Xbox

Xbox One Console

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Summary

Xbox is a gaming brand created and owned by Microsoft. The Xbox gaming console has been around since 2001 and since then, the brand has grown into a massive ecosystem of devices, games, accessories, and services.

Best Practices

This section includes tips and how-tos that have been used throughout different gaming programs. The following are only best practices and can be modified to best fit your programs needs and restrictions.

Popular Games

The following titles are widely used in hospital gaming programs. If included in this list, they are compatible with Xbox One and newer generations, unless stated otherwise. For an in depth look at recommended games for specific therapeutic purposes, reference Child Play's Therapeutic Game Guide. For ratings of games based on age/developmental appropriateness, visit The Entertainment Software Rating Board (ESRB) website. For consumer-rated content, utilize Common Sense Media.

• Minecraft | Rated E10+
• Rocket League | Rated E
• Madden NFL | Rated E
• Fortnite: Battle Royale | Rated T
• Overcooked! | Rated E
• Disney Dreamlight Valley | Rated E
• Forza Horizon 5 | Rated E
• Fall Guys | Rated E

Online Consoles

Xbox consoles have the most access to content when connected to the internet. The internet connection enables online multiplayer play, cloud streaming games, accessing the Game Pass catalog, and using media streaming apps such at Netflix, Spotify, Disney+, and more. Some system settings are also only available to adjust when connected to the internet. Internet connections can be established either wirelessly (WiFi) or hardwired (ethernet). Different facilities have different guidelines when allowing devices to have access to their network, so be sure to verify with your IT team that an Xbox can be connected to your network.

Pros:

Offline Consoles

Xbox consoles can still be used when disconnected from the internet. However, the console must establish an internet connection to complete the mandatory setup process. It can then be disconnected once the desired setup is complete. OFfline consoles enable access to the basic functions of Xbox, like playing games that are "offline" or have "offline" modes and installed on the console's hard drive. Many facilities restrict certain devices from connecting to their network for a number of facility-specific security and safety policies. Consoles that are offline cannot connect to the internet are not able to play online multiplayer games, however they can play local multiplayer games using multiple users on the console (includes Guest accounts).

Pros:

Discs vs. Digital

• Physical copies of games are still sold and used in some gaming programs. They offer versatility and flexibility in utilizing one disc or "game license" for multiple consoles. Discs do require game installations in order to play the game. The download time and amount of hard drive storage required is roughly the same as it would be when downloading digitally from the Microsoft Store. Once downloaded, the disc must be inserted into the console each time the user is looking to play the game. Physical discs do have the risk of being lost, stolen, or damaged, requiring the purchase of a new copy. With a larger number of consoles being used in one program, sometimes multiple copies of disks are needed to serve the larger population of gamers. With that being said, physical storage is needed to store all of the discs safely. For game updates, the disc does not need to be inserted in the console for the patch to be downloaded (I believe?).

• Digitally downloaded games can be bought and installed directly from the Microsoft Store on the Xbox console or purchased at retailers online or in-store through a redemption code. The redemption code is then redeemed on the owner's Microsoft account, which means that one code cannot be used on multiple accounts, and then able to be downloaded to the console from the Microsoft Store within the "Owned games" section. The installation time varies depending on your internet connection as well as the size of the game. Owning and using digital licenses of games removes the risks of games being lost, stolen, or damaged, with some stipulations around cost and requiring internet access in some scenarios. System and account settings can be aligned on your console so that digital purchases are limited. Settings can prevent games from being purchased without verification or credentials.

Policies & Procedures

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Sanitizing

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Account Settings & Management

Microsoft accounts grant users access to all of Microsoft's products, including Xbox, with one login. To play on Xbox, users must have a Microsoft account. The account can be created using an existing email address (ie @gmail.com, @yahoo.com, etc.) or creating a new email address using Microsoft's Outlook domain (@outlook.com). When creating any new account, it is critical to keep track of IDs, emails, and passwords associated with each account to avoid losing access to content.

