Conditions that impact Mobility to and from the table | Mobility accomodations to and from the gaming table are most often attributed to the use of wheelchairs and other methods of assisted travel. So in making attempts to accommodate individuals that either are wheelchair bound, or that have difficulty traversing over stairs and the like, you may need to investigate the potentials for a specific environment to game in, that more readily meets their needs. Most often, the player may have a preconceived location in mind that they are comfortable with. Consider relocating to that comfortable area, or confirm that the location you are playing in is accessible. If there is no official means to confirm this, then you may have take it upon yourself to determine if the room you are playing in is accessible from the exterior. Are stairs necessary, and if so, is there an available ramp? Does the entrance door have a restrictive footer? While many door widths have a measurements of about 23-27 inches, wheelchairs require a 32 inch wide door to allow the person to comfortably fit through. Additionally within the room, you must determine that a feasible path is available through the location to the seated area. I’ve seen this a lot in game stores, where access to the gaming tables, requires passage through very narrow pathways created by shelving. Ensure that a path is clear of tripping/snagging objects, and that there is enough space to either side of the individual so that they can pass through with ease. Additionally make sure that access to other facilities such as the restrooms also have those considerations in mind. Ensure that seating arrangements provide additional space to accommodate the individual at the table as well. This may include something as simple as providing adequate space between chairs, or possibly changing out furniture such as benches. |
Conditions that may require players to leave the table repeatedly or randomly. Sometimes with little to no notice. | Many issues can require that a player be able to leave the table (often unannounced, or with an irregular frequency). If the reason for leaving the table is due to a need for certain facilities, ensure that those facilities are accessible. If the player needs to move to an area that supports their desire for feeling safe (a safe space) try to determine the needs of that environment in advance, and make that environment available. This could be something as simple as putting a comfortable chair in another room. As always, the exact requirements, are best determined in the initial PreSession Communication meeting. If leaving the table is frequent, or persistent, and other players are affected by the absence, you can attempt to roll the disappearances into the narrative, so long as the accommodated player allows for it. Ex. “As you’re fighting Agent Orangutan, Tom notices scientific personnelle outside of the room trying to flee for safety. With a nod to his compatriots, he valiantly leaps through the door to ensure their safety.” If the player is the sole member of the team, and no other children/players are impacted, you can feel free to simply pause the game, and utilize the time toward future planning. |
Conditions that impact the ability to remain seated at the table | We’ve all been in games (sometimes weekly) where we sit down and get immersed into a game so much that 4 hours seems to just fly by. For some however, the ability to remain seated is difficult. If the need to rise from ones chair is controllable to a degree, then allow players to stand and walk around during turn orders, only to return when they prefer, or when it is time for them to engage with their group. Allowing this ability and communicating it’s availability at the outset of your session could alleviate some of the triggers that cause the need to leave to begin with. Additionally being out of one's seat may allow for increased opportunity for active roleplay. Just ensure that you create touchstone points, where it is preferred that the child return to the table, even if standing. Ensure that the environment is clear of tripping hazards, and if the need to remove oneself is due to a condition that requires access to other facilities, ensure that the path to that facility is clear. |
Conditions that may cause mild to moderate aversion from fellow players (flatulence, burping, body odor, etc) | This applies primarily with regard to other children at the table that interact with a child that has an accommodation need, however it is important to address in order to preserve the emotional needs of the child. Often if children react negatively or mockingly to a child that displays these symptoms, it could create additional factors like anxiety or a depressive state. The first step is being aware that these symptoms may occur and discussing with the guardian what actions are typically taken that are not seen as objectionable to the child. If those accomodations can be met then pursue them. It is also important to communicate in advance with the other children (and their parents/guardians) at the gaming table. In discussing the needs of children with disabilities, focus on the concept that each child has unique characteristics, and while the disability and symptoms exhibited is one of them, it does not make up the whole of who they are. If it’s possible for the other children to meet with the child’s caregiver, it may allow for questions to come up that may not have been asked, or may have otherwise unfortunately come up during the session. While playing, encourage the idea that the children are a part of a team, and that as teammates, it is one of the greatest goals of a hero to be supportive of each other. |
