#acquired disability

[sarebearcares]

Hey. *Cups your face in my hands* It's ok if you had to drop out because of your Chronic Illness. You're not "wasting your potential" or some shit like that. You are a human, not some battery filled with capitalist potential, and I'm proud of you for resting and taking time to recover even when it's hard.

[myalgicencephalomyelitiscfstom]

Skye Polk (@skyepolk) on Threads

People love to say ‘just file for disability’ like it’s a form you fill out and money appears. ‣ Most people get denied the first time. ‣ Ap

[dredgen-dumbass]

(Disabled) player's guide to making D2 more accessible

because so far (correct me if I'm wrong) I haven't seen one on here, & maybe (hopefully) it'll help someone.

Alright, to get it out of the way, I'm disabled. I have neurological damage from a tbi, and more recently another concussion, and among many many other things it makes gaming a lot more complicated. It can (unfortunately) be difficult to find advice for disabled gamers online that isn't just "get good" or "then gaming isn't for you", so I figure this might be helpful, since it was for me.

I can't speak to other conditions, so this is more about adjustments for specific symptoms, but I can only really speak from experience. That said, I've had to learn quite a bit, so it's sharing time :)

(I play on Xbox. Some settings aren't the same between platforms, just a warning. For that reason, some of this post is going to be xbox-specific.)

This is divided up into menus & subjects of bullet points are bolded to be easier to skim.

Controller settings - (and explanations for some of them in case y'all don't know)

Test out different look sensitivity. The default is 3, I moved mine up to 5. I have issues with spacial awareness and saccades dysfunction, and this has made it easier for me to keep whatever I'm looking at on-screen.

ADS sensitivity- if you don't know, this is the speed when you aim down sights. The default is 1, I have mine reduced to .5, and I've found that the larger difference between the look & ADS sensitivity can really function as having two look settings available when using a weapon that doesn't have a very extreme scope.

The default sprint-turn scale is 0.4, I bump mine up to 0.8 for similar reasons to the look sensitivity increase. (Turning this up makes you turn faster, turning it down makes you turn slower.)

Alternatively, if you have more issues with overstimulation/visual clutter/quick movements/etc, you may want to turn everything down a bit to slow down your camera, but that may make combat harder to keep up with, especially pvp.

Axial & radial deadzone. This helps with stick drift. Stick drift is a pain for everyone but if you have fine motor issues, tremors, arthritis, etc, it's even worse. Finding what works best for your hardware will help make sure you're compensating less, which puts less strain on your hands.

I've seen people recommend turning off controller haptics for the same reason- the vibrations make you grip the controller harder and can cause worse strain. Personally, I leave them on because the sensory input helps balance out the awareness issues, but maybe it's for you! (this one's a system setting, not a d2 one.)

Video settings

Brightness can be important if you have issues with eye strain. I would recommend changing this relative to the lighting in the room, not just your monitor. Turning it up may help with visual issues with the tradeoff of risking overstimulation. Again, all of this is very dependent on the person.

Motion blur- Evil, evil, evil, turn this off. Visual problems or not, it's harder to follow things on-screen with it enabled. Combined with any garden variety problem with eye movements or cognitive strain it's even worse.

Chromatic aberration- I turn this off. It's a nice vfx, but it can wind up just being added visual stimulus and if that's a problem for it's worth losing. It can also make the radar harder to read. Not worth it (personally.)

Film grain- off for the same reason. It's a smaller change, but a clearer view is worth it if it helps you.

Sound settings

If you have problems with your hearing/auditory processing, I highly recommend turning the sfx & music drastically down compared to the dialogue, and then just turning up your system audio.

Personally, I often play with music entirely off, but I know that can be a very boring experience to a lot of people, so take that as you will.

(my current settings: sfx 8, dialogue 10, music 1)

if you're playing with an Xbox party or in a discord call, etc, I really recommend messing with the mixing settings there when you first get on to balance out peoples mics, regardless of processing problems.

Gameplay settings

HUD opacity- I turn mine down to high, the default being full. Just another thing that makes it easier to keep track of stuff.

Radar Background Opacity- Opposite here. If you have problems with spatial awareness you're probably relying pretty hard on the radar instinctively, so the clearer it is, the better. I play with mine on medium, you may want to play around.

