A meta-analysis by Cui and colleagues assessed the effects of virtual reality (VR) exercise on social skills (SS) and emotional recognition (ER) among children with autism spectrum disorder (ASD). Analysing data from randomized controlled trials published between January 2005 and October 2025 across PubMed, Web of Science, Scopus, and EBSCO databases, the authors investigated the relationship between VR exercise interventions and children’s social-emotional development outcomes.
The authors employed standardized mean difference (SMD) as the effect size, utilizing random-effects models to synthesize results across studies. VR exercise interventions were compared with standard treatment approaches. The methodology included comprehensive database searches using keywords: virtual reality, autism spectrum disorder, and children. Quality assessment followed Cochrane Handbook guidelines, with heterogeneity evaluated through I² statistics. Subgroup analyses examined intervention duration effects (< 14 weeks versus ≥ 14 weeks), and secondary outcomes included cognitive function, anxiety, language function, and depression.
The results revealed significant positive effects of VR exercise on SS (SMD = 0.94 [0.71, 1.17], p < 0.05, I² = 74%) and ER (SMD = 0.42 [0.18, 0.65], p < 0.05, I² = 0%). Furthermore, subgroup analysis demonstrated that interventions lasting less than 14 weeks (SMD = 0.63 [0.36, 0.91], p < 0.05, I² = 0%) and those exceeding 14 weeks (SMD = 1.70 [1.27, 2.13], p < 0.05, I² = 44%) both substantially improved SS, with longer interventions showing greater effect sizes. Additionally, VR exercise improved cognitive function (SMD = 0.49 [0.06, 0.93], p < 0.05, I² = 0%) and reduced anxiety (SMD = 0.56 [1.10, 0.02], p < 0.05, I² = 0%). Notably, effects on language function and depression remained unclear due to insufficient evidence.
The findings underscore the effectiveness of VR exercise as a technological intervention modality superior to standard treatment approaches in enhancing social-emotional competencies among children with ASD. Therefore, future clinical practice should consider integrating VR exercise interventions into rehabilitation programs for children with ASD, particularly emphasizing intervention duration optimization to maximize therapeutic benefits. The moderate effect sizes and cautious interpretation regarding cognitive and anxiety outcomes require validation through larger-scale longitudinal studies with standardized outcome measures.
Source (Open Access): Cui, T., Ariffin, R. B., Wang, X., & Wang, X. (2026). Effects of virtual reality exercise on social skills and emotional recognition among children with autism spectrum disorder: a meta-analysis of randomized controlled trials. BMC psychology.