Conditions that impact incontinence or soiling | Children who have issues with incontinence are likely to experience anxiety with regard to their condition, and embarrassment if an accident occurs. Discreetly inform the child that they are always welcome to excuse themselves to use the facilities. Additionally scheduling regular breaks over shorter periods of time where children are encouraged to get up, move around, and use any facilities. This should help to mitigate accidents. If an accident occurs, do not overreact. Calmly escort the child to a restroom and follow instructions laid out by the guardian about how to respond. Remove any furniture that may have been soiled to be taken care of at a later time if possible so that the disruption is minimized. As always communication is integral, to acceptance. |
Conditions that can limit, delay, or terminate attendance | Keeping to a regular schedule may be difficult. Sessions can be designed to be only shorter increments, but chained together so that they can accommodate a group dynamic that can handle longer play times. Determine a story that can explain the occasional disappearance of a hero between sessions. Suggest that they are researching another angle to a mystery, holding back to ensure that a camp is secure, listening for a transmission, or decoding a program. Anything that explains an actual absence can be rolled into the narrative so that gameplay and experience isn’t slowed. While it may not be ideal to the gaming environments dynamic, consider options for remote play, or hybrid remote play using online technologies such as roll20, fantasygrounds, etc. A purely remote play session would allow all children to be located within their home or location of choice, while hybrid sessions allows for a single player to remotely connect into a device and interact with a seated group. Additionally you can encourage children by providing them puzzles or exploratory story lines that they can take or work on at home. This will encourage them to feel like they are still a part of the team working toward an overall case or adventure. If the issue is a matter of the availability to travel, you can consider the use of implementing technology such as online tele or video communication. Most smart devices allow for it, but there are also a host of applications that can be used. |
Conditions that can cause alarm and potential disruption of the game (Vomiting, Seizures, Loss of Consciousness) | A condition may occur that causes alarm to other players and require a response from you. Things like Seizures, Vomiting, Loss of Consciousness. If these occurrences are possible or likely to happen, it is critical to communicate not only the likelihood of it’s occurrence, but the response expected from the child’s guardian. This is why it’s important to front load information in the pre-planning session. If it’s acceptable to the child or guardian, communicate the possibility of such an occurrence to the other children and parents of other children. Often if symptoms are severe, or occur with regularity, the child may be accompanied by an aide or guardian. In preplanning ensure that you are accommodating for this individual at the table, and if they can be included in the game play due so. This would not only allow other children and possibly the one receiving the accomodations increased comfort, but also may create an opportunity for discussion and gaming to existing off the table. Most importantly immediately contact the child’s parents or guardians if an episode occurs, so that they are aware of the situation and can respond accordingly. |
Conditions that cause fatigue or drowsiness | Many conditions have an effect of creating drowsiness or fatigue in a child. Still others without this effect as a part of their condition, may experience it via medication they may be taking. If it’s desirable to allow the child to nod off, then ensure that they are comfortable and safe. Else if there is a preference toward managing the conditions try some of the following steps. Take regular breaks and encourage children to stretch. Ensure that engagement occurs more frequently with the child even if it is not within a turn. Avoid restricted diet foods that can also include sugary or caffeinated beverages. Because fatigue also can affect concentration, allow for additional time on the childs turn, and encourage/assist with notetaking. If the need calls for it, you can also shorten session times, group fewer sessions together, and avoid complex Session components. Much like in the case of if a child experiences increased absence or tardiness, you can provide reading materials, puzzles, and components for home use, so that the child can be working toward the end goals of the group on their own time and in their own environment without the structured limitation of a gameplay environment or make use of some form of free online communication tool (google hangouts, roll20, etc). |
Conditions that impact appearance that may create alarm or concern from other players | A child’s appearance may appear alarming to other children. While it is obvious to an adult that it shouldn’t matter, and may not come off as a necessary concern for accomodation, it’s important to communicate with other children in the group in advance, not only for to allow them a better understanding of individuality and differences, but to also reduce any potential negative reaction the impacted child might receive. |