Subtitles- Are on by default, so that's nice. Let's check out their settings menu for a moment.

Turning on show speaker name can be really good for hearing/auditory processing issues.

You can also change the color for the speaker name/caption text if the clearer contrast will help you.

The best background style for visibility is box, but it won't look as nice. Another trade.

Background opacity may be easier to lower if you switch to box, since the faded style isn't even. A lower background opacity may help you follow things on-screen at the cost of caption readability

If you don't need captions but do need to reduce visual clutter, try turning them off!

Colorblind mode is, obviously, helpful if you're colorblind, but I have also heard it recommended because the color changes can help improve contrast. Not one I've tried, but worth including.

Full auto firing/Full auto melee- Does what it says. Turning this on might help in the same way as turning off haptics/messing with deadzones, ie by changing how much you need to click. You can still fire normally with it on, so if anything it just gives you another option.

Reticle location is slightly below the center on d2. I prefer to center it, though it takes some getting used to. More helpful if you frequently switch between other games that center theirs.

Neutral/targeted reticle color- The defaults are white and red respectively. I prefer black for targeted because I feel like it makes it easier to see what I'm actually aiming at, but you may want to leave it for contrast. To each their own.

Other

Brief overview of Xbox accessibility settings

Xbox has a narration setting. I would assume anyone who needs it is aware of this, but just in case.

If you need more assisted play, there's controller assist where you can combine two people's input

Turning off haptic vibration (as mentioned) is in accessibility -> controller

You can make the on-screen keyboard larger!

There are party chat settings for both text to speech and speech to text

There's also game transcription!

Games that have the function can also do their own read-aloud. I don't know if/how this applies to destiny

Mono output for audio may make things easier to understand depending on your audio setup

There's also high-contrast mode for both dark or light

Colorblind filters are here, too

Night mode! You can change how much it dims/filters your device. If you have problems with blue light or eye strain, or have to limit screens for medical reasons like me, this setting is a lifesaver. The filter will affect how your games look, but personally it's worth the tint. Same is available on most PCs.

Hardware, etc.

The Xbox Adaptive Controller is highly customizable and great for anyone with physical impairments that make the standard Xbox controller difficult to use. Find it here.

I've seen thumbstick extenders recommended for arthritis, might also be helpful for similar conditions

If you have arthritis/fine motor issues/muscle weakness/tremors/etc/etc/etc controller grips might make holding a standard controller easier

If any of those are the case for you, then you might also benefit from a lightweight controller (or playing with a standard controller plugged in & removing the batteries for a lesser weight adjustment)

evilcontrollers also has one-handed controllers and a one-handed controller customizer much like the standard controller customizers

evilcontrollers for hardware accessibility in general

If you play on PC and have muscle or joint issues then you may want to look into different keyboard/mouse shapes. Lightweight, vertical, and ball mice are all options, though there's apparently some argument about using them for gaming. I've also seen good reviews of the Azeron keypad from people with muscular/joint problems. There's also split keyboards, wave keyboards, one-handed, etc etc etc.

If you have problems with auditory processing I would HIGHLY recommend gaming with noise-cancelling headphones. (Hell, do everything with noise cancelling headphones.) I would recommend these for everyday, but they also work pretty well for gaming. The mic is mid, but it works well enough, and there's multiple sound modes + active noise cancelling.

Other other (oh no I forgot these, editing now)

Compression gloves !!!!!

Pause and do hand exercises after a while

20/20/20 rule for eye strain

may come back and expand this as I think of more things

There is a lot that Bungie could do to improve the game's accessibility without causing an imbalance with abled players, but I'll save that for another post. Feel free to reblog this with any other advice/anecdotal stuff/whatever, I'm considering this as opening a discussion.

I don't know of any clans specifically for disabled players but I'm sure they exist? If anyone has recommendations for community stuff, please do throw that in.

As always, my dms are open. Being a disabled gamer can suck sometimes and if you need a space to vent w/ someone who gets it, I'm your guy. If you're just curious how it impacts gaming, I don't mind being asked, I just don't feel like posting about myself that much unprompted.

I think that's all for now. Happy gaming :)

[concerningwolves]

Hi! 👋🏼

First off, I just wanted to thank you for all that you do on your blog, not only has it been helpful to keep things in mind when writing, but I also genuinely enjoy learning more about sign language; I’m trying to self-learn it because it’s just that interesting to me hehe. (Also my church has a Deaf Service and I’d really like to be able to talk to the people there.)

