Högskolan i Skövde

This work-in-progress paper presents the design and development of a serious game aimed at supporting auditory rehabilitation for cochlear implant users. While cochlear implants effectively restore access to sound, many users experience challenges with pitch discrimination and listening in noisy environments. Traditional rehabilitation methods are often speech-focused and clinic-based, which may limit user engagement and training frequency. To address these limitations, this study explores the application of technical ear training, a methodology from audio engineering education, as a foundation for interactive, game-based auditory training.

Following a design science research approach, the project involves iterative prototyping and participatory design with cochlear implant users and rehabilitation professionals. The resulting game integrates technical ear training-based listening tasks, such as timbre recognition, pitch discrimination, and audio effect identification, into multiple gameplay modes. Emphasis was placed on player experience, gradual difficulty progression, and meaningful audiovisual feedback.

Findings from the design process highlight the importance of aligning gameplay mechanics with auditory training goals, accommodating variability in cochlear implant hearing, and addressing technical constraints such as audio latency. The prototype explores a language-independent and engaging complement to traditional rehabilitation. Future work will evaluate the prototype with CI users in a rehabilitation context.

A cochlear implant (CI) is an electronic device designed to assist individuals who are deaf or hard-of-hearing. It captures sound through a microphone and transmits it to electrodes, which directly stimulate the auditory nerve, bypassing the damaged areas of the ear. Although considered a very successful intervention, there is large variability in the outcomes of cochlear implantation. Patient- reported issues include difficulties hearing speech in noisy environments, disappointment in sound quality and difficulties appreciating music. A period of aural rehabilitation usually follows implantation, where patients see audiologists and speech language pathologists. There is evidence supporting the use of auditory training, actively practicing listening tasks, mainly focused on speech, at a clinic or at home. One such task, often suggested by audiologists and speech language pathologists is computer-based auditory training. There are a number of game-like computer programs and apps that are recommended to patients, most of which similarly focus on speech. In recent years there has been some research on serious games specifically aimed at CI-rehabilitation. This paper presents a literature review of studies using games for auditory training in CI-rehabilitation. The aim of this paper is to investigate how the reviewed studies relate to established game design knowledge, including how they evaluate player experience. The results reveal a gap, indicating that game design as a concept is rarely reported on, and the evaluation of player experience is seldom based on established instruments. While this study focuses on a specific and cohesive research community, it highlights the need for improved standards in the utilization and reporting of game design in such studies. We propose a set of guidelines for reporting on medical studies involving games. 

This article examines level design processes and challenges at professional game stu- dios. Thematic analysis of data, recorded through field studies and semi-structured interviews, identify four key themes: level design as an interdisciplinary effort; who is the level designer; the role of narrative in level design; and challenges of managing creativity in the level design process. Results indicate that while the role called level designer is often assigned to specific disciplines, the process of level design is usually highly interdisciplinary. Furthermore, this interdisciplinary collaboration requires management to maintain both creativity and efficient pipelines, by distributing owner- ship and facilitating communication and planning. The level design process seems par- ticularly vulnerable to suboptimal interdisciplinary communication and planning, due to significant reliance on narrative design, game design, art, sound design, and tool development. While this article addresses level design specifically, most observations are comparable to previous findings on game development in general.

This article examines how the unique characteristics of Marvinter, an inclusive transmedia Advent calendar, affected its production and the individual media workers involved in this. In the native transmedia Marvinter project, a radio series and a mobile game were created and released simultaneously. Using ‘partly shared’ resources, the project was developed by two collaborating, non-profit organisations. Each chapter of the digital game had to match the corresponding radio episode. The whole had to be designed to provide a shared cultural experience that included people with hearing or visual impairments. The authors of the present article were part of the game development team and thus directly experienced the complexity of developing a digital game as part of a transmedia project. This article presents the results of a case study with an insider perspective. It is supplemented by semi-structured interviews with key people in the project. The transmedia nature of Marvinter was justified by the need to include people with complementary disabilities. Although sometimes associated with negative connotations of ‘naked commercialisation’ in transmedia contexts, the marketing strategy was here an important element in promoting inclusivity. However, owing to the concurrent work processes, game production became overly complex.

INTRODUCTION: The problem addressed in this work is the lack of knowledge of what inclusive game design would mean in practice within existing design processes of game companies. A pilot project was devised to involve both the game industry and disabled people.

OBJECTIVES: The goal in this study was to identify activities that constitute the biggest obstacles to realising sustainable design processes for inclusive game design.

METHODS: The study is mainly based on two full-day workshops with the game industry and three game studios, three organisations of disabled youth and authorities.

