Simulating Autism

Auti-Sim was developed during the 2013 Hacking Health Vancouver hackathon, an event designed to foster collaboration between health experts, programmers, and designers. The first-person simulation game, created in the unity engine and playable in browser, immerses the player in a children’s playground and uses overpowering sound effects and visual distortion to raise awareness of auditory hypersensitivity. During my own trial of the game, my first action was to move closer to a circle of kids that I spotted near the play structure. As I approached them, a static television effect overtook the game world and the background chatter intensified.

As I grew closer, walking past and even through some of the faceless children, one child began to chant the alphabet over rising static punctuated by piercing screams. My first impulse was to turn the volume down. I decided that this would count as cheating in the same way that adjusting the brightness control on a television set to reveal enemies in a dark environment is cheating; I needed to find an in-game way to stop the noise. Unlike other games in which challenges can be lessened through manipulating external controls, in Auti-Sim, there are no clear objectives that need to be achieved despite the environmental difficulty. Sensory overload is the game and there are no points to be gained or victories to be won. In his developer’s blog on Game Jolt, creator Taylan Kadayifcioglu expresses his hesitation surrounding the use of the term ‘game’: “I tried using the words ‘simulation’ and ‘interactive experience’, but found that nothing communicated the immersion potential of Auti-Sim sufficiently without using the word ‘game’.”

Playing Auti-Sim clearly calls up the “What is a game?” question that game scholars debate. Like many simulation games, and open world or sandbox games, it lacks a cohesive narrative structure and distinct player objectives. It also isn’t – and it’s difficult to avoid speaking objectively here – particularly enjoyable to play. Bracketing off the discussion of whether or not Auti-Sim constitutes a game in a strict sense for now, I want to consider the unstated, but clearly implied player objective to stop the noise. During my own game, I stopped myself from turning down my speaker volume, ran away from the children, and retreated behind the bench, where the screaming stopped and the static faded.

Analyzing the game at the level of procedural rhetoric, which Ian Bogost defines as, “the practice of persuading through processes in general, and computational processes in particular”, the connection between the player’s retreat from the playground and the corresponding decrease in noise serves the persuasive function of highlighting how quieter environments may be preferable for people who have hypersensitivity (3). Auti-Sim explores sensory experiences that are often elided in the discourse surrounding autism; Stuart Murray, writing on the history of autism and its cultural representation, explains that, “[a]utism is as often encountered in terms of a response to light, textures, and sounds as it is seen in a love of railway timetables or computer games, and although this is mentioned in passing in diagnostic manuals such as the DSM and ICD, it receives limited focus” (Autism 32). At a procedural level, as the player moves away from the source of the visual and audio distortion, the game teaches how children might respond to overwhelming sensory experiences by moving away from large groups and retreating to quiet places. Moving forward, I want to consider the persuasive nature of the game as a disability simulation to suggest other potential narratives that players might construct from Auti-Sim.

Disabling the Player

Many player responses to Auti-Sim on Game Jolt concern the instructive value of the experience as an exercise in empathy. However, while some players express the extent to which the game is a valuable tool and a viable representation of their own experiences of hypersensitivity, others critique the game from grounds varying from inaccuracy, to the lack of consultation with autistic people during the design process, to the game’s representation of autism as a nightmare. Kadayifcioglu responds to concerns regarding inaccuracy and inadequate consultation in his developer’s blog, in which he reiterates the twelve hour time constraints he was working within to complete a project that received more immediate attention than he was expecting, and promises to collaborate with individuals on the spectrum to improve the game.

After considering player reviews and responses, the issue that interests me is not the extent to which the game is accurate, since individuals experience hypersensitivity differently, but rather the extent to which Auti-Sim induces fear to capture the experience of autistic people.  Drawing out the connection between the simulation and horror games, Nathan Grayson of Rock, Paper, Shotgun describes how, “Auti-Sim draws on horror game tropes juxtaposed against a bright, idyllic playground environment, to rather brilliant effect”. With this comparison in mind, I would like to engage with analyses of disability simulations and the literature of autistic self-advocates to consider another question: Is Auti-Sim’s representation of autism through recourse to an experience of discomfort that verges on fear compatible with a message of acceptance, and with a call to shape accessible environments?

One of the important messages that disability studies scholars and autistic self-advocates reiterate is that disability should not be understood through the lens of pity. Working against a medical model that suggests that disability is an individual problem, disorder, or defect, many scholars articulate a social model of disability that emphasizes the disabling impact of built environments and social attitudes. Some scholars question the idea of impairment; for example, Shelley Tremain, who exposes the realist ontology that informs our understanding of impairment, explains that our definitions of impairments are not objective, but historically contingent (34). Tremain and other scholars point toward a generative model of bodily difference. The question with respect to games becomes, can simulation games enable players to explore these alternative models?

Sheryl Burgstahler and Tanis Doe, in their article “Disability-related Simulations: If, When, and How to Use Them in Professional Development,” show how simulations can reinforce individual models of disability that overlook the disabling impact of social attitudes. Burgstahler and Doe thus argue if disability simulations are to be used, they must be designed with attention to disability as a social and political experience. They also caution that trying on disability, by using a wheelchair, wearing a blindfold, or navigating an inaccessible website, does not provide insight into the strategies that individuals develop over time to manage their environments (11). In other words, the panic that a player might experience may not capture the daily experience of disability, and may reinforce the ableist assumptions that being able-bodied or neurotypical is objectively preferable to being disabled. I think that some player reviews of Auti-Sim on Game Jolt, (such as, “I feel sorry for children who really have this disease.”) reflect the concern of scholars and activists that simulations promote pity.

