To support gamers with physical disabilities, an industrious community has for years modified existing controllers or devised new ones altogether.

And now those efforts, by organizations like Warfighter Engaged, the AbleGamers Charity and SpecialEffect, have been amplified by Microsoft, which in September released an adaptive controller for the Xbox One.

“We tried to figure out a way to accelerate their practices so that they could help more people,” said Bryce Johnson, Microsoft’s inclusive lead for product research and accessibility. “The idea of cracking open a controller for someone who just needs a couple of extra buttons is an arduous task.”

That gray rectangle with two red buttons is a gaming relic. Modern controllers require the player to combine a sweeping legato — two analog sticks, one controlling a character’s head and one its feet, are used simultaneously — with the precise staccato of four buttons, two triggers and two bumpers.

It can be challenging, and especially so for those with physical disabilities. Some e-sports competitors have operated controllers with their lips and chin, or their cheek and tongue. Ms. Hawley, 35, cannot use her index finger to pull the right trigger on the traditional Xbox controller.

Instead she can press an elbow against one of the two four-inch buttons on the adaptive controller, which she tested for Microsoft and which has resurrected a pastime. She now plays games like Mortal Kombat and Kingdom Hearts with her brother and her niece every Sunday.

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