RESULTS: Five activities were identified in the analysis of the workshops: 1) Find opportunities for inclusive game design; 2) Raise awareness about inclusive game design; 3) Handle integrity and security; 4) Recruit the right competence; and 5) Adapt workplaces and tools.

CONCLUSION: The five main activities should be considered to achieve sustainable inclusive game design processes.

Sexism in digital games has received a lot of attention in recent research. Most such studies are addressing the perception of sexist content in games and the attitude in gaming communities. This article analyses the digital game Behind Every Great One, which portraits benevolent sexism, i.e. sexism that may appear positive but that has a damaging effect. What is unique with this game is that it is played from the victim's perspective, a housewife. The article presents an inductive analysis of the game using a triangulation of three different methods: a textual analysis, a player study, and an interview with the developer. The result shows that the game manages to convey benevolent sexism to players and evoke empathy for the victim. This is achieved through a combination of mechanics, narrative, and visual and musical aesthetics. For example, the physical space available for the protagonist is constantly shrinking and crying is used as a powerful mechanics in the game. The player needs to find an empty space for the protagonist to cry and this provides insight into her emotional state. Through the game, the developer reflects upon his own behaviour towards women and the consequences it might have had for them. In particular how his, and other men's, self-absorption forces their female partners into an undesirable social role, in which their needs are constantly neglected. The combination of a meaningful gameplay and the use of game mechanics to convey a message lead us to suggest that the gameplay can be characterized as a persuasive meaningful play. The game has a potential to be used in educational environments as a starting point for discussions regarding gender roles and benevolent sexism.

While many studies have been done about creation of accessible games, they have mainly been conducted in an academic context and represents a gap between game research and the game industry. The pilot project presented in this paper (PowerUp) addresses inclusive design by involving both the game industry and disabled people. The goal is to identify activities that constitute the biggest obstacles to realising sustainable design processes for inclusive game de- sign (IGD). Four activities were identified through two full-day workshops with the game industry and game studios, disabled people and authorities: 1) Find op- portunities for IGD with disabled people; 2) Handle integrity and security of dis- abled people; 3) Recruit the right competence among disabled people; and 4) Adapt workplaces and tools for IGD processes. These activities are tentative and will hopefully be subject to discussion and further development to achieve sus- tainable inclusive game design.

A game is best evaluated by playing it and prototyping is therefore an important activity in game development. Game writers and narrative designers are responsible for the narrative structure of a game, which may have a varying degree of interactivity to it. The aim of this paper is to analyse the role of prototyping tools for game writers. There is a limited range of such tools available, of which Twine is one of the most established. Most of these tools have a text-based programming interface for modelling of game mechanics. This paper presents Deig—a proto- typing tool for creating point-and-click adventure games. In Deig, game mechanics is modelled graphically using nodes from a set of primitives. We present an interview study where game writing students reflect on their experience of using Deig and Twine as prototyping tools. The result shows that both tools have their merits and complement each other. Deig was found to be intuitive for modelling of game mechanics, which lead students to create interactive narratives. Twine was found to be more useful for experimental writing. The conclusion of this work is that there is a need for a diverse set of prototyping tools to support game writing.

This article presents the result from a study comparing the perception and understanding of a game story between sighted and visually impaired players playing the same game. In particular, whether sighted and visually impaired players could experience and recount the same story construed from the plot elements that are either manifested by audio and graphics in the case of sighted players or pri- marily by audio in the case of visually impaired players. To this end, we have developed a graphical point-and-click adventure game for iOS and Android devices that aims to show how inclusive game design may be used to facilitate a shared gaming experience between sighted and visually impaired players. The game pro- vides players with audio feedback that enables visually impaired players to interact with and experience the game, but in a manner that does not interfere with the overall appearance and functionality of the game. Thus, it has been designed to be fully inclusive to both groups of players and to give the same gaming experience when it comes to story content. The game has been evaluated through formal user tests where subjects have been asked to play the first chapter of the game followed by an interview. The study shows that the perception of the story was almost identical between the two groups. Generally it took visually impaired players a little longer to play the game but they also seem to listen more carefully to the dialogue and hence also build a slightly deeper understanding of the characters. The study also shows that the sighted players did not respond negatively towards the inclusive game design employed in the game. 

Computer games combine various artistic disciplines, such as visual art, sound, music and storytelling, with low-level data representations and algorithms in order to create an interactive experience for one or more players. This essay discusses the implications of exploring the design space at the intersection of games and art from a game design perspective. In particular, this essay argues that exploring and treating games as art is a step towards inclusive game development.