Microsoft Family Safety

For the most control over the security, privacy, and content settings of a Microsoft account, the Microsoft Family Safety app uses "parent" and "child" accounts. These separate accounts are connected in a Family Group so that the "parent" can set restrictions for the "child" account. Types of restrictions that the parent can enforce include: screen time limits, content rating limits, spending limits, and social permissions. There is currently no limit to how many members can be in a family group and family roles are designated between "Organizers" and "Members." Organizers act as the "parent," while "Members" act as the "child." The age on the account does not always determine family role type, as a "Member" could be an account with the age over 18 years old. Members do not have access to changing restrictions, limits, and privacy guidelines.

• Xbox Privacy and Online Safety Settings can be found and adjusted by signing into the "Parent" Microsoft Account > Opening the Family Safety Portal > Select the "Child" account you're looking to view > Find the "Overview" tab > Scroll down to "Xbox Online Gaming" > Click the link for "Review Xbox Settings".

Services & Subscriptions

To play online multiplayer games on Xbox consoles, an Xbox Live Gold or Xbox Game Pass Ultimate membership is required. Games can be purchased (or downloaded if free-to-play) from the Microsoft Store without a membership, however will not be able to be played without a subscription active.

Xbox Live Gold

Also commonly known as Xbox Network or Xbox Live, this service launched in 2002 and provides gamers with a way to play games with other players all over the world on Xbox consoles. The network operates as a subscription service that grants access to online multiplayer games and social communities to Xbox Live Gold subscribers. Xbox Live subscribers also receive free games every month ("Games with Gold") that can be downloaded and owned on the player's account indefinitely. Free-to-play games like Fortnite: Battle Royale, require Xbox Live Gold memberships to open the game, let alone play it. Any local co-op/multiplayer games could still be played on Xbox consoles without Xbox Live Gold memberships. Xbox Live Gold memberships are applied to a single Microsoft account and cannot be shared between multiple accounts. The subscription can be purchased through payment methods attached to the player's Microsoft Account, whether that's a credit card, PayPal account, or Xbox gift card.

Xbox Game Pass

Xbox Game Pass launched in 2017 as a service that offers gamers a catalog of hundreds of games for one monthly price. Today, it has grown to host even more games and benefits in different ways for different kinds of gamers. Think: the "Netflix" of Xbox games. Very few games are removed from the catalog each month, but you do receive a members-only discount on games from Game Pass that you want to buy and keep forever. It's a great, cost-efficient way to try out new games or widen the offering of game options to players of all backgrounds and experience. This service requires internet access to operate. It does not require an Xbox Live Gold membership, unless you're looking to play an online title from the catalog. Xbox Game Pass memberships are applied to a single Microsoft account and cannot be shared between multiple accounts.

• Xbox Game Pass for Console

This tier of Game Pass provides Xbox-only players with a catalog of hundreds of games. Any game on Xbox Game Pass can be played on Xbox consoles (Xbox One & newer) for however long the title is available in the catalog. Not every title that is on Xbox Game Pass for Console is available on Xbox Game Pass for PC, and vice versa.

• Xbox Game Pass for PC

This tier of Game Pass provides PC-only players with a catalog of hundreds of games. Any game on Xbox Game Pass can be played on PC (should the PC meet minimum system requirements) for however long the title is available in the catalog. Not every title that is on Xbox Game Pass for Console is available on Xbox Game Pass for PC, and vice versa. Xbox Game Pass for PC also includes access to EA Play, a subscription service from developers, EA, that features popular EA games at no additional cost.

• Xbox Game Pass Ultimate

This tier of Xbox Game Pass combines the benefits of Xbox Game Pass (Console and PC versions), Xbox Live Gold, and EA Play. Xbox Game Pass Ultimate also enables access to games via Xbox Cloud Gaming. It is the all-in-one tier for all Xbox Gaming services.