I do have a question, but feel free not to answer; I’m currently working on a story where a very young child has acquired deafness after a severe illness (vaguely Hellen Keller vibes), and I was wondering if you know of any things I should specifically keep in mind when writing about the aftermath (immediate and long-term) of it? The setting is mildly fantasy where sign language exists, but hearing aids and cochlear implants have yet to be invented.

Thank you again for your blog, and the care you put into all your posts!

You're very welcome, and thank you! ☺️ It's always lovely to hear that people are helped by this whole... [insert vague hand-wave at my blog] thing I'm doing

Things to consider with a young character who loses hearing after illness

I don't know anything firsthand about what it's like to go deaf, so the first thing I'll recommend is to find stuff written by people who do. A search on r/deaf for "lost hearing" brings up a lot of different threads; for example, this post where people discuss things they wished they'd done/known when they first lost their hearing might provide some good insight.

As another starting point, Jessica Kellgren-Fozard has a fair few videos on her channel about her experiences as a deaf person, and specifically as someone who lost her hearing in her late teens. These two in particular might be helpful to you:

So You're Losing Your Hearing...

This is a video for people who think they're losing their hearing, but while it's not strictly about lived experience, it could certainly be helpful to note both the issues Jessica discusses and the solutions to them.

For example, she mentions isolation is a big problem, and talks about the importance of using the tools provided by the internet to find communities of people in the same boat. Even without the internet (or some fantasy equivalent), people are very community driven and prone to bonding over shared experiences, even if those experiences aren't wholly analogous. Are there other disabled characters in your story that your recently deaf character could speak to? Other d/Deaf characters? Who does she have by way of support and community? – these are all good things to think about.

Why I Don't Sound Deaf

In this one, Jessica talks about her experiences and her relationship with speech and sign languages as someone who lost her hearing. With applying this to your character, her age is important – the "golden period" for acquisition of a new language is typically thought to be before ten years old. Theoretically, the younger someone is when they lose hearing, the easier it will be for them to learn sign language. As Jessica points out in the video, sign language has a different grammatical structure, and because of this she finds it easier to use Sign Supported English instead of BSL. A much younger child, if given immediate or near-immediate access to sign language, is likely to take to it far more easily.

More on speech and language acquisition (or: the evils of consonants)

The impact of hearing loss on speech isn't something I can speak to (pun unintended) with great knowledge or certainty, but I can sort of extrapolate based on personal experience with learning to speak while not being able to hear well. (I had speech therapy, but that was as much to do with my narrow jaw + teeth overcrowding as with language difficulties caused by deafness). I misheard a lot of words and phrases – I spent years thinking that the "big girl swings" were "barbecue swings" 😅

It's worth looking into what level of speech your character would have based on her age, and using that to work out how much verbal proficiency she could retain (if any). Muscle memory accounts for a lot, so if your character already knows how to say certain words or phrases ""properly"", she could retain that ability. It's not an automatic or effort-free process, though: I'm in my twenties and I still have to consciously think about how my mouth is shaping sounds every time I speak. I don't think that will ever change.

If your character is young enough that she's still learning to speak, there will likely be a more marked impact on how her voice sounds. Different phonemes – units or "parts" of sound in speech – are uttered at different frequencies, which affects how easy/difficult they are to hear and therefore learn. This is, AFAIK, one of the biggest causes of the slurred/indistinct speech that people tend to expect d/Deaf people to have. Consonants are evil little fuckers, by which I mean they're spoken at higher pitches so anyone with loss in the high frequency range (hi!) is more likely to miss them. There are different types of consonants, too! And yes, each type presents its own challenges, because consonants exist purely to vex and frustrate everyone with high-frequency hearing loss and/or speech difficulties. For example, labiodental fricatives (e.g., the 'f' in fan and the 'v' in van) are particularly tricky, because they sound virtually indistinguishable.

