Lucy has a C6 spinal cord injury and hadn’t tried playing games with a standard controller since her injury. She got in touch with SpecialEffect as she wanted to be able to access console games.
She came to the SpecialEffect Games Room (pre-Covid_19 restrictions) and our occupational therapists worked with her as part of our Loan Library project.
In this post we’ll share the techniques and equipment the SpecialEffect team used to create Lucy’s controller. The solutions we used were combined to create a customised controller setup specific to her abilities, but we hope that sharing them will help show some of the range of options that are available to create a customised controller setup tailored to the needs of the individual.
The information in this article is correct to the best of our knowledge at the time of writing (September 2020).
Controller Access
To start the visit, we had a conversation with Lucy about what games she wanted to access and told us she was interested in playing The Legend of Zelda: Breath of the Wild (PEGI 12) on the Nintendo switch.
Difficulty: Lucy had not played games since her injury and due to having no movement in her fingers was unsure how she would access the Nintendo Switch. Lucy has good movement in her shoulders and full movement with her biceps, and full wrist extension.
Solution: A conversation took place with Lucy about her functional movement and what she finds difficult. She demonstrated her movements and it was felt that she might be able to use some parts of a standard controller. Lucy tried a PowerA Nintendo Switch controller, and as she has good movement in her arms and some wrist extension, she was able to use the joysticks and the ABXY buttons on the face of the controller.
Mounting the Controller
Difficulty: As Lucy was unable to grip the controller and hold it in place, the controller moved around too much when she was playing.
Solution: The PowerA Nintendo Switch controller was mounted onto a Trabasack Curve connect tray using Velcro.
The Trabasack Curve Connect tray has a surface that enables Velcro to stick to it. To give Lucy’s hands room to move around the controller, a piece of foam was placed underneath the controller to lift it off the tray. Different thicknesses of foam were tried until Lucy found the height comfortable.
Accessing Buttons and Triggers
Difficulty: Lucy wasn’t able to press the four buttons on the back of the controller (R, L, ZR and ZL).
Solution: Lucy was shown the different types of switches that were available. Specs Switches were the most appropriate for her: they offer a fairly large surface area for people who need to use gross movements to press the them but don’t want a switch as large as a Buddy Button.
The Specs switches were fixed to the Trabasack tray using Velcro. They were positioned carefully where Lucy could easily use them but still access the joysticks and the buttons on the PowerA controller.

Connecting to the Console
Difficulty: An Xbox Adaptive controller (XAC) was needed to get the Specs switches working with the Nintendo Switch. The Xbox Adaptive Controller is an interface which enables you to create a customised controller setup.

Solution: A Titan Two device was used to get the XAC working on the Nintendo Switch. The XAC and the PowerA controller were plugged into the Titan Two which was then plugged into the Nintendo Switch. The Titan Two device allowed the PowerA controller and the XAC to be used simultaneously.

Before using a Titan Two on the Nintendo Switch, ‘Pro Controller Wired Communication’ needs to be turned ‘on’ in the ‘Controllers and Sensors’ settings of the Switch. This post explains step by step how to do this: https://gameaccess.info/nintendo-switch-console-settings-for-using-a-titan-two/
The Specs switches were plugged into the RB, LB, RT and LT switch slots in the XAC.
By the end of the visit Lucy was able to play The Legend of Zelda: Breath of the Wild on the Nintendo Switch. We will keep in contact with her and will alter her setup if needed.

List of Equipment Used:
Below is a list of the equipment we used to create Lucy’s controller set up, with unaffiliated links to the products on the manufacturer’s own websites where possible. Other suppliers are available in most cases:
Xbox Adaptive Controller:
https://www.xbox.com/en-GB/accessories/controllers/xbox-adaptive-controller
https://gameaccess.info/279-2/
Titan Two:
https://www.consoletuner.com/products/titan-two/
https://gameaccess.info/nintendo-switch-console-settings-for-using-a-titan-two/
Trabasack Curve Connect:
https://trabasack.com/products/curve-connect/
AbleNet Specs Switch:
https://www.ablenetinc.com/specs-switch
PowerA wired Nintendo Switch controller:
https://www.powera.com/product_platform/nintendo-switch/#cont1-p
If you have any questions about this controller setup, please visit the Contact Us page.