Conditions that cause bleeding | Conditions that cause bleeding may come in a variety of degrees from minor to severe, but in all cases, if bleeding occurs, it must be treated as soon as possible and parents/guardians should be informed. Most typically in the somewhat non-active environment of the gaming table, you will find that nosebleeds can be the most dominant form of bleeding concern, and if the child suffers from a bleeding disorder, problems with clotting may mean that the bleeding goes on for longer. In certain circumstances, kids may have internal bleeding that occurs, especially at joints. Recognizing this may come from seeing the joint swelling, and warm, or the child may express their discomfort and not use the joint. If in the presession discussion you are informed about a child with a bleeding disorder, than investigate and refresh yourself on recommended guidelines for supporting that condition. It will also help to print out and have ready materials that support PRICE (Protection, Rest, Ice, Compression, and Elevation.) This may include having ice packs, bandages, and gloves (important) on hand. It may also be advisable to seek out a private location for the child to move to safely, as the site of blood may be upsetting and create anxiety for other children and the afflicted child. The condition may also impact a child’s anxiety when it comes to gameplay. In communicating with the child determine if the inclusion of blood in the game is upsetting, and avoid it where applicable. |
Conditions that cause seizures or short term paralysis | If a child is prone to a condition that causes seizures or paralysis or temporary paralysis, it is important to communicate the typical severity, trigger if one exists that is environmentally enabled, regularity, and the expected response. You may be called upon to reach out to an ambulance. If there are are conditions that externally activate seizures, remove them from the environment. If the seizure is nonconvulsive (short term paralysis) steps you can take care to ensure there are no dangerous objects near them and ensuring they are in a safe environment. Continually talk gently to them, and those around the person explaining what is happening to reduce a sense of anxiety. If the seizure is convulsive (This can involve more violent responses or falling) the first step is to stay calm. You may at this point ask someone to call out to emergency services. Try to ensure the person is in a safe location, and if they have injured themselves try as best you can to treat the injury. Gently position the person onto their side, and ensure nothing is tight around their next. The idea is to prevent any fluids from choking them. Talk to the person reassuringly throughout the event. If it’s possible, time the length of the seizure to be able to provide that information to any respon In either case it is imperative that you not restrain the person, and do not (as often portrayed in movies) try to jam anything into their mouth like a wallet or spoon. |
Conditions that cause long term paralysis | Long term paralysis may impact a specific or several body parts that hinder various capacities for extended indefinite periods of time. Depending on the level of paralysis or the area affected, it may be advisable to utilize more theater of the mind in your play style. Theater of the mind means that you focus less on movement of object movement, and maps, and focus heavier on descriptions of the environment, gameplay, and interactions with other sentient creatures. This allows players to engage regardless of physical limitations that might prevent ease of movement. For conditions where paralysis, impact mobility to and from the table, please refer to Conditions that impact Mobility to and from the table |
Conditions that impact manipulation with one’s hands (detailed motor control). | Detailed motor control could impact the players ability to write, or control smaller manipulatives in a controlled manner. These limitations can range from minor control issues to a full loss of mobility. For conditions that impact motor function with one’s hands that severely limits the ability to manipulate objects at a table, please refer to the guidance for Conditions that cause Long Term Paralysis. For minor to moderate motor control difficulties, a change in the way manipulatives are presented or made available can go a far way to assist someone. The use of miniatures for example, can be enlarged, or designed with extended piping to allow for easier grasping and movement. To assist in dice rolling, dice towers can be employed, or assistive technology such as virtual dice apps can replace the standard dice throw. Likewise, considerations on where a dice throw can be read from (for example not limiting a dice throw to be only throws within designated areas) could relieve undue stress for those children who prefer to use more typical dice. Additionally dice can be positioned so that the differently sided dice can be retrieved from a set location without having to hunt about or lift dice to a viewable range. This can be done either through spacing or the tactile use of compartmentalization containers, like you might find in many art/supply stores. Use of powers and actions when not spoken, can be presented as cards and Yield Points and other numeric record keeping can be done through the use of larger counters, to alleviate the need to write. Recording devices can also be utilized for note taking rather than the typical scratch paper or character sheet. Occasionally cards may be difficult to retrieve from the table, so creating resistance to assist picking cards up, such as creating a line of glue on the card from a hot glue gun may make all the difference. |
Conditions the cause jerking or spasming movement of limbs | Jerking, spasming, and other forms of involuntary movement may create a difficult scenario for children attempting to manipulate components in a map setting or on a dice board. If this is a concern for the child try to alleviate these concerns by following recommendations under the sections for Conditions that impact manipulation with one’s hands or an increased focus on the use of Theater of the Mind. However additional methods for accommodating these situations could include lettering and numbering spaces on a map (for instance A-Z above, with numbers down the side) and keeping track of existing placement per turn. This alleviates concern from the player with regard to having to reposition pieces that may get knocked over or swept out of place. Most importantly, communication is critical with other players, to encourage patience as turns may take additional time. Provide extended time for all player movements to not single out the particular player. |