StudySmarter has an easy-to-understand comprehensive breakdown of phonetics. You don't need to become an expert in phonetics, but reading through this will help you understand how sounds are formed in speech, which is helpful to keep in mind when thinking about your own character's speech. Pay particular attention to the phonemes that sound similar (like the aforementioned fan/van) or are soft/breathy (like the 's' in 'sound' or 'h' in 'half') – these are the most common problem areas, as are distinctions between 'sh' and 's'. If they feel soft or breathy in your mouth, they're probably going to be harder to hear.

Deafness and illness as trauma, and adjusting to change

Last thing I'd suggest thinking about is the experience your character has with the illness itself, and how she feels and copes with the changes to her life caused by acquired deafness. Illness can be a traumatic experience, especially when it has long-term after effects. If you've ever lost the ability to do something you can usually do, even temporarily, you'll probably be familiar with the frustration, and sometimes humiliation. It's also hard to overstate just how much auditory information there is in the world, and how much hearing people rely on that information without knowing it. Suddenly losing that ability isn't going to be easy, even if your character is young enough that they won't be able to remember anything different once they're grown up. Add to that the realisation that your body isn't as reliable as you thought it would be, that you suddenly can't trust your own health, and possibly not being able to understand why that's the case. That's a lot to deal with! And you shouldn't be afraid to show your character going through it!

Thinking back to my own childhood experiences, the strongest emotions connected to my deafness are confusion, embarrassment and alienation. Confusion because the world can be confusing when you're constantly missing auditory cues; embarrassment because unfortunately not everyone is kind and accommodating when you make mistakes due to missing aforementioned auditory cues/information (and sometimes even if people are lovely about a mistake, you can feel stupid for making it anyway); and alienation because of a sense that I was somehow "different". Thing is though, this was normal for me. I have never known anything different. But my relationship to and understanding of deafness as an identity has evolved hugely throughout my life. So, once again, age is going to be a deciding factor in how your character adjusts.

From some rudimentary googling and fuzzy memories of my brief stint as a Psychology student, children develop social awareness (awareness of how others think and feel) and self-awareness (awareness of own existence and how others perceive you) fairly early on, but these awarenesses take time to develop fully. Basically, this means that your character’s age will influence the scope of their reaction to acquired deafness. Some examples as a frame of reference:

A two-year-old is going to be primarily focused on their immediate emotional experience – they can’t hear things they could hear before, it’s confusing. They will also likely be aware if people treat them differently, but unlikely to have a socially-installed idea that they are now different.

A four- or five-year-old, on the other hand, has probably developed enough social and self-awareness to understand that certain people in society get treated differently. They might already have a sense that this is unfair, or they might still be trying to understand why this is the case – it depends on what they’ve learned about disability from adults around them.

(I mentioned above that you can feel stupid/embarrassed for making a mistake even if people are genuinely supportive regardless. The first time I vividly remember someone making me feel stupid and embarrassed for not hearing something, I would have been 4 or 5. The first time I can recall feeling stupid because I was aware that other people didn’t have that problem and that I’d made a social faux pas, I would have been about 7 or 8)

By early adolescence (ages 10–13), children are more aware of, and possibly more susceptible to, peer pressure and social norms [1]. Any understanding of and biases/prejudices concerning disability will be more deeply ingrained, as will concerns about the social impact of going deaf.

The support network that your character has access to is going to be crucial to how they manage this change at any age, so think about the characters in their immediate family/community and how they’ve acted towards disability and social difference.

[1] In a fantasy setting, you as the author are in charge of what those social norms and attitudes are, and I always encourage authors to examine their own biases when worldbuilding them. How are disabled people viewed and treated in your world? Have you made it similar to your own social and cultural experience? If yes, is that because you see that as the norm, or is there a narrative or worldbuilding reason for that? Are there any assumptions about the current or historical treatment/existence of disabled people that have influenced your worldbuilding?

Tropes to watch out for

There are three main tropes to be wary of when a character acquires a disability of any kind:

The acquired disability as an inherent tragedy akin to a death sentence and nothing else. As I’ve already said, an acquired disability can be significantly emotionally difficult, especially if the circumstances around acquisition were traumatic. Acknowledging and exploring this is important. The problem is when writers leave it there – the character is disabled, their previous way of life is lost to them, and therefore the character no longer has any worth to the story (and, by implication, to society). Think of the trope of the ex-athlete (or any other hobby/profession, although fighters and athletes are the most common components off this trope) who acquires a disability and then becomes a bitter, depressed hermit who lives in a state of misanthropy and misery because their life is effectively over. (This happens to Will in Me Before You by Jojo Moyes. Content warning for assisted suicide there). The main issue with this trope isn’t its content, per se, but its execution: Writers rarely examine why someone might end up like this (hint: institutional and internalised ableism, and lack of structural support for disabled people), and instead treat it as an inevitability because they cannot conceive of disabled existence as anything but inherently miserable.

