Neurodivergent Gamers Are Getting a Seat at the Tabletop

The tabletop gaming community offers a place for communication and togetherness that can be incredibly rare in modern culture. It’s a privilege that nerds have gotten better at sharing in recent years, particularly with those who need community most. 

Dr. Elizabeth Kilmer is a clinical psychologist who uses tabletop role-playing games (TTRPGs) in therapy, and she herself was diagnosed with ADHD. “Narrative and metaphor have been used in therapy, healing, and educational practices for a long time,” she explains. “You can see examples in folk tales, parables, and other oral traditions. TTRPGs can be a powerful tool because they are so interactive, and they allow us to be vulnerable through our character, while protecting ourselves.”

“At the role-playing table, we can pretend to be braver than we feel in real life,” agrees Jacob Wood, founder of the Accessible Games Blog and a longtime blind TTRPG player and GM. “Through fantasy, I learned to be comfortable talking to groups of other people, even if I didn’t know them very well. Without these chances to express myself, I’d still be hiding away in my house on my own.”

As experts who have brought tabletop gaming to disabled and neurodiverse people for years, and part of the community themselves, people like Wood and Kilmer have created accommodations for people who haven’t always been able to participate.

“Communication is hard,” Kilmer reminds us. “Passive and indirect communication strategies can be particularly challenging for neurodivergent individuals (and isn't great for neurotypicals either). This can contribute to the stigma that autistic and ADHD players shouldn't or can't play TTPRGs.”

In Issue 11 of Wood’s Accessible Gaming Quarterly, autistic author Divid Poetters lends their take on autism at the table, highlighting the expectation for masking behaviors—the imitation of neurotypicality at some games. Masking can range from the avoidance of stimming, hiding over-interest, or otherwise denying one’s discomfort, all of which can frustrate neurotypical people who may have no frame of reference for such behaviors. This misconception has the potential to lead to burnout and shutdown, but it also means people on the spectrum and other maskers are hiding who they are because they aren’t treating the table as a safe place, nor an opportunity for self-expression, which defeats the very purpose of coming together to create a space to play the game. At worst, it can accomplish the opposite, by turning what ought to be a safe space to unwind into a socially draining one.

“Personally, I lean toward two-hour play sessions,” Kilmer explains, “I design a character that allows me to lean into tendencies that can work well in TTRPGs (like impulsivity) that I have to manage in my day-to-day life, fantastical or otherwise, and I make sure to have a “session zero” with other players where we talk about our hopes and expectations for the game. I also have something to fidget with if needed, and I try to plan games for a time where I'm able to stay focused.”

Session zeroes like the sort Kilmer insists upon have grown as a quality-of-life improvement for all players concerned about synergizing play style and bringing fantasy to life. It’s especially important for those concerned about potential pitfalls with their group. Even so, much more can be done.

“Accessibility is more cultural than physical,” agrees Dale Critchley, creator of the Limitless Heroics project, which publishes materials for accessible play. “Creating places where we can feel comfortable and open about neurodivergence and other conditions goes a long way, because masking is exhausting.”

While the cultural issue can feel insurmountable, crafty thinking can unlock tabletop gaming piece by piece. “I used to run D&D for blind folks,” Naomi Hazlett, a sensitivity consultant on Limitless Heroics says. “The game was not at all accessible for them back then, without assistance from myself and a volunteer team. With simple additions like a commercially available tactile character sheet, braille dice, or assistive tools for digital materials, groups like that could be able to play together just like anyone else does.”

Indeed, major players in the tabletop space like Wizards of the Coast and Paizo are already taking these needs into account. Wizards of the Coast didn’t respond to requests to comment on this subject, but Paizo was happy to speak to their focus on representation and inclusiveness. 

“We've worked with disability consultants and have introduced assistive devices in Pathfinder Lost Omens Grand Bazaar and elsewhere,” said Aaron Shanks, director of marketing. “Our Starfinder iconic precog, Ciravel, uses a chair, and our Pathfinder iconic inventor, Droven, has a prosthetic arm. In addition, the followers of Tsukiyo, a Tian Xian god of the moon, jade, and spirits, practice faith through counseling and aid for ‘those whom society shuns or strikes down for their differences, particularly those with mental illnesses or disabilities.’”

“One of the things I love about TTRPGs,” Kilmer says, “is how flexible they are! I talk about a bunch of strategies to promote accessibility with ADHD Youtuber Jessica MaCabe in this video.”

Of course, the question of how to enable personal accessibility in tabletop role-playing is still being debated by enthusiasts and academics, and there are different schools of thought.

“In some of our materials, we described neurodivergent traits in terms of their impact on everyday living and took time to consider, wherever relevant, what strengths a player with a given trait would have,” Hazlett explains. “For example, a person with sensory sensitivities might be prone to being overwhelmed but have an affinity for perception. I feel this is an accurate reflection of that lived experience, and codifying it into our mechanics can help inform, break stigmas, and start a conversation.”

This was a point that resonated with Shawna Spain, founder of the Spoon Conservatory, an accessibility consultancy group that was approached by Limitless Heroics as a potential writer for Kickstarter rewards material. She felt the project resembled “something more for the abled community to ‘play’ disabled characters,” she says. Despite admiring the project's goal—to open doors for disabled and neurodiverse players in tabletop gaming—and appreciating the company’s desire to get feedback from disabled players, Spain decided “the effort required to influence the final product to be aligned with the disabled community was too large for me to commit my personal resources.”

Games attempting to “gamify” disabilities by turning them into stat bonuses and penalties caught Kilmer’s attention too. “Though it's important for individuals to feel represented in the games they play, adding mechanical buffs and debuffs for mental illnesses and neurodivergencies has the potential to increase stigma and cause harm to those populations,” she says. “Antero Garcia published a great paper in 2017 called ‘Privilege, Power, and Dungeons & Dragons: How Systems Shape Racial and Gender Identities in Tabletop Role-Playing Games,’ where he does an excellent job talking about concerns around representation with regard.”

"As both physical and cultural concepts within D&D,” Garcia says, “race and gender depictions are not defined solely by the game’s author. Instead, players extend and build from the tools of narrative construction they are provided in order to collaboratively extend problematic representations embedded within this system."

We’ve seen popular culture closely analyze the problems with falling into the trap of recognizing “high-functioning” spectrum syndromes and other conditions as pseudo-superpowers with social glitches. While the notion of exceptionalizing a stigma to actually be a point of strength may seem empowering, it can place model minorities on a pedestal and leave behind those with disorders and disabilities where those expectations don’t match reality.

Ultimately, play should be negotiated for the comfort and enjoyment of those actually at the table, so long as their preferred methods of empowerment aren't harmful on a macro scale and are recognized as personal affectations. The conversation about how exactly, is still a matter of discussion, one that disability advocates are already leading on. 

Spain concludes on a great point. “Homebrewing accessibility is a tough concept. Homebrew is about crafting the fantasy you want, which can be so freeing to those who don’t feel the rules as written are capable of engaging with their vision. When the disabled TTRPG community works hard to create resources to realize worlds like that, through a comprehensive dialog with the relevant lived experiences, I’m completely behind them.”