Conditions that cause digestion or esophageal problems (nausea, cramping, heartburn) | A GM often not only serves as guide, and prompter, but often as host. Sometimes this may include providing food to players or taking breaks and allowing such things. If food is allowed at your table, be aware of the dietary restrictions of your player, as well as any concerns they may have with regard to other foods/smells that could trigger gag reflex. Once again this falls to communication in presession. If there is a likelihood of esophageal distress that induces vomiting regardless of a control of environment, ensure that the necessary receptacles are available and at hand, or that access to facilities are clear and within reasonable traveling distance for the child. |
Conditions that cause pain | There are two types of pain that children may experience while playing in your sessions. Either persistent ongoing pain, or rapid onset pain. Conditions that cause this can vary and are often supported heavily by specialized equipment the child will have in advance. Ensure that your environment has the capability of accomodating that equipment in space and access. Certain pains may derive from things that occur from their conditions that standard first aid support can respond to, such as joint swelling, or bruising. In this case it will also help to print out and have ready materials that support PRICE (Protection, Rest, Ice, Compression, and Elevation.) One coping recommendation also comes from distraction. Reducing time when players are not engaging can help in creating that distraction. Preplan character actions, reduce monologues and exposition. When roleplaying focus more on interactions and back and forth dialogue. In combat preplan attacks to return your turn order and shifting it back to them. In describing combat actions reduce discussion of concussive battle actions and focus descriptions primarily to things that limit the hero to reduce their YP. For example a hero can just as easily be described as “numbed for 4 YP” as they could be described as “hit for 4YP”. Remove a focus on painful interactions will help shift focus away from pain and thus assist in distractive efforts. The opposite may occur in that a sedentary position or continued focus can generate pain. In these instances take frequent breaks, and focus on creating moments as touchstones to check on the players needs. |
Conditions that cause dizziness | Most sessions typically take place while seated which should help out dramatically with children that experience dizziness for various reasons. Still it might be advisable to game in an environment that the child has ready access to a comfortable place they could lie down. This will help in multiple recommended responses to an attack that might cause dizziness. If you’re so inclined, and the conditions are caused by something like Vertigo, look into information on any or all of the 4 response maneuvers, including Epley, Sermont, Foster or Brandt-Daroff maneuvers. |
Conditions that cause sensitivity to light or other atmospheric conditions | Sensitivity to atmospheric conditions can come in many forms. If sensitivity to light is a concern try dimming lights to a level that is comfortable, while still allowing yourself and other players to read through materials. If this needs to be accommodated by desk lamps or book lights it can help create more personalized lighting and even improve on the atmosphere built into certain adventures. For other conditions, communicate the needs of the player with the players caregiver and try to accommodate the needs as best you can within the environment while still allowing for comfortable play of others at the table. |
Conditions that cause breathing irregularities | Conditions that impact breathing may require specialized equipment such as inhalers, nebulizers, respirators and other dedicated systems. While it is most likely that the child’s caregiver will provide a majority of the assistance for each technology, it would be prudent to familiarize yourself with any specific devices operation so that you can provide additional or in certain instances first response support. Environmentally, there are conditions that can exacerbate breathing conditions. If you know a child has breathing conditions in advance, and have communicated the particulars with their caregiver, then you can ensure the environment allows for a reduced likelihood of events such as asthmatic episodes. Your gaming environment should take place in a well ventilated environment, free of smoke. Limit food consumption in the area to additionally help prevent allergic responses, while at the same time reducing likelihood of pests. Additionally limit the use of perfumes or other harsh/strong smelling odors that may occur. It may additionally require the use of either a humidifier, or dehumidifier to normalize humidity within your environment, based on the preferences of the caregiver. Reduce clutter as much as possible, and if potentially switch to digital copies of material to reduce the glut of papers that might trigger incidents. It may be preferable to relocate to an environment that has already been approved and designated as preferable to the specific child. Finally, it is recommended to familiarize yourself with response requirements to varying responses the child may experience, upto and including incidents that require you to reach out to emergency service. |