The second trope is when a character manages to “throw off” the disability. These characters either only remain disabled as long as the disability is narratively useful, are magically cured, or overcome the disability by an act of willpower (sometimes only for narrative effect). The issue here is the content: the idea that disability can be overcome or cured by sheer willpower (or yoga, or the right diet, or religion) is pervasive and actively harmful to real-life disabled people, because it implies that disability is somehow our fault. Closely related to this trope is the one where an acquired disability never tangibly impacts a character (or only does so when it would be dramatic); you see this primarily with characters who use prosthetics effortlessly or, in the case of the latter, characters who appear abled until their disability can cause tension or drama in the plot. Again, the content is the issue: disability is flattened to nothing but a plot device, with no thought given to how it affects characters (and therefore real disabled people).

Finally, there’s the idea that an acquired disability is actually a “blessing in disguise” as a type of inspiration porn. That’s an icky trope, but I think it has some itty bitty grains of potential – crucially, the fact that there can be joy in disabled existence. Someone who acquires deafness might not see it as a blessing in the same way as some congenitally deaf people do, but they may still come to appreciate and embrace (aspects of) Deaf culture. Or perhaps they just manage to develop a neutral relationship with their acquired deafness. That’s fine, too!

A solution is to all of these is to consider the practical and proactive aspects of recovery, as well as the emotional fallout. Consider:

How does your character adjust?

How do the people around her adjust?

What support does she have? / What support systems are available?

How does she make sense of her new reality?

What accessibility aids does she have access to, and what are they like to use?

Long story short, nuance and consideration of different aspects of the disabled experience are key.

Hopefully this’ll help! (I’ve also wanted to talk about acquired disability in fiction for a while, hence the wall of text lol). Best wishes for your writing, anon ☺️

[thecripicon]

Since my Blind!James AU received a lot of positive feedback, I'll post a sneak peek of the first chapter I wrote (I might publish this fanfiction next year, but it really depends on how many chapters I can write).

TW: mention of anxiety, mention of crying, and ableism (sort of).

A crippling anxiety has been creeping up his entire frame since yesterday evening. Well, since he received the news to be precise, but only yesterday evening, while he was packing his trunk and his parents, came to talk to him, he realised the tragedy that is falling upon him. Because it’s that, a tragedy. James can’t consider it in any other sense, no matter his parents’ soothing words and calming reassurances. 

He almost can’t breathe, fear, panic rising to his throat and almost choking him. He doesn’t want to believe it, he can’t believe it. Nothing bad has ever happened to him, he never had health-related issues, never broke a bone. So why now? What went wrong? Was it a punishment? Was it a test? James can’t shake the feeling that it’s all so unfair. He can’t accept it, it can’t be real. Right? Right? But the images of his parents standing in the hospital room next to him, holding his hand, while the doctor explained everything, their concerned but soft gazes flowing in his mind and making it so real. The feelings of fear and incredulity and shock immediately clenching his insides are making it so real. James didn’t cry at that moment, he didn’t cry in front of the doctor, at least he can be proud of that. But he cried at home, in his mother’s arms, clutching at her dress like a lifeline. Then she made him a cup of hot cocoa and tried to rationalise it all, telling him that they don’t have to talk about it now. James didn’t want to talk about it. He doesn’t want to talk about it ever. 

[johannas-motivational-insults]

It was ten years ago tonight that I had the accident that changed my life. Maybe it was the second impact less than a week later or the poor management of the injury that really did me in, but that was when the whole thing started. It was not my first head injury, not by a long shot, but it was the first I struggled to recover from. In a way, I never really did. And unfortunately, it was far from my last.

