designing simple but engaging content. Other relevant features that should be considered are the graphic style, the control devices, and the difficulty. It should also be brought to attention the overall customizability of the game, the information available on the interface, and the rewards that are offered after an adequate progression.

On the one hand, selected papers followed mainly two methods: they either reviewed research on a concrete aspect of cognitive accessibility or they studied the development of an accessible educational game. On the other hand, they targeted players with all kinds of disabilities, that is, not only users facing cognitive barriers, but also visual, hearing, or motor ones. Only two papers focused on a single type of needs, namely those of players with autism.

This variability in the methodology and in the scope of the target audiences, which spans from being overly broad to extremely specific, implies that our concluding set of recommendations, as given in Table 6, may not be applied to every video game. Instead, developers should evaluate which ones are useful for the game's purpose (educational or not), mechanics, and users.

To validate these recommendations, future research should include developing a game following these recommendations. Then, a reception study with players with diverse accessibility needs and preferences should be conducted. This could be done by introducing the game in a real educational context to better understand how game-based learning fits in with more traditional practices, and how developers should treat certain educational content so as not to trivialize it, which is one of the main criticisms of educational games.

In conclusion, this research is a starting point for developers and researchers to create and analyse educational games with cognitive accessibility features. It aims to overcome the scarcity of resources regarding this topic and to bring together players, teachers, developers, and researchers to create more interactive and engaging educational experiences for all.