Conditions that cause high energy or jumpiness | Hi levels of energy become a condition that requires supportive accomodations when the energy expressed in a child is overly distracting and thus detracting from their desired play experience. Please note, that this means that a high level of energy in thus the outcome of movement, response, and involvement (or lack of involvement) is still in control of the player, and the primary concern occurs when the player themselves wish to find accommodations to assist in their gameplay. This can also play out with group members as well. The decision on how involved a player is during the session may depend on other player preferences as well, and as such, careful mediation between what is fair for all players should be considered. That said there are several accommodations that help children that display high energy, better engage in group play experiences. One such suggestion is the implementation of hand strengthening or hand involved exercises, such as working with clay, working stress balls, or even other non-distracting activities such as drawing or coloring. All of these activities can also be redirected to flow back into the game. Draw characters or scenes, create sculptures that help energize powers, increase impact attacks by performing exercises. Additionally supplementing more art, or tactile objects into your sessions, by creating objects or providing visuals can help center the child within the adventure. Plan your turns ahead as much as possible to reduce your turn, and increase the availability of turns on the players side. This allows increased play time on their end. Taking breaks often should also help reduce tension. Environmentally reduce outside distractions, possibly dimming lights or removing clutter in advance. Depending on seating arrangements, provide the child more room to either side in case movement becomes a distraction to other players, or in case the child needs to get up from their seat. It may even help to play mild music in the background Assign tasks to the player that they can be responsible for, such as tracking YP, or taking notes of conversations. |
Conditions that affect body temperatures | An ideal environment is one that is climate controlled. A climate controlled gaming space allows for proper control of external temperatures that might impact children that have conditions that cause difficulty in regulating body temperature. However in the absence of a “perfect” atmospheric conditions, allowances should be made for those children. This can include the use of personal heating and cooling apparatus. Provide a safe source of power if such is required for a device such as a fan or space heater. Provide the child as much personal space as available, so that they can sit comfortably without the impact of other players body heat. Beverage may also help to either degree (cold or hot) so keeping either on hand would be beneficial if not already provided by the child’s caregiver. If it is recommended by the caregiver, familiarize yourself with any technology for monitoring temperature, and response according to instruction if that temperature exceeds what is considered normal to no response. You may need to keep access to medication, or contacting emergency services close at hand. |
Conditions that cause abnormalities with skin (rashes, sores, bumps, swelling, bruising, discoloration) | It will also help to print out and have ready materials that support PRICE (Protection, Rest, Ice, Compression, and Elevation.) This may include having ice packs, bandages, and gloves on hand to help with swelling or irritation that is caused by rash symptoms. Understanding the causes for the skin conditions is imperative to treating it, so communicate with the child’s caregiver in advance of the sessions about how best to aide the child in coping with their condition if it is something that requires attention. If the condition does not impact comfort, then it should not be something focused upon, and allow the child as much discretion as they need. You can however, in your roleplay aspects of gameplay avoid prompts that describe skin types as a negative characteristic. The condition may also impact a child’s anxiety when it comes to gameplay with other children. Communication may be required with other children within the session to explain concepts about how single conditions do not define children as a whole, but are simply one of many aspects that any unique child inhabits. |
Conditions that cause mild to severe allergic reactions | Prior to meeting in sessions, discussion with a players caregiver should specifically confirm any and all allergies and their severities, with which a child might suffer from. These allergic triggers should simply be avoided. If there are several food based allergies, then food should be restricted from the gaming table, as even designating a separate snacking area may provide complications such as cross contamination, particulates on hands, and clothing, and even odor as a trigger. If the allergy is based off of environmental conditions that are purely within your control, seek to remedy those conditions, or if that is an impossible option, determine a new playing location. While it may not be ideal to the gaming environments dynamic, consider options for remote play, or hybrid remote play using online technologies such as roll20, fantasygrounds, etc. A purely remote play session would allow all children to be located within their home or location of choice, while hybrid sessions allows for a single player to remotely connect into a device and interact with a seated group. Communicate with the group what these items to be avoided are in advance of play to prevent any potential risks, and determine from the caregiver proper responses to take in case of an unforeseen allergic reaction, upto and including contacting emergency services. |
