Examining the use of extended reality to improve the adaptive behavior of autistic people: a systematic review.

PURPOSE: To systematically review the use of Extended Reality (XR) as an assistive technology for improving adaptive behaviour in autistic individuals.

METHODS

Databases were systematically searched, and eligibility criteria were used to select items; ACM Digital Library, IEEE Xplore, PsycINFO, PubMed, Web of Science, Scopus, Google Scholar and ProQuest were systematically searched. Inclusion criteria required empirical studies (2000-2025) involving autistic individuals and XR (i.e. virtual reality (VR) and augmented reality (AR) interventions targeting adaptive behaviour. Data extraction included study location, design, participant characteristics, adaptive behaviour domains addressed, XR technology and level of immersion, research methods, main findings and quality appraisal scores using the Quality Assessment for Diverse Studies (QuADS) tool. The review followed PRISMA guidelines.

RESULTS

Forty-five studies were included in the final review. XR interventions most frequently targeted social understanding and practical skills such as shopping and transportation. Immersive VR (head-mounted displays) and non-immersive desktop/mobile systems both demonstrated feasibility and effectiveness. Sessions longer than 20 min and repeated over multiple weeks were most effective. Limitations across the evidence base included small, single-site samples, limited participant diversity, brief follow-up and occasional technical instability; overall QuADS ratings indicated moderate methodological quality.

CONCLUSION

XR shows strong potential as an assistive technology to enhance adaptive behaviour, particularly in social and daily living skills, among autistic individuals. Future work should involve stakeholder co-design and assess generalisability across diverse populations.