Cognitive rehabilitation in people with autism spectrum disorder: a systematic review of emerging virtual reality-based approaches.
Leila Shahmoradi, Sorayya Rezayi
PMID 35982460WHAT IT FOUND
Across 17 small studies of 226 people with autism, virtual reality training often reported improved attention, memory, executive skills, or daily skills, but only nine showed clear gains.
Evidence is too uneven to change routine practice.
Key findings
01The review included 17 studies of 226 people with autism, with sample sizes from 1 to 56 participants.
02Nine studies reported statistically significant cognitive improvements, seven reported positive effects without statistical tests, and one reported no improvement.
03The quality assessment found 70.58% of studies weak on blinding and only 23.52% rated strong overall.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The 17 studies were very small, with sample sizes from 1 to 56 participants. Only three studies were randomised; ten had no control group, so changes could reflect time, practice, or attention rather than virtual reality alone. Study quality was weak or moderate overall, and blinding was weak in 70.58% of studies. The review could not combine results statistically because studies used different devices, sessions, outcomes, and participants. Most participants were male (85.05%), so findings may not apply to girls or women with autism. Follow-up was often short or absent, and several studies did not test whether skills transferred to real life. Only English-language studies were included. Virtual reality glasses were sometimes intolerable for children, and cost limited use.
The easy way to misread this
Do not conclude that virtual reality training is an established treatment for autism-related cognitive problems. The review included 17 studies, but only three were randomised, nine reported statistically significant improvements, and 29.41% were rated weak overall while 47.05% were moderate.