Conditions related to loss of or underdeveloped limbs | Be sensitive with regard to any roleplaying aspects that cast dismemberment or loss of appendages as a negative part of the narrative. Communication may be required with other children within the session to explain concepts about how single conditions do not define children as a whole, but are simply one of many aspects that any unique child inhabits. Provide assistance where needed AND when prompted, but never assume to provide the assistance in advance. Ask questions in polite tones, with regard to whether or not assistance is desired, and accomodate the player in kind. The loss of mobility or dexterity from complications in loss of or underdevelopment of limbs can equate to extension of time needed per turn. Plan for this time accordingly, and balance the need for movement or note taking versus theater of the mind. Familiarize yourself with the specific assistive technology the player may be using. |
Conditions that affect ability to consume food (diet, appetite, masticating) | Food at a gaming table is more a components of socialization and less one that is a requirement for gameplay. If a player is on a restrictive or specialized diet then food at the game table should follow suite. If the player desires food, the dm is able to provide, and food consumption is preapproved by the players caregiver, then familiarise yourself with the condition in question and how best to respond to those needs. Likewise it may make sense to cut out or avoid topics within gameplay that relate to food or it’s consumption. Be aware of dietary restrictions, and if they exist, avoid the specifically restricted consumables. |
Conditions that affect seated posture and the ability to reach or view the table | At times children with disabilities may have difficulty seeing or reaching board to due restrictions in posture and seating. In situations where assistive technology does not aide in creating this access, focus more heavily on theater of the mind (using descriptions and verbal cues to establish settings rather than tangbiles and maps). Provide space and environment that allows for increased mobility as needs may require for physical access to a gaming environment. Build additional time into gameplay on the players end, reducing focus on interactive manipulation and more on communication and roleplay. |
Conditions that affect the heart | Be aware of the specifics of the heart condition through presession discussion with the caregiver, particularly with regard to implications it may present in your gaming environment. Tabletop RPGs are often low energy activities that don’t require a lot of strenuous activity, but determine what actions or activities should be avoided, and if there are META (real life) implications or activities that impact game play, minimize or modify any that require substantial activity. Medications are typically taken at home, but often with heart conditions, specific schedules may need to be adhered to. If medication is required that occurs during gameplay set an internal notification or timer and potentially build engagements that work around temporary interruptions in game play to allow children a break and/or take medication. If you are required to administer the medication (again, not often the case for non-counselor situations) ensure that you are reading directions EACH time before providing the medication and give yourself time to administer them properly. Children with heart conditions may also experience long term absence with potentially leaving the game. Develope Roleplay story elements that can explain the absence of the player for a time, and pre plan so that the dynamic of a group does not suffer from a players inability to attend. |
Conditions that cause loss of control or use of limbs of body parts | Players that experience temporary or permanent loss of control or numbness in limbs are likely to have pre-existing conditions that require the use of assistive technology. In situations where assistive technology does not aide in creating this access, focus more heavily on theater of the mind (using descriptions and verbal cues to establish settings rather than tangbiles and maps). If these conditions are likely to develop during game play, communicate with the caregiver during pre session meetings to discuss the appropriate responses, up to and including contacting emergency services. Jerking, spasming, numbness and other forms of control issues may create a difficult scenario for children attempting to manipulate components in a map setting or on a dice board. Build more theater of the mind aspects into the game, replacing the requirement for manipulation, with story elements and descriptions of setting and engagements. Provide space and environment that allows for increased mobility as needs may require for physical access to a gaming environment. Build additional time into gameplay on the players end, reducing focus on interactive manipulation and more on communication and roleplay. |
Conditions that affect physical sensitivity or preference to being touched | Allow additional space for children and clear paths to and from the gaming table. Additionally if on a rectangular table, a child may prefer to be positioned at a corner, providing them a maximum amount of space to eithe side but do not suggest that as a default. Ask their preferences of seating arrangements and attempt to accommodate them. It is important to communicate with the group with regard to the child’s preferences, and explain that the preference is not an indication of personal preference or rejection of fellow players, but simply a unique quality of the player. Explain that all people have unique qualities that are only a part of but not defining of the individual. |