Types of consoles

The generations of Xbox consoles that remain widely used across gaming programs are the Xbox One, Xbox One S, Xbox One X, Xbox Series S, and Xbox Series X. Previous generations that you may encounter less often are the Xbox (original) and Xbox 360. To identify and differentiate between all Xbox consoles, visit the Wikipedia Xbox Console Comparison Table.

Xbox One

Released in 2013, the Xbox One fueled content and accessories across multiple generations of Xbox. These consoles are still seen in some programs, as they remain compatible with most of the new Xbox equipment and games that are released today.

Xbox One S

The second generation of the Xbox One lineup was released in 2016, with improved graphics and capabilities, as well as an updated design. The accessories and games that were playable on the previous Xbox One remained playable on the new Xbox One S. In 2019, the Xbox One S re-released an "All-Digital" version of the console that excluded a disc drive, prioritizing the use of digitally-downloaded games from Xbox Game Pass or the Microsoft Store. This generation of Xbox is still widely used across many hospital gaming programs.

Xbox One X

Following the Xbox One S, the Xbox One X was released in 2017 as the next step-up from the Xbox One S. The One S and One X remained on the market alongside each other, the One X as the higher-end option. Most accessories and games that were compatible with the Xbox One and One S remained compatible with the One X. This generation of Xbox is still widely used across many hospital gaming programs.

Xbox Series S

Microsoft's most recent installment of consoles are the Xbox 'Series' devices. These launched in 2020. The Series S and Series X were released alongside each other, with the Series S being the "low-end" option compared to the Series X. The Series S lacks a disc drive, prioritizing digital downloads and cloud play. Updated and enhanced "Xbox Series S|X" versions of games are being released for these new consoles, however most developers continue to release Xbox One standard versions for access on previous-generation consoles, as well. Most accessories that were compatible with Xbox One S/X consoles are still compatible with the Series S/X consoles.

Xbox Series X

Microsoft's most recent installment of consoles are the Xbox 'Series' devices. These launched in 2020. The Series S and Series X were released alongside each other, with the Series X being the "high-end" option compared to the Series S. The Series X has a disc drive. Updated and enhanced "Xbox Series S|X" versions of games are being released for these new consoles, however most developers continue to release Xbox One standard versions for access on previous-generation consoles, as well. Most accessories that were compatible with Xbox One S/X consoles are still compatible with the Series S/X consoles.

Xbox (original)

The Xbox original console launched back in 2001. All of the equipment and accessories that paired with this console are no longer compatible with the recent-generation consoles. A catalog of certain games from this era, however, have been made compatible via digital downloads from the Microsoft Store. Some titles are even available on Xbox Game Pass.

Xbox 360

The Xbox 360 console followed the original Xbox with a release date in 2005. Several improvements were delivered in this generation from the previous. 2 more "versions" of the Xbox 360 console were launched as well, one being the Xbox 360 S (Slim) and the other being the Xbox 360 E. These versions offered overall smaller housing and different internal storage options. Many of the accessories made for this generation of Xbox are no longer compatible with the new-gen consoles. Many games have been made compatible - mostly for digital purchase from the Microsoft Store or Xbox Game Pass, some compatible with the original Xbox 360 disk.

Compatible Accessories

Driving wheel & pedals

• Steering wheel and pedal accessories offer a different, engaging way to interact with video games, specifically games focused on driving.
• Steering wheels and pedals can be helpful accessories to utilize in situations where patients have low or poor fine motor skills, as it requires more gross motor skills to turn the wheel and press pedals with feet or hands. Although the accessory is not marketed as an adaptive tool, with creativity, it can be implemented into an adaptive gaming setup in many ways.
• If working in a healthcare environment, it is important to find device options with little to no leather components, as it is more difficult to sanitize. Look for options using plastic or silicone or opt for users to wear gloves throughout the experience.

