The Utility of Virtual Reality in Interventions for Autism Spectrum Disorder: A Systematic Review

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by impairments in social communication and interaction. Prevalence rates of anxiety are higher in this population compared to the general population. Anxiety and autistic traits can seriously impede an individual’s capacity to function in the social world. Current psychosocial interventions for ASD individuals are aimed to develop skills in interaction and communication or to address anxiety. The development and use of virtual reality for clinical interventions is on the rise, and its potential benefits for ASD individuals are numerous. As yet, little is known about the utility of VR-based interventions for ASD. We conducted a systematic review of randomised and non-randomised studies that employ VR for intervention in the core deficits of ASD and/or anxiety, and which report pre- post intervention data or change over time. Twenty-four studies met the inclusion criteria for the review. A quality assessment of included studies was conducted to evaluate their risk of bias. The review yielded five randomised controlled studies and 19 non-randomised or case studies. Studies employed VR in its variety of forms, including head mounted displays, desktop VR, and cave environments. A variety of interventions were employed, including CBT, scaffolded hierarchical learning, and social cognition training. Findings from the review suggest that VR-based interventions for ASD individuals are feasible and demonstrate effectiveness in the development of affect recognition and emotion regulation skills, as well as for job interviewing skills. Additionally, studies demonstrate its promise for development of communication and conversational skills. Further research is required of higher quality to determine the efficacy and effectiveness of studies in this and other areas. In particular, it is important that studies progress from exploratory use of VR toward more theory and evidence informed intervention protocols for ASD individuals. Additionally, follow-up research studies of the impact of intervention on individuals’ daily lives is also necessary to determine the generalisability of skills developed in VR, and real-life impact.