JMIR Publications

ABSTRACT

Background:

Virtual reality (VR) technology has shown significant potential in improving the social skills of children and adolescents with Autism Spectrum Disorder (ASD).

Objective:

The primary objective of this study was to systematically review the evidence supporting the effectiveness of VR technology in improving the social skills of children and adolescents with ASD.

Methods:

The search for eligible studies encompassed four databases: PubMed, Web of Science, IEEE, and Scopus. Two researchers independently assessed the extracted studies according to predefined criteria for inclusion and exclusion. These researchers also independently extracted information regarding gathered data on the sources, samples, measurement methods, primary results, and data related to the main results of the studies that met the inclusion criteria. The quality of the studies was further evaluated using the Physiotherapy Evidence Database (PEDro) scale.

Results:

This review analyzed 14 studies on using VR technology interventions to improve social skills in children and adolescents with ASD. Our findings indicate that VR interventions have a positive effect on improving social skills in children and adolescents with ASD. Compared to individuals with low-functioning autism (LFA), those with high-functioning autism (HFA) benefited more from the intervention. The duration and frequency of the intervention may also influence its effectiveness. Additionally, immersive VR is more suitable for training complex skills in HFA individuals. At the same time, non-immersive VR stands out in terms of lower cost and flexibility, making it more appropriate for basic skill interventions for LFA individuals. Lastly, while VR technology positively enhances social skills, some studies have reported potential adverse side effects. According to the quality assessment using the PEDro scale, six studies (43%) were classified as high quality, four studies (29%) as moderate quality, and four studies (29%) as low quality.

Conclusions:

This systematic review found that VR technology interventions positively impact social skills in children and adolescents with ASD, with particularly significant effects on the enhancement of complex social skills in HFA individuals. For LFA children and adolescents, progress was mainly observed in basic skills. Immersive VR interventions are more suitable for the development of complex skills. At the same time, non-immersive VR, due to its lower cost and greater flexibility, also holds potential for application in specific contexts. However, the use of VR technology may lead to side effects such as dizziness, eye fatigue, and sensory overload, particularly in immersive settings. These potential issues should be carefully addressed in intervention designs to ensure user comfort and safety.Future research should focus on optimizing individualized interventions and further exploring the long-term effects of VR interventions. Clinical Trial: Our research protocol was registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols(ID: INPLASY202420079U1).