Paul Lane uses his mouth, cheek and chin to push buttons and guide his virtual car around the “Gran Turismo” racetrack on the PlayStation 5. It's how he's been playing for the past 23 years, after a car accident left him unable to use his fingers.

Playing video games has long been a challenge for people with disabilities, chiefly because the standard controllers for the PlayStation, Xbox or Nintendo can be difficult, or even impossible, to maneuver for people with limited mobility. And losing the ability to play the games doesn't just mean the loss of a favorite pastime, it can also exacerbate social isolation in a community already experiencing it at a far higher rate than the general population.

As part of the gaming industry's efforts to address the problem, Sony has developed the Access controller for the PlayStation, working with input from Lane and other accessibility consultants. Its the latest addition to the accessible-controller market, whose contributors range from Microsoft to startups and even hobbyists with 3D printers.

"I was big into sports before my injury," said Cesar Flores, 30, who uses a wheelchair since a car accident eight years ago and also consulted Sony on the controller. “I wrestled in high school, played football. I lifted a lot of weights, all these little things. And even though I can still train in certain ways, there are physical things that I can’t do anymore. And when I play video games, it reminds me that I’m still human. It reminds me that I’m still one of the guys.”

Putting the traditional controller aside, Lane, 52, switches to the Access. It's a round, customizable gadget that can rest on a table or wheelchair tray and can be configured in myriad ways, depending on what the user needs. That includes switching buttons and thumbsticks, programming special controls and pairing two controllers to be used as one. Lane's “Gran Turismo” car zooms around a digital track as he guides it with the back of his hand on the controller.

“I game kind of weird, so it’s comfortable for me to be able to use both of my hands when I game,” he said. “So I need to position the controllers away enough so that I can be able to to use them without clunking into each other. Being able to maneuver the controllers has been awesome, but also the fact that this controller can come out of the box and ready to work.”

Lane and other gamers have been working with Sony since 2018 to help design the Access controller. The idea was to create something that could be configured to work for people with a broad range of needs, rather than focusing on any particular disability.

“Show me a person with multiple sclerosis and I’ll show you a person who can be hard of hearing, I can show someone who has a visual impairment or a motor impairment,” said Mark Barlet, founder and executive director of the nonprofit AbleGamers. "So thinking on the label of a disability is not the approach to take. It’s about the experience that players need to bridge that gap between a game and a controller that’s not designed for their unique presentation in the world."

Barlet said his organization, which helped both Sony and Microsoft with their accessible controllers, has been advocating for gamers with disabilities for nearly two decades. With the advent of social media, gamers themselves have been able to amplify the message and address creators directly in forums that did not exist before.

“The last five years I have seen the game accessibility movement go from indie studios working on some features to triple-A games being able to be played by people who identify as blind," he said. “In five years, it’s been breathtaking.”

Microsoft, in a statement, said it was encouraged by the positive reaction to its Xbox Adaptive controller when it was released in 2018 and that it is “heartening to see others in the industry apply a similar approach to include more players in their work through a focus on accessibility.”

The Access controller will go on sale worldwide on Dec. 6 and cost $90 in the U.S.

Alvin Daniel, a senior technical program manager at PlayStation, said the device was designed with three principles in mind to make it “broadly applicable” to as many players as possible. First, the player does not have to hold the controller to use it. It can lay flat on a table, wheelchair tray or be mounted on a tripod, for instance. It was important for it to fit on a wheelchair tray, since once something falls off the tray, it might be impossible for the player to pick it up without help. It also had to be durable for this same reason — so it would survive being run over by a wheelchair, for example.

Second, it's much easier to press the buttons than on a standard controller. It's a kit, so it comes with button caps in different sizes, shapes and textures so people can experiment with reconfiguring it the way it works best for them. The third is the thumbsticks, which can also be configured depending on what works for the person using it.

Because it can be used with far less agility and strength than the standard PlayStation controller, the Access could also be a gamechanger for an emerging population: aging gamers suffering from arthritis and other limiting ailments.

“The last time I checked, the average age of a gamers was in their forties,” Daniel said. "And I have every expectation, speaking for myself, that they’ll want to continue to game, as I'll want to continue to game, because it's entertainment for us.”

After his accident, Lane stopped gaming for seven years. For someone who began playing video games as a young child on the Magnavox Odyssey — released in 1972 — “it was a void" in his life, he said.

Starting again, even with the limitations of a standard game controller, felt like being reunited with a “long lost friend.”

“Just the the social impact of gaming really changed my life. It gave me a a brighter disposition,” Lane said. He noted the social isolation that often results when people who were once able-bodied become disabled.

“Everything changes," he said. "And the more you take away from us, the more isolated we become. Having gaming and having an opportunity to game at a very high level, to be able to do it again, it is like a reunion, (like losing) a close companion and being able to reunite with that person again.”