Arcade fighting stick

• Arcade-style fighting sticks offer players an enhanced experience when playing fighting games of many kinds. The accessory uses a simplified layout of critical buttons and features to give players easy access to the buttons they'll need to use for combos.
• The fighting stick operates nearly the same as the standard Xbox controller, with the only difference being the way it looks and the kinds of buttons available. They feature an analog, multi-axis joystick and several flat-face buttons.
• Fighting sticks can also be utilized in adaptive gaming scenarios, as well. They are simplified controllers with a larger joystick than what's provided on standard controllers, making it more accessible to use for players with low mobility or poor fine-motor skills.
• Most models are almost entirely plastic and easily wipeable.

Audio

• There are many different options for gaming audio. Depending on your program's restrictions (online vs. offline play, use of personal accounts on program-owned equipment, etc.), there may be better options than others.
• For programs that allow online play and communication with online players, an audio accessory with a microphone is critical. For programs that don't allow online play, but players are interested in playing video games with a headset, there are audio accessories without microphones or detachable microphones.
• For single-use options, simple earbuds with a microphone and a 3.5mm input can be inexpensive and serve the intended purpose.
• For multi-use options, wipeable materials are critical in healthcare environments. Many headsets use leather components, which are difficult to sanitize. Look for options with mostly plastic or silicone components or opt for users to wear gloves and hairnets.
• Having multiple options of audio devices is important to allow different kinds of players a positive gaming experience. Some players have restrictions with items that can be worn on or around their heads (incisions, sensitivity, halo-rings, etc.) and a smaller options like earbuds may work best for them. Over-the-ear headphones may be beneficial and sensory-friendly for players with auditory sensitivity.

Keyboard & mouse

• Xbox consoles support the use of keyboard and mouse inputs in some apps and games, but not all features may be accessible while using the accessories. Most of the compatible accessories must be wired devices and work with Windows 10 and newer platforms.
• Keyboard and mouse accessories can provide an adaptive gaming experience to players that cannot use the standard Xbox controller.
• The Razer Turret for Xbox One is a device bundle designed for Xbox. The Turret bundle includes a wireless mechanical keyboard, wireless gaming mouse, and a built-in, retractable mouse pad. For programs that do not have a gaming PC setup, the Turret is an affordable option to offering a PC gaming experience to players. The hardware is entirely plastic and metal, easily wipeable. The retractable mousepad lives on the right side of the keyboard and enables "lap play" so that a hard surface like a desk or table is not required for use. Many popular FPS (first-person shooter) titles are compatible with this accessory, along with several games in many different genres across Xbox.

Third-Party Controllers

As Xbox generations get older, it'll become harder and harder to source controllers for the aging generations that might be found inside hospitals and especially in gaming carts provided by various vendors.

This is a loose list of third party companies that make controllers, especially for late-lifespan consoles.

• 8bitDo
• PowerA
• Hori

Adaptive & Inclusive options

Xbox Adaptive Controller (XAC)

The Xbox Adaptive Controller (XAC) released in 2018 as a customizable controller solution, designed for gamers with disabilities. The XAC provides a less-expensive alternative for players with disabilities, all while being compatible with many external inputs already on the market. Microsoft closely collaborated with organizations such as The AbleGamers Foundation, The Cerebral Palsy Foundation, Special Effect, and Warfighter Engaged to design this controller to be as adaptive as possible. The XAC features two large buttons on the face of the controller and inputs along the sides that allow specific accessories to be programmed to certain functions of the controller. On the software side, sensitivity and "shift-press" functions can be designated to buttons. There is no "one-size-fits-all" solution for assembling the best XAC setup for players; it can be tailored to each players specific needs. The XAC is designed for Xbox, however, is compatible with Windows, Playstation, and Nintendo Switch with the right adapters.

Xbox Copilot

In addition to the hardware programmability, there's software exclusive to Xbox that enables further customization. This customization includes being able to have two controller inputs (for example, one standard controller and one XAC) act as one controller input - this feature is called Copilot. Copilot can be used in situations where the one player can be responsible for set functions in game and another player can be responsible for the remaining functions. Copilot is a great tool for making games accessible, versus finding "accessible" games.

Additional Resources

• The Microsoft Learn portal offers free training modules around accessible gaming and inclusive gaming experiences. Visit here to get started.