I used to be really angry about it. Sometimes I still am. It’s been an adjustment in a lot of ways and caused or contributed to a number of other health problems in the past decade. I’ve missed a lot of work, and my capacity for sports and other physical activities is limited even when I’m not dealing with an acute head injury, simply for safety reasons. I had to retire from roller derby and I know I had the potential to be an exceptional player, and I’m sure I’ll never stop wondering what I could have accomplished. I still cry when I think about it. Then again, I cry a lot easier these days, one of the many perks of a damaged brain.

The injury also forced me to change the way I handle things and even how I identify. I used to put so much stock in being reliable and physically capable, and now I’m that person who sometimes has to miss work for health reasons on short notice. I can’t just push through things the way I used to. But maybe that’s for the best. This entire situation kind of forced me to re-evaluate how I view my worth as a human being and some of the capitalist and ableist views I’d absorbed, and I think I have a healthier relationship with myself now.

I’ve also come to appreciate other attributes about myself that I didn’t before. I always used to place more value on what I could do with my body than what I could do with my mind, succeeding at physical endeavors was very important to me. But with competitive sports mostly off the table I found time for and fulfillment through other interests. If not for this injury I’m certain I wouldn’t have become as invested in fandom stuff and probably wouldn’t have started writing for it, and people have told me my writing has changed their lives. I remember when I graduated high school I said I’ll know I’ve succeeded in life when I have changed someone else’s for the better, so maybe I have succeeded after all even if my life looks very different than I thought it would 10 years ago.

Am I glad it happened? No. Do I wonder what could have been and mourn for the identities and outlets I lost along the way? Absolutely. But if I was given a chance to hit a button and be transported to an alternate universe where it never happened, I don’t think I would. I don’t know that I’d be any happier. I could have easily had some other terrible accident, given my clumsiness. Hell, I could pretty easily be dead, and I think I’d probably still be struggling to accomplish enough to love myself. I feel like I care less now, but in a good way. I’ve learned that I don’t always have to struggle, that it’s okay to admit weakness and ask for help or even just give up if something isn’t working. I’m a lot better now at identifying my own boundaries. I have more compassion for myself… admittedly I owe a lot of that to my therapist and my autism diagnosis, but it’s a work in progress. Anyway, I dunno. I think the injury made me come face to face with myself in an uncomfortable way but I’m better for it, in the end.

[tumbleweedtech]

Jaskier sat on that boulder, looking out over the valley. Well. He’d never hidden his love for the grumpy witcher, sang it in songs, proclaimed it loudly. Poured it out in actions, in stitches on his body, in food in his belly and hot baths to soothe his muscles. He had done everything he could think of, until now. Now, when he asked him to take a rest, give him a chance to prove himself further. To make Geralt happy. And the witcher just walked away.

He was pretty sure that he actually heard his heart break, but he was a grown man. If Geralt wasn’t interested in his love that was okay. He’d distracted himself this long with flings and whores, he could keep it up. All he had to do was prove that he was still okay just being his friend.

Until Geralt made it clear that was unwanted, as well. So he went quiet, following the witcher down to the inn at the bottom of the mountain. Geralt got himself a room, handing Jaskier the saddle bag to take up while he ordered food. Jaskier declined an order for himself, and set up to the room. He unpacked the whole bag neatly, pulling all of his own belongings. It wasn’t much. He took a small travel bag, and packed his things neatly inside.

Then he looked at his coin purse- they’d long since just combined their funds. Some towns Geralt’s contracts paid more, others it was Jaskier’s songs that carried them. Jaskier poured it out on the table, dividing it in half and put the rest in the bottom of his bag. It would be annoying, carrying the sack and his lute, but he’d gone so long with Roach carrying his belongings it probably was only fair. He repacked Geralt’s bags the way he liked them, but left the coins on the table. Geralt had his own purse on him.

Jaskier took one last look around the room, and walked downstairs. Geralt was still in his corner, but Jaskier didn’t bother waving goodbye. He slipped across the tavern to leave only to find himself caught. Geralt had a grip on his elbow, pulling him back in. “Where are you going? I got you an ale.”

“I’m finding what pleases me, Geralt.”

“Ale pleases you, come sit down.”

“Goodbye, Geralt.” Jaskier tugged his arm free, and did not look back.

Standing on the Precipice - A03

This is my big beasty. It’s 34 Chapters right now... I think it’s going to end up being about 50. We’re getting there, slowly.  --heed the tags, please--

[myalgicencephalomyelitiscfstom]