With a smile, Paul slips his fingers beneath a cable and dangles the large plastic button attached at the end between his teeth. “I could never find another place to put this one, so it just goes in my mouth,” the 27-year-old from Luton laughs as he returns to playing Call of Duty.

It’s an apt, albeit minor, example of what life can be like with a disability: meeting a challenge with a unique and sometimes clever way that works for you. It’s certainly common ground that gamers with disabilities face on a regular basis. Paul Phillips is a C4/C5 tetraplegic, meaning he is paralysed through most of his body, he has limited movement in his arms, and uses a motorised wheelchair to get about. But none of this stops him from playing his Xbox.

It was 2012 when Paul broke his neck in a car accident – the same day he had been accepted full-time as a carpenter after completing an apprenticeship. Months of life-threatening complications and stresses followed for both his family and him. “I couldn’t see a future, to be honest. Depression and anxiety hit me quite hard,” he says calmly, “I had a long-term girlfriend for six years, I had many friends I went out with, and I lost a lot of that straight away.”

One of the hardest parts was the boredom. Stuck in a hospital bed as he began adapting to a new life, Phillips longed for the nights where he could relax with some friends again, carelessly mashing controllers in front of TV sets until they couldn’t bear it any longer. Like many others with his level of injury, Phillips just assumed gaming wasn’t an option as he could no longer grip an everyday controller in his hands. Suddenly, something that was such a huge part of his life had been taken away.

Thankfully though, this didn’t last long. Today, sat comfortably around his living room in St Albans, a large customised Velcro tray rests on his lap covered in a multitude of buttons – with an extra one in his mouth, of course. Through a few simple changes, Phillips has his own personalised controller, and a barrier that had such an impact on his mental health is lifted once more.

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It’s all thanks to the disability gaming charity SpecialEffect that Phillips knew what to do. They visited him in hospital, helped to assess what he needed and advised him on the right equipment. As soon as he was back at home, he was putting in the practice to challenge his friends again. And he hasn’t looked back.

“If it wasn’t for this charity, I wouldn’t be playing,” says Phillips. “I still play for a couple of hours every day. I like being competitive online, and showing that people with disabilities can play just as well, which is always fun. Me and my brother play games together now too, which is something we never really used to do. Now I can say I’m as happy as I was before my accident.”

SpecialEffect was set up by Mick Donegan back in 2007. Working at a special needs school in Birmingham at the time, Donegan says parents would constantly ask if he had any ideas for accessible extra-curricular activities for their children, as disabilities often prevented them venturing outside with friends. When Mick didn’t have an answer, it got him thinking about how he could help change that.

Paul Phillips, 27, in his home in St Albans: ‘I like being competitive online, and showing that people with disabilities can play just as well’ (Photos Matt Murphy)

The ultimate goal for his organisation is to enable as many people as possible to have easy access to video games. The charity employs occupational therapists and works with specialists to assess people with disabilities, lending out kit and providing advice when they can to overcome any obstacles. Whether someone can use part of their body, or even just their eyes, there's a way to play.

“Gaming is probably one of the most inclusive uses you can possibly make of assistive technology, and that actually surprised me,” says Donegan, his eyes lighting up, “I suddenly realised – goodness me, you’ve actually got people with disabilities, and you don’t need a separate competition for these guys. We can actually get them joining in with everybody else – and beat them. This is what drives me. That’s what makes me shoot out of bed at a silly time in the morning.”

“It’s a great opportunity we have,” he adds. “We’re building expertise all the time, we’re getting more and more specialist teams together, and it’s really exciting to see what the charity is able to achieve for as many people as possible.”

A winding journey 30 miles up the M1 from Paul Phillips is Laura Haddon in Milton Keynes. Haddon has cerebral palsy, and only started playing video games in the past year. Like Phillips she uses a wheelchair to move about the house, and has a similar Velcro board with detachable buttons. She asks her Amazon Echo to turn her Xbox on before pausing, “it’s probably not going to work now!” says the 31-year-old, before laughing as it responds successfully.

Laura Haddon playing the Xbox at her home in Milton Keynes: ‘Gaming gave me a way to enjoy time with my friends’

“I need a lot of help with day-to-day life. Like the simplest things to the normal things, if you know what I mean. And gaming makes me forget it a bit, because I can sit there for hours playing games. And I even forget when the carer comes and they walk in and say ‘what you doing?’ and I say ‘gaming!’”

Haddon’s interest in console gaming first came about when she saw other disabled friends playing and wanted to get involved. She was getting bored of simply using her tablet all the time. She wanted something that would get both her arms moving, as she explains one can be weaker than the other.

“Gaming is so important to me because it gave me a way to enjoy time with my friends. I think it’s really good because you can have people with different disabilities or no disability playing together. There was one friend last month who I collected points and I beat him [on a driving game online]. I was well chuffed,” she says with a mischievous chuckle, “he won’t be.”

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Though the technology most of the charity’s clients use isn’t exactly new or uncommon, it’s the widespread awareness that is still lacking – for gamers and game developers alike. Many players face the same ignorance Phillips did in thinking their own console is off limits due to their disability. Multinational groups like Microsoft have invested in the field, releasing the Xbox Adaptive Controller last year, which Phillips and Haddon both use, and Logitech have recently brought their own customisable controls to the table. But there is definitely more to be done, and the signs are there that things are improving.

“I’m really delighted to see the way that developers are taking on board the idea of making gaming more accessible to people,” Donegan says. “We’re now being approached by some pretty big companies globally. With the Xbox Adaptive Controller – for Xbox to produce a mainstream control device is such a great statement for me. They asked us to give them advice and also test the controller to make sure it was fit for purpose. That’s a big help, and a welcome addition to our very large toolbox when we come on visits to support people.”

Mick Donegan, CEO of SpecialEffect: ‘Developers are taking on board the idea of making gaming more accessible’

Where at the beginning it was the likes of SpecialEffect trying to attract the attention of these large gaming firms to prioritise accessibility, the tide is turning and it’s now the organisations that are taking notice and reaching out instead. Electronic Arts (EA), which produces the football simulation game FIFA –​ one of the most popular in the world with hundreds of millions of players – are one of many designers listening to Donegan and his team about how they can make minor changes to their future releases.

Back in St Albans, as Phillips shares his love of the new versions of FIFA and Call of Duty, he nods in agreement that things have come a long way, but there is still some distance to go.