Engagement and participation in gaming continues to be a powerful and enjoyable outlet for leisure purposes for many people. Occupational therapy practitioners understand the value and benefits of meaningful engagement in leisure as an occupation. One way occupational therapists are harnessing this is through the implementation of gaming as an intervention. Occupational therapists help gamers overcome barriers such as physical or cognitive deficits to be able to continue to participate in the games they love. Gaming has cognitive, physical and social demands that can all be simultaneously addressed by occupational therapy when it is incorporated purposefully into therapy. Gaming can be categorized as a meaningful occupation in two distinct ways:

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1. Patients who have, or will have grown up with gaming as a part of their daily lives include Millennials, Generation Z, and future generations. These generations of individuals and future patients grew up with a Gameboy, tablet, or console controller in-hand from the time they were young enough to merely grasp the object itself and press buttons tactlessly; as such, this activity is ingrained in the culture and is a normative part of these generations’ life experiences (Jones 2018).

2. Other patients who may not have necessarily grown up with gaming or technology can still benefit from the implementation of gaming as a means of simulating a task they do find meaningful. An example of this could be having a former homemaker who sustained a traumatic brain injury engage in a cooking game on the Xbox in order to work on her sequencing, planning, and executive functioning skills required to prepare a meal without the risks associated with sharp knives and open flames during recovery (Jones 2018).
 

Definitions (Craig Hospital, 2020)
 

• "Gaming Controllers - One of the most important pieces to accessing and engaging in gaming is the controller. In the past, this fell onto the individual gamer to adapt the devices; today, manufacturers and organizations are taking the lead.

• Accessible Gaming Shop - Features OneSwitch products, various controllers including a one handed gaming controller as well as information and links to others dealing in accessible gaming. Available for most gaming systems; access options include large switches, as well as eye, mouth or head control options.

• Ben Heck - Markets single-handed controllers and Xbox One and Xbox 360 controller monitors.

• Blue Tip Gaming- Ideal for gamers with extremely limited mobility such as C5 spinal cord injury. Available for Xbox 360, Wii and PS3; modified controllers with larger buttons and adapted joysticks.

• Broadened Horizons - Unique video game controllers allow anyone, regardless of ability or disability, to play competitively as an equal. Available for most gaming systems; access options include button style switches, sip 'n' puff switches and head control options.

• Cross Console Gaming Devices- These USB devices allow you to use your favorite adaptive controller on other gaming systems including PS4, Xbox One, PS3, Xbox360, Playstation TV, PC and Wii. You may need additional equipment for wireless use. Comes with Gtuner Pro software so you can create macros and remap any button or joystick on your controller. Examples include the CronusMAX PLUS, Titan One/Two, and Brook Super Converters.

• Evil Controllers - Modified and customized controllers for Xbox One, Xbox 360, PS3 and PS4. Some can be used by one hand or are switch-activated. They include features such as auto-aim or rapid-fire.

• Mayflash Arcade Sticks - Compatible with PS4, PS3, Xbox One, Xbox 360, PC and Android. This product's larger buttons and joystick may be easier to access if you have limited dexterity. Note: This controller only provides users with the left joystick function, and not the right.

• QuadStick - This mouth-operated game controller for quadriplegics is compatible with the PS3, Android and many PC games that use a joystick, mouse or keyboard. It can also be used as a mouse and can control other infrared devices. The Quadstick site features a large user forum as well as downloadable controller profiles for specific games.

• RJ Cooper & Associates - Multiple options for custom controllers which include button location, size, larger joysticks and mounts.

• VoiceAttack - Voice-activated control for PC games and with voice commands that the user creates.

• Xbox Adaptive Controller - The first adaptive controller designed and manufactured at large-scale by a leading technology company, the Xbox Adaptive Controller allows gamers with limited mobility to play their favorite games on Xbox One and Windows 10. Players connect external devices such as switches, buttons, mounts, and joysticks to create a custom controller that meets their needs. The controller can also be customized using Button Mapping and Copilot features using the Xbox Accessories App. Compatible switches and USB devices can be found on the Xbox website. This controller was developed with input from a variety of adaptive gaming organizations, including therapists at Craig Hospital."