As someone who is committed to understanding autism through a paradigm of neurological diversity, it concerns me that players might conclude that autism is only characterized by suffering. Many autistic self-advocates speak back to discourses that construct autism as a tragic condition that needs to be cured through advancing the concept of neurodiversity. Ari Ne’eman, the president of the Autistic Self-Advocacy network, positions neurodiversity against a deficit model of disability:

The essence of neurodiversity, or neurological diversity, is the idea that the paradigm of acceptance extended towards racial, religious and other similar differences should apply to neurology as well. A relatively new concept, the term originates from conversations held amongst individuals on the autism spectrum in various discussion boards, listservs and other areas of community interaction in the fledgling autistic community. Groups like Autism Network International and, more recently, the Autistic Self Advocacy Network, advocate a new conception of neurological difference along a social rather than a medical paradigm. (qtd. in Broderick and Ne’eman)

The understanding of autism as difference as opposed to defect that Ne’eman articulates here is also central to the message of the youtube performance piece “In My Language” by Amanda Baggs, an interesting piece to watch in conjunction with “Inside Autism,” the video that inspired Kadayifcioglu’s Auti-Sim.  The video is divided into two segments; the first part, “In My Language,” captures Baggs interacting with her environment.  The video shows her engaging her senses through such actions as stroking the surface of a laptop, pressing her cheek against the page of a book, and waving her hands while making an ‘e’ sound. In the second part of the video, “A Translation,” Baggs uses a text to speech synthesizer to create a monologue that serves as voiceover as she continues in her embodied language. She explains that being sensitive to her surroundings is her way of communicating with the world, stating: “…my language is not about designing words or even visual symbols for people to interpret. It is about being in a constant conversation with every aspect of my environment”.  Her argument that her movement constitutes a language in its own right calls attention to the lack of self-reflection often involved in efforts to teach children to increase their eye contact, or refrain from stimming. (Baggs is one contributor to The Loud Hands Project, a transmedia celebration of autistic culture that addresses this issue).

I understand that Auti-Sim, in its current form, is limited in its duration and its scope, as it specifically focuses on a child’s experience of auditory hypersensitivity. (Although, in the context of controversies concerning corporate charities that focus on autistic children to the exclusion of autistic adults, the decision to feature a child’s experience is a scope that has representational consequences (Representing Autism 139)). However, if the game is to become a tool for professional development, I wonder if future iterations might capture meaningful pleasurable sensory experiences alongside simulating painful or traumatic ones.

Disability Studies and Games Studies

Events like the Hacking Health event that spawned Auti-Sim indicate that researchers are increasingly harnessing the power of games for health care. Auti-Sim is an interesting game in this regard because it attempts to intervene at the level of social attitudes, as opposed to directly attempting to change the behaviour or communication styles of autistic people. In raising issues surrounding the representation of disability in games, and simulation games specifically, I am not suggesting that games as a medium cannot contribute to a generative discourse on disability; I certainly think that they can. However, I would like to conclude my commentary by expressing my own interest in seeing more research connections between disability studies and games studies at a critical level, alongside ongoing gaming health projects and important efforts to make games accessible for multiple playing styles. (On that note, The AbleGamers Foundation is an excellent resource that outlines accessibility initiatives and offers accessibility reviews of popular games.) I am interested in reading contributions that I have not come across in my own research, and I welcome comments on this topic or any others.

As a literature student, I’m interested in how textual analyses of disability, from David Mitchell and Sharon Snyder’s concept of narrative prosthesis to Ato Quayson’s aesthetic nervousness, could be redeployed, reframed or extended through a consideration of the intersection between play and narrative. Lennard Davis has suggested that the novel form itself is inextricably tied to ideas of normalcy – what could we say about the form or genre of games (21)? How is overcoming obstacles to complete a game as a disabled character different from reading a narrative about overcoming the body? How does disability function in a role-playing game like Deus-Ex: Human Revolution (2011), which involves enhancing the player’s through biological modifications and prosthetics to proceed through the game? Can science fiction games that increase the difficulty level for players without bodily modifications speak to how our understanding of impairment is historically or environmentally contingent? More broadly, what are the messages, meanings, and stories surrounding disability that we enact, participate and produce as creators and players of games?

Works Cited

Bogost, Ian. Persuasive Games: The Expressive Power of Video Games. Massachusetts: The MIT Press, 2007. Print.

Broderick, Alicia and Ari Ne’eman. “Autism as Metaphor: Narrative and Counter-Narrative”. International Journal of Inclusive Education. 12.5-6: 459-476 (2008). Print.

Burgstahler, Sheryl, and Tanis Doe. “Disability-related simulations: If, when, and how to use them”. Review of Disability Studies 1.2: 4-17 (2004). Web. 8 April 2013

Davis, Lennard. “Constructing Normalcy: The Bell Curve, the Novel, and the Invention of the Disabled Body in the Nineteenth Century”.  The Disability Studies Reader. New York and London: Routledge, 1997). Print.

Murray, Stuart. Autism. New York and London: Routledge, 2012. Print.

—. Representing Autism: Culture, Narrative, Fascination. Liverpool: Liverpool University Press, 2008). Print.

Tremain, Shelly. “On the Subject of Impairment”. Disability/Postmodernity. Eds. Marion Corker and Tom Shakespeare. New York: Continuum, 2002. Print.